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.

The ER staff's slow snow day becomes chaotically hectic when the casualties of a 40 car traffic accident flood in.

It's Christmas-time and the expected range of emotions is to be found among the ER staffers. Susan Lewis treats a middle-aged woman who is overjoyed at finally getting pregnant. Susan is also shocked to hear that her boyfriend Div Cvetic has quit his job and moved out of his apartment. Mark Greene treats a young drowning victim. Doug Ross takes Greene's advice and decides to tell Carol Hathaway that he loves her; unfortunately he chooses to do so at her engagement party. Peter Benton jumps the gun and arranges for transplant teams to harvest an accident victims organs but the man's wife is now refusing to give consent. Susan's sister Chloe announces that she is pregnant.