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.

As Carter prepares to open a new facility for the underprivileged, some old friends/colleagues gather. Rachel Greene, Mark Greene's daughter, applies for an internship at County.