Andy worries about a patient who continues to ask for surgery to make her breasts perfect even after she has had many surgeries. Andy warns her patient that if she continues to have more surgery she could make it harder for machines to detect a possible sign for breast cancer due to the fact that she has a lot of scar tissue. Andy believes her patient may have a body-image disorder and is worried that her patient could go to extreme measures to improve her body image. Lana's computer breaks down with Marc's thesis on it and Lana, Peter, Ben, Lu, and him must pull an all-nighter to get it done and get the thesis done and turned in in time. Lu must say good-bye when Ben is transferred to Miami and Marc goes away to college.

Kayla is frustrated when a patient refuses to let her treat her due to her race and her intern status. Andy refuses to treat her and insists that Kayla handles the patient. A complaint is filed against Andy because she refused to treat the patient. A new doctor at Rittenhouse must take over Milo's patients and replace him in the hospital.

An estranged sister must work up the courage to ask her Olympic gymnast sibling to donate her liver to save her life. Andy and Kayla help a clinically depressed and struggling resident get back on track after a suicide attempt. Lu tries to convince Jonas not to build a large discount multi-purpose store in her neighborhood as it would close down many of the mom and pop stores that had been there for years.

Andy diagnoses a patient with uterine cancer. The patient had gone to nine other doctors and all of them had declared her perfectly healthy as they didn't give her the test needed to diagnose the cancer. She is furious and sues her insurance company. In the end, she does something that will shock you. Meanwhile, an adoptive mother of a 5 year old daughter may be forced to return her to her former-drug addict mother who abandoned her at Rittenhouse 5 years before.

On a stormy Halloween night, a 7 year old girl suffers a serious burn while trick or treating and the only person who could possibly save her life by giving her a skin transplant is her twin sister. Lu must decide if it is ethical to ask the young girl to proceed with such a risky and painful procedure. Meanwhile, Lizzy and her friends witness a crime in the hospital morque while Peter and Lana get the hospital into the Halloween spirit.

Lana finds a crafty way to help one of Lu's patients, a construction worker with a brain tumor, raise enough money for a necessary surgery. Andy treats a woman who needs to have surgery to save her life. However, the woman refuses to have the surgery performed until she meets her first grandchild, who is about to be born in Paris. Peter tries to find the father of a patient's child.

Andy treats a beauty pageant finalist and finds that she has a shocking disease caused in part by her breast implants that requires surgery. Also, Andy tries to find time to talk to her friend, a presidential aide who is visiting from Washington D.C. Meanwhile, Lu deals with the pain and struggling of immigrants when a truckload of them show up on her block and is shocked to learn that all twenty of them are pregnant. Jonas invites Lu to dinner with his extended family and Lu gets a toxic surprise. Later, Lu has difficulty finding a fuel-efficient car and a lost box could ruin her relationship with Jonas' family. Finally, Peter and Kayla try to work through the red tape of workplace romance and start a relationship.

Lu meets Andy 's replacement, Dr. Dylan West, an obnoxious man she worked with when she was an intern as they struggle to save the lives of the many people involved in a train accident. Later, she discovers something shocking while talking to a bipolar patient. The president is in town and the Secret Service makes sure the hospital keeps plenty of B- blood (the president's rare blood type) on hand. Dylan tries to help a pregnant patient make the right decision about a potentially hazardous surgery. Meanwhile, Lu contemplates marrying Jonas while dealing with the obnoxious woman who caused Dr. Jackson to lose his job. Later, the unthinkable happens to Lu and she and those close to her struggle to save her life.

After a policewoman uses a stun gun to discipline an 11-year-old boy with behavioral problems, Lu takes a special interest in him and the new technique. Dylan is asked to perform a risky procedure by a multiple sclerosis patient who is willing to risk her life to beat the disease. Kayla finds that a patient has come into contact with the deadly poison ricin and is forced to report it to the U.S. Department of Homeland Security.

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