After suffering a heart attack, Andy tells a young pregnant woman that in order to save her and her unborn child she must get a heart transplant. However, unexpected complications with the donor's family place the transplant in jeopardy.

Andy and Sophia treat a car crash victim named Victor dying from ALS who asks to be to taken off of life support so his organs can be used to save others. Meanwhile, David tends to a foster parent with pulmonary hypertension who refuses admission to the hospital.

When a woman's husband needs a new kidney, she contemplates beginning a "Daisy Chain"; which means she will donate a kidney to someone and they in turn will donate their kidney until the chain is completed with her husband getting his kidney. Andy is not sure he wants to support such an action and he is concerned that another patient is rejecting his recently transplanted heart.

When Dr. Luc Bovell returns to Three Rivers, Andy is annoyed at his rival's status and popularity since he is rude to his patients.