In a montage set to music, Andrews, Lim, and Glassman get ready for work.
Shaun and Lea announce to everyone that they're not getting married.
Andrews appoints Lim as Chief of Surgery. However, he has decided to close Glassman's clinic and wants Glassman assigned to the OR.
A family is brought into the ER after a car accident. The mother might have bleeding around her brain and the father is crashing at the same time. The little girl is scared as her parents are rushed to the OR first.
Lim and Park amputate the patient's leg. No circulation in the arm. Park thinks Andrews can help. Lim isn't interested but is forced to page him when they have no other option.
Glassman doesn't want to open the patient's skull but her BP is still dropping. Where is there a leak? Asher says it's the heart.
The little girl has a lot of questions for the social worker. Shaun is very blunt about her father's chances. The social worker tries to stop this. The little girl sends her away. She asks if her parents could die. Shaun tells her that it's too soon to tell.
The little girl shows up while Shaun and Jordan are discussing another patient and complains her sandwich had pickles which were gross. Shaun calls a nurse to take care of her. Jordan tells him the child is scared and looking for attention but Shaun says he has to maintain boundaries as a doctor.
Lim and Andrews argue about whether or not the arm can be saved. Asher interrupts. They need a trauma surgeon for the other patient. Andrews says he and Park can close this patient and Lim should go.
Morgan is meditating and sees the patient she lied to interfering with her visualization. Shaun interrupts to ask what she is doing. He doesn't know what practicing mindfulness means and doesn't understand even after Morgan explains. She says he's being mindful by being in the moment with Lea. He says but they are only doing that for now. Morgan sucks at living in the moment. Jordan interrupts. Isla is bleeding nad becoming anemic.
Shaun convinces Isla to take off a gum wrapper her dad gave her instead of a ring so she can have an MRI.
Lim and Glassman get into an argument because Lim thinks Glassman put Shaun's needs above the rest of the hospital.
Shaun is worried about a re-rupture of Isla's artery. He needs to think about how to handle this. Jordan says he gets some QT with Isla then. She leaves. Isla is bored.
Lea thinks Isla is Shaun's friend. Shaun explains in one breath and asks Lea to watch Isla. Isla asks where Lea's ring is and when the wedding and asks 10 questions in one breath. Isla doesn't understand how Lea is Shaun's fiancee with no ring and no wedding date. She changes the subject to what IT is.
Andrews has fixed the arm instead of amputating. Lim isn't happy. She accuses Andrews of serving his ego. She's upset that he leveraged the Salen situation for his own benefit.
Shaun asks Park about Isla's situation and also are he and Lea moving backward? What should he do? Park can't tell him.
Glassman and Andrews argue in the OR when Andrews apologizes for closing the clinic and Glassman thinks Andrews is power hungry.
Isla needs to hold Shaun's hand while he gives her an anesthetic shot. He is used to it from when Lea was pregnant. Isla asks about the baby. Shaun tells her the truth. Jordan comes in. Isla's dad is out of surgery. Isla doesn't want to see him.
The fluid is backed up in Elaine's brain. Glassman asks if Elaine's heart can take a shunt. No, but there's another problem: a tear in the trachea. Andrews' help is retired.
Morgan has brought in an old man from the nursing home who has a chest problem.
Lea asks Shaun how Isla is emotionally. He doesn't know what's bothering Isla and wants to choose a wedding date because he's not okay with not having a plan. Jordan comes in and says Isla is not talking to her and she doesn't think she will talk to the social worker. Isla chose him.
Glassman, Lim, and Andrews argue over which procedure to do first. Elaine goes into heart failure, rendering the question moot.
Shaun goes to see Isla. He thinks her drawing of her dog looks like a horse and she crumples it up. She won't tell him why she doesn't want to see her dad. Eventually she explains how she was kicking her dad's seat which he hates and he turned around to tell her to cut it out and that's when the accident happened. Shaun tells her that it was his fault his brother died but it was his fault too. He reassures her that the accident wasn't her fault and that her parents will likely still love her even though his parents never liked him. Isla is sorry about all the bad things that have happened to Shaun. Shaun says a lot of good things have happened too. Isla is ready to see her dad but she begins bleeding in her chest and crashes.
Jordan says they have to do surgery or Isla will die. Shaun hesitates then agrees to prep and OR.
Park wonders if Morgan's volunteering is because she feels guilty. She almost lost everything and wants to cultivate virtuous intentions and not be so awful. Park doesn't want her to become a different person.
More tension between Glassman and Andrews in the OR. Andrews says the death of that baby keeps him up at night and he should have taken a stand but Salen promised to make changes and he believed her. He should have stepped up sooner. The patient begins crashing.
Shaun paces back and forth. They don't have 20 minutes to wait for a doctor. He asks for them to get an attending NOW so he can open Isla's test.
The patient is tachycardic. Andrews says the tracheal injury is lowering her heart rate. Jordan comes in. Andrews says he needs 10 minutes before he can get there.
Shaun has found the bleeding vessel but is nervous about clamping wrong and causing Isla problems. He needs Andrews now. There is no time. Jordan says he can do this. He asks for instruments.
Isla wakes up next to her mother. Shaun says they will have chest pain for a few weeks but will most likely be okay. Shaun has the gum wrapper for Isla. Isla holds out her arms for a hug.
After Shaun doesn't want to do that again. He wants to go home.
Morgan talks to Andrews. She thinks telemedicine for nursing homes will cover the cost of the clinic. Andrews says ideas aren't her problem, she bungled everything up. She thinks Glassman needs to be in charge of the clinic until she's ready.
At home, Shaun surprises Lea with a homemade ring (hum wrapper?) and gets down on one knee to propose to her. Lea says yes. They kiss.
Lim and Glassman show up in Andrews' office. Glassman is looking for his Scotch. Lim wants her fizzy water. They all drink together.