Taylor walks the new surgical attending, Dr. Guthrie's son Cole, through the ER. Three fire victims are brought in -- a 55 yo male, a 22 yo female, and a 5 month old infant. The old man is the only on conscious. Guthrie Jr. and Taylor observe from the platform around center stage, and Guthrie tries to correct his father's instructions to Malaya.Christa hesitates while working on the baby, unable to perform an invasive, painful procedure.

Rorish advises Christa on how to treat children after losing one of your own to tragedy. 

Jesse advises Mario to discharge a frequent-flyer patient before he goes into alcohol withdrawal, the patient insists on being admitted so that he'll be sober for his daughter's wedding. Rorish intervenes and declares that Chef is already in withdrawal. Jesse takes Mario and Christa to a storage room where they will oversee his detox.

Angus admits a 3rd grade teacher who is suffering from psychosomatic sexual over-stimulation. Uncomfortable, he passes the woman off to Mario. 

Malaya treats a teenage girl (Keesha) presenting with vomiting and bruising on her legs. The girl is planning on applying to Stanford, Malaya's alma mater, and she makes the mistake of mentioning the school's diversity program, offending the  mother.

The 55 year old from the fire (Dennis) asks Neal about his daughter and grandchild (Tommy), and tries to insist on seeing hem. 

Rorish finds Cole in a classroom and takes him to task for correcting his father. Cole thinks the method used was outdated, Leanne stresses the importance of her residens learning to do things without machines in case the machines should ever fail. 

Mario is unsuccessful with the orgasm lady and Jesse steps in.

Malaya has to tell Keesha that her pregnancy test came back positive in front of the the girl's mother. Keesha insists she's a virgin; her mother is upset about her daughter's ruined future. 

After identifying that there was something wrong with the baby before the fire, Christa explains her difficulty with the baby to Neal. Nurse Isabel brings them news that the fire department thinks the mother (Tina) may have started the fire.

Christa and Neal discuss why Tina may have set a fire. They question Dennis about Tina and Tommy. 

Rollie talks to Leanne about his relationship with Cole, trying to excuse some of his behavior. Leanne says she'll treat him just like any other doctor.

Mario treats an OD (Darrell). Rorish leaves him to the treatment to take care of Chef. Darrell is uncooperative once he regains consciousness. 

Malaya goes to discharge Keesha, whose mother is upset. Keesha asks to be tested again, insisting that there's no way that she's pregnant. Malaya puts off the discharge to look for another answer.

The teacher leaves the ER, thanking Jesse. Mario questions what Jesse did, and Jesse tells him he made the woman sneeze. 

Darrell wants to be discharged, and has to be restrained. Mario leaves him on the gurney after Darrell spits on him.

Christa asks Chef about his daughter to distract him from the pain of withdrawal. He mentions that his daughter is a supporter of GW Bush. Jesse brings news that the ER is out of the typical drugs, so Leanne uses IV ethanol to wean him down.

Tina regains consciousness and writes a note on her her bedside table, but it falls to the ground before anybody notices it and she is re-sedated. 

Angus helps Malaya walk through Keesha's case, helping her realize that she didn't account for the girls bruises.

Chef wakes up sober and Leanne stresses that he needs to do this for him and not for his daughter. 

Neal and Christa are still stymied by what's wrong with Tommy. They, along with Leanne, decide to do an LP. 

Leanne notices that Darrell is missing from his bed, and admonishes Mario for not working with the rest of the staff to manage patient care.

Christa is unable to perform the LP and Neal takes over. Tommy's spinal fluid is cloudy, indicating an infection.

Tina wakes up again and removes her intubator. The doctors perform a retrograde intubation to resecure her airway. As they're cleaning up after, Jesse finds her note on the floor -- it says she was kidnapped. Neal notices that Dennis is missing.

The hunt for Dennis is on. Neal finds him in a back hallway, and stops him from leaving. Dennis tries to claim that he cared for Tina, and Neal doesn't react well. Leanne shares that the cops think that Tina set the fire in order to bring rescue services to the house after Dennis wouldn't let her get treatment for Tommy.

Rollie and Malaya meet with Keesha and her mother to reveal that they think she may actually have a brain tumor that is presenting as a pregnancy in the tests. 

Christa moves Tommy to the bed next to Tina and he decels. With no senior doctors around, she hesitates over what needs to be done, but Jesse talks her down, giving her confidence. She is able to drain his lungs with the chest tube.

Darrell is brought back in, seizing uncontrollably. Leanne has Mario take point and they realize that he ODed on his antidepressants, which changes their course of treatment. 

Rollie stops Cole as he is leaving the hospital. Cole is upset that Rollie helped him get the job, and after Cole rebuffs his attempt to bond, he tells him to grow up and get over the past. 

Christa brings Tommy over to Tina's bed, and they share a moment. 

Christa meditates on her son's toy at her locker, speaking to him before she leaves for the day.

Neal asks Christa to breakfast, but she already has plans with Malaya and Angus. She invites him along but he declines. 

Mario watches the other residents leave, and then checks in with Leanne, who is stitching up an unconcious Chef. He asks if it bothers her that all her work was for nothing, since Chef won't make it to his daughter's wedding. Leanne reveals that Chef's daughter died ten years ago, and the last place he saw her was Angels ER. She calls his behavior a grief ritual. Mario offers to help, but she declines.