Kate returns to duty and finds that her reinstatement comes with a cut in title, salary, staff, and office; Jack replaces the hip of an older man who has opinions on everything, including how Jack should live his life; Aaron has mixed emotions when Grace comes up with a much-needed improvement for a surgical shunt he's been developing; Kate is humbled when a young couple whose daughter needs a heart transplant chooses another doctor after they discover her change in status; Tommy thinks it would be a good idea for the hospital to advertise, and hires a publicist who manages to get under everyone's skin as she creates a commercial that ends up looking strangely familiar.

White supremacists on the run following a failed assassanation attempt against the President hole up in a grocery store with an injured member and demand a doctor from Chicago Hope to treat him.

McNeil doesn't cope well with the demands for attention from Karen, his ""roomate"" and a thereapy patient claiming that McNeil's his father. Billy lears that Aaron kissed Diane, and handles it very badly. A depressed Nyland gets one more unwelcome surprise. Phillip receives an offer from Emma.

A woman may be making her daughter sick purposely. Kronk wants a child. Shutt's patient dies, and McNeil joins gamblers anonymous.

A cardiologist in NASA's Doctors in space program has a heart attack and Kate takes the doctors place in the program. Dr. Shutt has a patient who needs to tell his father, an Orthodox Rabbi, that he is gay.

The E.R. is flooded with teenagers poisoned by an unknown rave drug; Kate and Sara are hit by a drunk driver; Phillip's fate is decided.