Ethan treats a woman who is found asleep in the waiting room and can't be woken up. He suspects OD, and when her record shows past arrests for possession, he ignores the obvious diagnosis of a blood clot (Maggie found birth control and cigarettes in the woman's purse). He and Stohl figure it out after TPA is indicated, but manage to still reverse the effects of the stroke using thrombolysis.
April invites Ethan to her cousins 15th birthday party, which is a big to-do in Brazilian culture, and urges him to bring his sister. He's hesitant at first, but ends up bringing Emily along. Noah is smitten.
Connor pisses off Ava by gaming the system to ensure that his patient is the one to receive the donor heart of a motorcyclist brought into Med. Ava's patient had just been in surgery for his second heart transplant, but rejected the donor. She decided to use an artificial heart so that he would have a better quality of life while waiting for a third match, not imagining there would be one that same day. Connor's patient was significantly lower on the wait list for a heart, but he skips medication interventions to control the mans heart pressure, opting instead for ECMO in order to buy him a higher UNOS ranking. When Ava finds out, she's furious, and goes to Sharon, pointing out that Connor's patient has elevated antibodies, which eliminate him as a candidate for a heart. Connor again skirts protocols by giving his patient medications to temporarily make him look like a better candidate, betting that the immunosuppressants the patient will be given after surgery will keep him from rejecting the heart.
Nat treats a young man with a TBI who is in a vegetative state for pneumonia. The mother is the primary caretaker, and the pneumonia turns out to have been caused by her lack of care for his trach tube. Nat assumes that this was because the woman was overburdened and is shocked when the mother admits to purposefully denying her son care in the hopes that his suffering would end. Will is outraged and insists on calling the police, leading the family to covertly end the young man's life by having the brother wear his monitors while the mother blocks his trach. Nat, in the meantime, has found out about Will's pedophile patient, and accuses him of having double standards, which leads to a blowout fight in the break room.
Daniel finds out that Haywood has asked Sarah to co-sign a loan, and tries to warn her not to mix family and finances without giving away the diagnosis. Sharon assigns Daniel to review the latest batch of transplant candidates, and Robert is among them. He tells Haywood that ASPD is a contraindication for being considered for a transplant, but that the board can still approve him if he's taking steps in his treatment. Haywood asks what he'd need to do, and Daniel mentions financial independence as a prerequisite. This pisses Haywoood off, and he tries to manipulate Sarah into thinking that Daniel is out to ruin their relationship. However, this gives Daniel the opportunity to give Sarah a heads up without breaking confidentiality -- he points out Haywood's behaviors and then asks what her differential diagnosis of him would be. Later, she refuses to cosign the loan.
Noah treats a 55 year old woman who comes in with back pain after a spin class. After giving her something for her back pain that works, she complains of nausea. The zofran works, but then she starts having severe cramps. When she stands up to go to the bathroom, a rush of fluid is expelled, and Noah realizes that she's in labor. The couple later introduces their son and granddaughter to the new baby.