Dr. Greene gets offered a new job by Morgenstern.

It's a day of birthdays. Peter Benton's mother is celebrating a birthday and he tries desperately to find someone to cover his shift. He makes a choice however when Dr. Hicks suggests that he's been absent too often and may wish to consider a leave of absence until his mother's situation is resolved. Carter thinks it's Benton birthday and has a surprise for him. Mark Greene's daughter is also having a birthday but he misses that due to an emergency at the hospital. An elderly, solitary man in the final stages of cancer arrives in the ER on his birthday. Carol Hathaway suggests to her fiancé that they adopt little Tatiana, the AIDS patient abandoned in the ER. Ross has to deal with a young child who was kicked out of a window.

Greene finds his marriage falling apart and is concerned at how little time he's spending with his daughter. He also treats an eight week old child with a heart murmur who requires surgery. Susan tries to get her pregnant sister Chloe to take her pregnancy seriously, but her head isn't quite into it. Benton tries desperately to find a surgeon who will operate on a 16 year-old with a severe brain aneurysm that could burst at any time. He's also concerned at his mother's care and is growing ever more attracted to Jeanie Boulet. Doug Ross' commitment to Diane Leeds gets more serious when he agrees to be an assistant coach for her son's little league baseball team.

It's Carter's last day in the ER and finally fed up with Dr. Benton's apparent indifference, rejoices when he learns that he gets to write an appraisal on him. He subsequently regrets his negative input when he gets offered the surgical sub-internship he'd hoped for and learns that Benton gave him a glowing appraisal. He also spends a good part of the day with young leukemia victim who is fed up with life. Benton and Jeanie Boulet's relationship reaches a crossroads. Mark Greene is offered an attending position at the hospital but also learns that he is being sued for malpractice over his handling of the Jodi O'Brien case. The big day for Carol Hathaway and Tag is here but doubts creep in and one of them gets left standing at the altar.

Shep and Raul enter a house with about a dozen abandoned and ill-fed children and bring them to the ER.