Carol Hathaway returns to work after her suicide attempt. Doug Ross still feels guilty about what happened. An ER patient found walking the streets takes to singing, constantly. Susan Lewis has a run-in with the cardiologist on duty, Dr. Kayson, when he disagrees with her treatment of a heart attack victim. At a case review session, she gets very little support from her colleagues. She also treats a woman who is dying of leukemia and who has good advice for Hathaway. Greene treats a woman who has obviously been beaten by her husband but can't get to agree to get help.

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.