Natalie sleeps in Carol's room. Marcel wakes her up. There is a donor heart available for her mom but it isn't perfect. Latham tells her the heart has a tumor that is benign and can be removed but it is only viable because of an experimental procedure. Nat isn't happy with this but there is no other way to get Carol a heart...
Will tells Charles about a patient who got into a fight with his landlord. The patient is sedated and only speaks Russian. Charles knows a translator.
Maggie tells Ben that today is Vanessa's last day. Ben thinks she is doing the right thing.
Carol gives Nat a ring passed down from her own mother. Nat will hold onto it but is sure Carol will be okay.
The helicopter arrives wot the heart and it being transported is intercut with Carol being brought into the OR. Nat tells her mother she loves her. The surgery begins and we see the beating heart.
April has a make-up interview with the program head. However she got one poor recommendation from a trauma surgeon. The woman says she has everything she needs.
The Russian patient was previously committed to a special psychiatric hospital. They go to see the patient who is super agitated, Lankoff goes and pukes in the bathroom.
Choi goes to talk to Dean in the parking lot. He's worried about them continuing to work together. Dean says he knows they got off to a rocky start but they're in a good place. Dean doesn't see any problem with lying to patients. He thinks this is out of the blue. What's wrong with Ethan? Ethan says he thought it would be better to talk out here. Dean thinks Ethan hired him to knock him down a few pegs. The patient who thinks everything is a game shows up with a gun all of a sudden. Ethan and Dean try to talk him down. Sharon comes down the aisle and honks, giving Ethan a chance to disarm the patient... but not before he gets shot.
April is upset to see Ethan be brought into the ED. Will takes the case.
Lankoff tells Charles he has a heital hernia. Charles thinks he was upset by the patient. Lankoff wants to drink something stronger, which Charles doesn't think is a good idea, but he gets paged to the ER so he asks Lankoff to wait while he goes downstairs for a minute.
The team works on Ethan. Dean won't let Will be the one to intubate. April stands and watches. April monitors vital stats.
Charles comes down and Sharon tells him that Ethan was shot. Charles recognizes the patient.
Will and Dean argue over how to proceed with Ethan's treatment. Dean accuses Will of hating Choi and not having objectivity. April tries to stand up for Will. Dean says she's not in a position to judge. Will tells Dean this is not Dean's decision to make and Dean backs off but is pissed.
Charles comes back and finds an empty bottle of alcohol and no Lankoff. Meanwhile, Latham gets impatient with Marcel working on the heart. Marcel finishes, they pray in Arabic and then start the surgery.
Dr. Abrams consults. He is annoyed that Dean is imposing his opinion but agrees with him.
Lankoff is also in the ED. Vanessa is working on him. Lankoff has fallen down the stairs and appears to have been drunk at the time.
Dean is now butting heads with Abrams, who says they do not need to remove fragments. Dean's idea is more dangerous and could leave Ethan paralyzed. Will tries to put in his two cents but Dean turns off the intercom.
Sharon tells Maggie that Vanessa has been invited to continue a rotation in the ED. She expects Maggie to treat Vanessa like anyone else. No favoritism. She then wants to talk to Veroni.
Charles talks to Lankoff. He wants to know what the real story is. Lankoff tells him that the patient is not really psychotic. Sluggish schizophrenia is a phony diagnosis given to political dissidents to make an excuse for incarcerating them (I knew it!) This is why the patient is freaking out. He says that Charles must explain he was trained that the Soviet Union was the most perfect union and that dissidence was delusion. But they were all delusional just like the man who shot Ethan.
Nat watches as the heart doesn't appear to be beating. Latham says give it a minute. Nat can't watch and leaves.
Marcel tells Nat that Carol is good and the heart is beating fine now. She will be okay. Natalie tells Marcel she wasn't fair to him and wasn't honest. He is grateful she taught him to risk.
Veroni checks on Ethan. Will asks if everything is good with Goodwin but just then Ethan goes into shock. He is bradycardiac. Will says to Veroni that Dean's idea is going to kill Ethan. Dean tries to orchestrate. Abrams doesn't appreciate that. Heart rate begins to rise. Dean is happy that it all worked out.
Goodwin wants to see Will. She reads him the riot act because Kender has pulled the trial from this hospital and possibly all future trials. She says this is why she did not name him chief of the ED. She fires him. He seems shocked.
Vanessa is congratulated on her new position. She tells Maggie they need to talk after work.
April updates Ethan on his condition. She says she has been trying really hard to move on from them but seeing him brought in made everything come back to her. She takes his hand.
Dean comes to see Goodwin. She congratulates him on what he did with Choi. She says that Choi had great faith in Dean's abilities. She'd like him to be interim chief until Choi can resume his duties. Dean is honored..
Neal is still insisting everything was fake. Maggie wonders how they got to this point with so many lost souls. Charles goes to talk to Lankoff about this guy . He wants to try to find a way to help the Russian patient together.
Charles takes Lankoff to see the Russian patient. He removes the restraints and talks to him in Russian. The patient cries.
April gets a letter from the admissions department. She got accepted. She glances at Dean.
Vanessa goes to meet Maggie. She is aware that Maggie is her birth mother. She says her parents were open to helping her find her birth mother but she never wanted to. She's upset because she doesn't want people to think she only was accepted because she's Maggie's daughter. She doesn't want anyone to know about their relationship. She asks what Maggie wanted. Maggie says she just wanted to meet her. Vanessa says this isn't right and leaves.
Natalie goes to see her mom, who asks if she is alive. Marcel asks to see her. He tells her that Will was fired. Nat confronts Will and he says he told Goodwin he took those pills because of everything he and Nat had been through. He thinks a change will do him good. Nat doesn't want to let him do this. He says it's done.
Sharon tells Ethan when she saw him get shot she assumed this was a hate crime and knows now it wasn't. This has been a difficult year and she is a little shellshocked. Ethan knows. She will let him rest. He says they all need to heal.
Outside, Nat approaches Sharon. She has to reinstate Will. Sharon says she knows they're close but - Nat confesses she was the one who stole the trial meds.