Rachel is less enthused about her graduation than Joey -- her mother isn't coming in, and she's still not completely enthralled with the idea of pathology. She ends up treating a baby with Nat, and as Joey takes her around the lab explaining the rapid DNA test he's going to do, he picks up on her ambivalence. He tries to convince her that pathology is the right choice because there aren't patients to become attached to and thus she can't be hurt. After she misses her graduation to keep vigil over the baby, Joey presents her with her new lab coat. She heads down to the path lab to meet with her supervisor, but instead of an orientation, she hands in her resignation. Charles congratulates her on her decision.
Maggie notices that Nat isn't wearing her ring, and mentions it to Will. He doesn't give it much thought as he assumes he won't be staying in Chicago, but when he gets an offer letter from Gaffney, he's thrilled. Unfortunately for him, one of the new fourth year medical students is an old friend of Nat and Jeff's...and is recently divorced. Will doesn't look like he's taking Nat's relationship with the former firefighter with a lot of grace.
Downey is brought into the ED with complications from his last treatment. Connor takes him into surgery, and though things get tricky, he manages to stop the bleeding. But Downey doesn't recover from the anesthetic as quickly as he should, so Rhode's calls Abrahms in for a neuro consult, suspecting a stroke. The MRI shows something worse -- the cancer has metastasized to his brain, and Abrahms isn't comfortable operating because of where the tumor is located. Downey could lose the ability to interpret what he feels as well as communication between his extremeties and his eyes. The non-surgical outlook isn't good either. Downey asks Connor to help him "check out early" but Connor insists that he can't do that. Connor does what he can to make Downey comfortable, and ends up bringing him a lei and informing him that he's accepted a cardiothoracic fellowship...after Connor leaves the room, Downey codes. Rhodes takes Downey's ashes to Hawai'i to scatter them in the ocean per his mentor's wishes.
Choi is concerned about the bird he has acquired and talks to Charles about him. After having lunch with the bird and Choi, he diagnosis the animal as likely suffering from PTSD, and sites a program at a CA VA hospital that pairs veterans with affected parrots. Choi tries to teach the bird to fly again, which is hilarious, and becomes very excited when the bird learns a new phrase. He invites Charles over for a followup (and showoff session) but the bird refuses to perform. But when Choi walks away, he stops his pacing and flies to him.
Things are going well between April and Tate. After she's hurt by a patient in the ED, he's very concerned, and even more upset to find out this isn't the first time she's been hurt. He tells her she could quit, and then proposes to her. She asks for more time to consider. When Will notices her still wincing the next day, he insists on xrays, which reveal a lesion on her lung. Based on her history, they suspect that she's contracted TB.
Sharon is still trying to mollify Bert, but nothing is working. When she misses a budget meeting, Maggie goes to her house and finds Sharon distraught after Bert has left her.