Mario tags along when Ethan heads out for a call, but doesn't disclose that he's already worked two shifts straight. While they work atop a 400 ft crane to save two brothers, he loses his footing and has to be rescued, taking valuable time away from their patients. Back at the hospital, Ethan orders him to go home when his hands start to shake from exhaustion. He later advises Savetti that until he knows his own limits, he won't be the great doctor he is striving to be.

 When a school prank goes afoul, high schoolers and their teacher are brought into the ER. Jesse gets the girl behind the pepperspray bomb to confront her issues and admit her guilt to an understand teacher. 

The wife of an orthopedic surgeon comes in after taking a tumble down the stairs post percocet and chardonnay lunch. Although the family claims it was a substance abuse relapse, Leanne digs deeper and finds evidence of several older fractures and multiple ER visits. She suspects the husband of domestic abuse, but it turns out to the the adult daughter, which they discover after she attacks both of her parents in the CT room, resulting in the father suffering from a carotid dissection.

Elliot tries to help Angus out when he proves to be a dismal texter, but ends up setting the second year up on a hiking date instead of a coffee date.