The Pearson family finds themselves at the hospital on Christmas Eve after little Kate comes down with appendicitis. When they run into Dr. Katowski, who is alone at the hospital, they realize they need to be there for him as much as he was once there for them. Presently, Kevin celebrates Hanukkah with Olivia and her family, Kate continues to pursue her big surgery and someone from William's past reappears in his life.

Jack and Rebecca get in over their heads when they decide to throw Kate, Kevin and Randall three separate parties for their 10th birthday. Randall struggles to make time for William as things intensify at the office. Kevin makes a major decision in his romantic life. Kate's gastric bypass journey takes an unexpected turn.