Rollie starts his first day as chaplain and is admonished by Campbell to stay away from medicine and only provide council to patients. Campbell and others pressure Rollie about the DBS surgery.
THe ER is flooded when an apartment building catches on fire. Among the victims are a middle aged man and his daughter, who was injured trying to get her father out of the building, a young Arabic speaking mother, the building manager, and a teenage boy left home alone.
The older man and his daughter, Lola, are frantic about each other while in center stage. The father ends up having a heart attack and being taken up to an OR for immediate bypass. Lola has broken both of her legs and has a liver injury that only gets worse when she tries to get out of bed to get to her father. They were having an argument when the fire broke out and she's desperate to apologize to him. Ethan finally gets more of the story out of her, and promises to take her up to see her dad, but gets caught up in other matters. Meanwhile, Rollie visits Emanuel, and receives some comfort from the pastor. Emanuel then codes, and Rollie looks on helplessly as the doctors are unable to save him. When Lola gets the news, she blames Ethan.
The young mother is frantic about her baby when she comes, but once her son Sami is found, it's discovered that Ethan's Arabic is rusty -- she was saying babies, not baby. Her daughter, Sami's twin, is still missing. Unable to help in any other way, Rollie gets on the line with the EMT's and the others hospitals, trying to find the baby. Amira is finally brought in, but she's not responsive and shows signs on CO poisoning. Rollie and Eliot take her up to the hyperbaric chamber, but Eliot is unable to intubate the baby, despite Rollie talking him through it. They are unable to save Amira, and Eliot has to stay in the chamber with the baby until it decompresses. He takes the loss very hard and wants to quit, but Rollie talks him out of it. When the mother finds out about Amira's death, she refuses to see Sami, unable to see past her grief over her daughter.
The building manager is convinced that the teenage boy who is often left to fend for himself while his father works is the one to blame for the fire -- he's had to go and shut off the smoke alarm several times when the kid tried to fix his own dinner. Overcome with guilt, the boy later confesses to Mario that he had been playing with fire works on the roof of the building and that one had ended up going down the drainage point. Mario gets him to fess up to his dad, who starts freaking out about the boy's recklessness and having to get a lawyer, only for the building manager to arrive and confess that the fire was actually the result of faulty wiring.
Another woman is brought in, with evidence of past suicide attempts. Her young son is fine. It turns out she ODed, which actually kept her from breathing in enough smoke to kill her. Angus tries to get her to see everything she has to live for, but she's resentful that her son's father left them and that her boy doesn't have the life he deserves. She ends up slitting her wrists while left alone. When the team takes her to center stage, they suddenly turn to Rollie for help, but he's paralyzed at the red line, unable to cross. As they beg him to open his eyes and help them, the scene changes.
Leanne is still asking Rollie to open his eyes, but he's in the OR, in the middle of the DBS procedure. As Leanne asks him questions, he slips into his past, connecting the cases from the fire to his own life. When he wakes back up, the procedure is down. He is surprised to see Cole at his bedside, and he confesses everything about his past to his son.