After Karen begins having seizures, Aaron discovers that she is terminally ill from the multiple brain metastases of a melanoma; Jeffrey resents having to perform surgery on a mobster about to enter the witness protection program; when the residents attempt to pull a practical joke on Jeffrey, they unwittingly provide comfort to a dying Karen.

Jeffrey strongly objects when his old nemesis is hired into the plastic surgery department, but they are able to set aside their differences to bring some peace to the mother of a young girl who dies during surgery; a nurse impedes Aaron's plan to allow Karen to die peacefully.