Michaela "Mike" Quinn, of Boston, followed in her father's footsteps by becoming a doctor. Dr. Mike worked side by side her father. But his sudden death caused her the loss of, not only her best friend, but the loss of their medical practice. The lack of job opportunities for women doctors lead Michaela to answer an ad for a doctor in Colorado territory. Michaela left her fancy home in the city of Boston for the western town, Colorado Springs. When she arrives in town she is met with mockery, for they expected a man doctor. She is befriended by Charlotte Cooper (Diane Ladd) and becomes good friends with her. Charlotte and Dr. Quinn become close friends and when Charlotte is bitten by a rattle snake, she leaves her three children Matthew (Chad Allen), Colleen (Erika Flores, later Jessica Bowman) and Brian (Shawn Toovey) for Dr. Mike to look after. As the town continues to mock Michaela for expecting to be the town doctor, she meets Sully, a white man ""turned"" Native American who lets he

Mike's Christmas Eve gets off to a bad start, triggering a personal crisis for Mike. Through no fault of her own, a patient dies of a heart-attack on the operating table as Mike performs a routine operation on Christmas Eve. The deceased man's family blames Mike. Later, at home, the Cooper kids bicker. Next, as Mike, Sully and the kids are on their way to the town's Christmas Eve party, Robert E comes to ask Mike to deliver a baby for a couple who's just come into town. The couple, married against their parents' wishes, are on the run. Robert E offers them the use of his stable for the birthing, as the couple's fathers, who're in close pursuit, will certainly find them at the clinic. Mike goes to attend the delivery, which causes her to miss the event.

Mike and Sully go to the Reverend for a dose of preventative pre-marital counseling, and recall the path of their romance.

When Colleen, who is working on a college paper, asks Dr. Mike to recall her most memorable case, Dr. Mike looks back on the five turbulent years she's lived and loved in Colorado Springs. As they sit with Andrew, who is mysteriously ill at the clinic, Dr. Mike reminisces about her tumultuous career -- its successes and its failures -- and realizes how many divergent cases she has seen and treated.

When Andrew's condition takes a turn for the worse, Dr. Mike warns Colleen about the fine line between emotional involvement and professional detachment, an issue with which she has long struggled in the frontier town that's now her home.