Dr. Hope Martin returns to ask Maura for a life-altering favor. Jane worries about the impending spinal surgery for Lt. Col. Casey Jones (guest star Chris Vance), and Tommy shows off baby T.J. But all gets shoved to the side when a building collapses, trapping loved ones inside.

When a food truck chef dies suddenly, all signs point to poisoning; Tommy announces some big plans; Maura's birth mother tries to make amends with her daughter.