Vivian is brought in with abdominal pain. She collapses in a restaurant, getting breakfast with her sister Ruby. Ruby was in the bathroom, and she wants someone to find her. She starts spitting up blood. She's concerned about her sister, as she is the one who looks after Ruby. Their dad is a pilot. Vivian needs surgery but won't consent to go in until they find her sister. She's a miner. They find Ruby just as Vivian is being rushed into emergency surgery. Vivian's mother died in St. Mary's. Vivian has an ulcer, which is uncommon for a child her age. Their mother committed suicide, and she blames herself because they had a fight right before.

Grace ends things with Kabir and decides to find a new way to deal with the Dr. Hamilton situation.

Nazneen's patient Veer asks for pain killers and she fears he may be a drug seeker. He also recognizes her as a Bollywood child star. He has an opioid overdose. Naz meets the cousin in med school who was in love with her. She tells him about her twin brother who loved to party and wrapped his car around a pole.

Wolf needs to do a monthly lump volume check-up for Edward Miller's pulmonary disease. Edward is Damien's best friend from Afghanistan. Wolf has never done that kind of check-up before. Edwards's numbers are significantly up. Wolf takes him to transfer and they get stuck in an elevator. Edward panics because of claustrophobia created by PTSD. The tank Wolf grabbed with air is almost empty. His mistake almost gets Edward killed. He's told no more extra shifts, and he sneaks half a bottle of medicine to Red.

Keon and Dr. Banks discuss their kiss and the dangers of the power dynamic.

It's Sinead's Brithday.