Doug Ross' hopes of renewing his relationship with Carol Hathaway take a positive turn after the two of them kiss following a particularly stressful trauma, but his hopes are dashed when she decides to move in with boyfriend Tag. John Carter has a particularly good day when Dr. Green successfully walks him through a complex procedure. Haleh takes Dr. Benton to task when he refuses to act as a role model for a young gangbanger she has an interest in. Benton is also competing with Dr. Langworthy for a prestigious fellowship. It's Susan Lewis' birthday and her sister Chloe shows up at the ER drunk.

Carol Hathaway faces an ethical dilemma when a patient admits that he, and not his friend, was driving the car that ran a red light and killed a pedestrian. She decides to tell Tag about kissing Doug Ross. It's Thanksgiving and the doctors treat an animal rights activist who was attacked by the turkey he was trying to save. Doug Ross is going to the Bahamas with Linda Farrell and he is very much feeling like a kept man. Carter has to treat a transgender woman who has now reached an age where she can no longer pass as a woman. Carter's indifference is the final straw. Susan Lewis continues to worry about Div Cvetic, whose condition seems to be worsening.

Susan Lewis has a run-in with Dr. Jack Kayson, the cardiology attending, when he accuses her of not providing him with all necessary information on a patient who subsequently died. He makes it very clear that Susan will bear all responsibility for his death. Her sister Chloe informs her that she and her boyfriend are moving to Texas. John Carter is still frustrated by Peter Benton's apparent lack of interest in teaching him anything but a new go for it attitude leads to an invitation to assist in a surgical procedure. Benton's sister suggests to him that the time has come for them to put their mother in a care home.

Kayson, a married man, tries to start a romance with Susan by asking her to dinner. Deb unknowingly eats LSD-laced chocolates. Carol takes an interest in a Russian girl abandoned in the ER.

Doug and Harper had sex. Mark finds out about this. So does Carter.

Mark has to deal with the fact he can't see Rachel during the holidays and takes care of a Holocaust survivor whose grandchild is missing.

Susan has therapy to get over losing little Susie and Jeanie's ex-husband is brought in.

It's Susan's last day. Carol stands up for her nurses when one of them is being rotated to another department.

Following the incident in the OR, Dr. Morgenstern and Dr. Benton present the case to their colleagues. As a result, Peter Benton finds himself suspended for insubordination pending a full inquiry. Jeanie attends Scott Anspaugh's funeral and has some information to share with the boy's father. Anna Del Amico finds herself ethically unable to perform an abortion and is taken to task by Dr. Weaver. John Carter gets the hospital to take legal guardianship of a patient he feels has been subjected to elder abuse, but subsequently doubts that he made the right decision.

It's Halloween in the ER, and the medical students throw a party; as a result, Carter decides that Lucy isn't mature enough to take responsibilities. A candidate for the ER Chief position arrives from New York and drives home disappointment for Kerry. Mark screws up when he doesn't recognize a homeless schizophrenic woman is pregnant before treating her. Benton treats Corday to a fun Halloween.

Kovac and Haleh take care of Hathaway's twins so the new mother can finally get some rest. The job transfer for Carla's husband does not get approved allowing Reese to stay in Chicago. Lucy endeavors to get a heart transplant for a young woman and goes to Romano's house begging him to perform the surgery.

In order to get her patient to tell her the location of a missing body, Corday agrees to grant him a fatal wish. Kovac befriends two brothers. He tells Weaver that his wife and children died in the Bosnian war. Former medical student Deb Chen returns to County General as a resident, using her Chinese name, Jing-Mei Chen.