Conrad and Nic have chicks! They're caring for the little beauties before the oncoming storm. It's a storm that Conrad wants Nic to sit out, but she's still going to work.
Nic needs to keep busy so she stops rehashing all the ways they could have kept Mina here. Conrad has a letter for Nic from Mina because she knew that Nic would need it.
AJ wakes up to an empty bed and a text from Mina.
The storm is beginning.
The tornado is just outside of Metro Atlanta after changing course, and they're expecting a marked increase in traffic through Chastain. Irving is clearing the hallways to make room.
A cute little girl is one of the first people into the ER, and Bell is on hand to greet her.
Kit has called Cain and Billie into her office. She's assigned Billie as Cain's new resident, and as they battle it out, the tornado rages in the near distance. It's coming right at them!
Devon checks on Leela, who is waiting with a repairman. As the tornado swipes the building, Devon grabs Leela and tosses her to the ground.
Meanwhile, Conrad and Nick are trying to get everyone away from the doors and to safety, but a couple of idiots won't leave the door as the ambulance begins to move independently outside. Conrad tosses himself on top of Nic, and when the action subsides, they start assessing patients. The first person has an exposed spine. OMG.
Conrad is injured, but he says it's nothing.
Kit arrives on the scene and they begin triage on the hospital.
Devon and Leela discover the man who was working on the lights has a giant piece of metal sticking out of the side of his head. He says he has a headache. You don't say?
EMT Piper's leg is trapped under a vehicle. Her partner, Wes, tries finding the upside and their digs keep her alert. They need to move the metal and get her inside stat.
Ted the repairman has a seizure. They can't get cell service from their location, so perhaps the phones are not working.
Wes and Piper are still at it, and they decide they need to amputate her leg before she bleeds out.
Rose fell and bumped her head, and Billie told them not to call unless there's an actual neuro problem, but Cain heads straight to Rose. He's getting feelings!
When Rose says this is doing a number on her, Cain props her up. She hasn't seen him since they went to Waylon's, and he says he's been really busy.
Bell has called Jake to help him with Sammi, whose nose started bleeding on its own. She's a newly adopted girl who hadn't picked up any English. Of course, Jake is patient with her, and she needs it. She's got tumors everywhere, and Bell promised he'd take a look and possibly do a risky surgery to help her.
Sammi's eye begins to bleed.
Nic and Conrad are sawing through a leg in the parking lot. Good God. (Can you all believe Jasmine missed this??)
Nolan tries connecting with AJ who tells him to go on about his business. Jake is there and commiserates. He's had it with sad looks from people about losing the baby they were going to adopt. They both loathe pity. Bell suggests that they both try wrapping their head around Sammi's case so they can take their minds off their troubles and save a life. The Raptor is all in.
Billie asks Cain about Rose. Does he like her as much as Rose likes him? She thinks it's no big deal since doctors and patients fall in love all the time. Guess I should have been gearing for the male doctors!
Cain tells Billie to mind her own business.
Devon calls Cain and he and Billie weigh in on Ted's head injury. Cain's initial assessment is they need to get him to an OR. His second is for Leela to begin cutting immediately.
Devon and Cain begin winging it with a drill, pliers, and an Exacto knife. Before they get it all, they lose Cain. They're on their own.
Jake sends Bell into surgery because Xiao An is crying. She doesn't want to be alone. Her parents died of the virus, and she never got to say goodbye. Jake promises her that he won't leave her alone.
Devon tells Leela that she has to do the surgery since he hasn't cut since med school. She needs time to learn one new thing, and this is many. Devon helps her to visualize what she needs to do, and she calms, begging to cut.
Bell is scooping organs out of Xiao An, and Jake cannot believe it. Jessica questions AJ, and he launches into a diatribe about loss.
Things aren't going well with Piper's surgery.
Billie is using the pliers to remove Ted's rod.
AJ has run across a smattering of tumors inside of Xiao An, and it's going to affect their closing. They congratulate each other on having the very best in that operating room.
Leela talks her way through the issues they face, and they use Ted's soldering iron to close the wound.
Shoot. They lost Piper. Kit calls it. Billie looks defeated.
She delivers the bad news to Nic and Conrad. Piper lost too much blood to save her. Nic and Conrad decide to tell Wes. Wes is devastated, and Nic uses Mina's earlier sentiments to assure Wes that Piper wouldn't want to be an anchor around his neck. Wes needs to get Piper's dog. The only other relationship Piper had.
Cain gives props to Leela for conducting brain surgery with power tools.
Conrad dangles the idea of Nic taking it easy for the rest of her pregnancy, and she thinks it sounds great.
When AJ sends Mina tests, she responds with emojis, and it's not enough for him. He's breaking.
Sammi is in for years worth of surgeries and exhaustive rehabilitation. The Ackermans don't know how they're going to swing it. Jake is so going to adopt that girl. Their family is falling apart, and they don't think they're the best people for them. Bell doesn't understand, and they say they're going to relinquish her. All three of them are beyond shocked, and Bell sends Jake and AJ from the room. He'll handle it from here.
Jake sits beside Xiao An.
After a tornado and losses and saves, the gang heads out for booze and pool. Devon and Leela grab a couple of shots. He asks if her dad was impressed, and he was more concerned that she was trapped in a room with an eligible Indian. Her dad thinks her dyslexia will cause her to kill someone, so a husband is insurance upon the inevitable failure of her career.
AJ is drinking heavily at the jukebox when Jake and Bell come over. It's a pain-free zone. They congratulate each other again, and toast Sammi.
Billie thinks Cain looks sad, wondering if there isn't a part of him who wants to blow off steam with his colleagues. Billie admits she does want his job. They're cut from the same cloth, he says. No hidden agendas. She asks about him and Rose. He says no. Since she could die at any time, he's keeping his distance.
He shares the story of his college girlfriend dying on his table. Nobody knew how it affected him, but he can't go through that again. Billie says its a dangerous way to live. He'll avoid heartbreak but remain alone at the bar.
Everyone else contemplates a game of darts with drunk and sober contestants, and bets are placed. Leela is a ringer.