Casualties of a disaster flood the ER, which is short-handed because everyone is at Dr. Carter's going-away party because he's leaving the ER after 11 years. Dr. Pratt looks for the courage to confront his father, Charlie.

Much to Ray's dislike, a surrogate mother in labor doesn't want to have a C-section and endangers the life of the baby. Meanwhile, Sam tells Luka she and Alex are moving out. Pratt meets his half-brother and -sister, and Abby makes a difficult decision about a young boy.

A new attending, Dr. Victor Clemente, comes aboard and quickly makes a stir on the ER. Abby's breast cancer patient convinces her to take a long awaited test. Luka befriends a young woman who awakes from a six-year coma. Also, Weaver shows Clemente who runs the ER.

Pratt's half-brother tries to get him to make ends meet with his estranged father. Clemente treats an infant chimpanzee and involves Abby and Neela on the secret case. Eve promotes Sam and her first tasks is to fire a beloved nurse.