Mario is on radio duty when a call comes in from a young girl in a small plane with her mother, who has lost conciousness. Leanne takes control of the call, and brings in Ariel to help keep the girl, Ruby, calm. They talk her through a precordial thump, and when that doesn't work, they take Ariel's suggestion to help Ruby build a defibrillator. That doesn't work either, but before the ATC takes over to force the plane into the desert so that no one else is injured when it crashes, Leanne has Ruby combine the two ideas. The mother wakes up, and is able to crash land the plane without harming anyone else. Leanne and Mario head out to the scene, where they find Ruby has been injured in the crash. Back at Angel's, Leanne has to do emergency surgery in the ER to save Ruby. She freezes up, but Mario snaps her out of it by asking her to teach him something. 

Rox and Ethan resond to a call only to be hijacked. The man takes them to his girlfriend, who was shot while robbing a dispensary. Diego brings a chest tube kit to them but instead of letting him leave as agreed upon, the gunman brings him into the cabin as well. Ethan and Rox wordlessly come up with a plan to debiltate the gunman by tricking him into a blood transfusion, but Diego gets ansty and makes a break for it before everything is in place. He ends up getting shot in the thigh. The plan finally works, but there's a tense moment when the gunman realizes what they're doing and Ethan has to tackle him as he points the gun at Rox. 

Guthrie puts Noa on scut, and she calls him on it. He thinks that her mistake with the drug addict was because of her relationship with Mario, which she denies. 

Angus and Will take a man in for an appy, but he doesn't want Will to treat him. Angus is left to do the lap appy on his own, but runs into trouble when the bowel perforates. Angus opens the man up, and Will joins him when he finishes the other procedure, but only to supervise. In the recovery room, the patient tries to explain that he's not a racist, but that he didn't want to risk that Will had earned his position due to a quota. Angus is about to let it go, but then turns back and tells the man that he should have gone with Will if he wanted the most talented surgery, that he is only in the program because of privilege and nepotism.