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.

Austin sprays a subpoena server with mace, inspiring his fellow servers to wage war on the hospital. Hancock tries to counsel a woman in her late forties whose health is severely threatened by her pregnancy but who refuses to let the baby be delivered early. Kronk finally returns to Chicago, dressed in Masai garb, and tries to reconnect with Diane.

Austin and NcNeil fly to London for a conference and are forced to perform lifesaving surgery with only an airline medical kit. Shutt begins his psychiatric residency.

Jack returns after his brother's death; fearing the impact of HMOs on his practice, Joe begins to sell doorway products; Billy's friend comes to the hospital for a heart transplant, and ends up getting an experimental procedure after the hospital receives the wrong organ.

A doctor with Tourette's Syndrome is brought to Chicago Hope to operate on an infant with a severe heart defect. A patient comes into the ER with, what he claims to be, Albert Einstein's brain and gives it to Dr. Wilkes. A woman is using plastic surgery to make herself look like a Barbie Doll.