Ava and Connor are getting along better than expected...until they realize that one of them screwed up on the surgery they just performed. They get shorter and shorter with each other as they open the patient back up to find the missing instrument. When they find it, it turns out that it was Ava's mistake. She walks out of the surgery, leaving Connor to finish closing the patient. He storms into the locker room later, taking her to task for leaving him to clean up her mess. But he's shocked into silence when he finds her crying. When they go to Latham's office, he ends up also claiming responsibility for the mistake. Their relationship is improved by the sense of comradery that comes from being in trouble together.

Nat is surprised when tests show that the nine year old girl she is treating for abdominal pain is suffering from testicular torsion. The mother is very much that her daughter continue to present as a girl and wants the testes removed, but the hospital requires that Emma give her own informed consent. When Nat and Daniel try to explain the situation to her, the mother keeps intervening and mildly coerces the child into agreeing to the removal of the errant gonads. Nat and Daniel try to get an emergency ethics panel convened so that the child can make a meaningful decision but they are denied. At the last minute, Nat convinces the mother to agree to only correcting the torsion by saying that children are constantly revealing who they are but that regardless of gender, Emma will always hate ballet and love ice cream sundaes.

Nat is ready to start patching things up with Will, but he comes clean about hooking up with another woman the night before. He tries to protest that it was no big deal and didn't mean anything, but Natalie storms out of Shaws anyway. 

Sarah's father is brought in to the ED and she refuses to see him, much to Noah's confusion. She later explains that it isn't that she doesn't want to see, it's that she doesn't want to want to see him. She only stops by Robert's room on her way out of the hospital, when she's sure he'll be asleep. 

Noah and April treat an old patient of hers who is refusing extraordinary measures. April becomes determined to hunt down his son. He agrees to come to the hospital, but never shows. Instead of disappointing the man, Noah plays into his delusion that he is the son. 

Sharon's godson is brought in with another boy from a house fire. At first it seems that Carter was the golden boy in the situation -- he was found performing CPR on his friend, who he told cops was making a concentrated from of marijuana. But Will and Ethan find evidence that the boy's roles were reversed. Sharon tries to get her friend, who is also set to make a multi-million dollar donation to the hospital, to come clean, but she refuses. Sharon then visits her godson and urges him to tell the truth, afraid that he won't be able to bear the burden of his friends death and the secret that he's responsible.