Sam and Kovac report to the police that her diabetic son, Alex, is missing and is possibly trying to find his father. The boy mistakenly thinks his dad is in Colorado, but the man is actually incarcerated. Unfortunately, Alex left without his insulin. And Neela, Ray and Abby struggle with their first shifts in charge of the new interns.
Ray attends to Claire, a surrogate mother who goes into premature labor after being involved in a car accident. Claire refuses a cesarean section even though the unborn baby is in fetal distress, forcing the doctors to make an emotional decision. Pratt deals with his feelings from the past and the possibility of embracing the family of his future after he encounters his estranged father, Charlie. Despite Kovac's objections, Sam finds a new apartment and starts to pack.
The emergency room is jolted when a new nurse manager, Eve Spellman, enforces her strict and efficient new procedures. Kovac and Sam are uncomfortable working together on the same shift. Meanwhile, Abby treats a breast cancer patient who is having a hard time accepting her condition.
Songs: The Fray
-- Over My Head (Cable Car)
A patient wakes up from a nine year coma.
A patient who has been in a coma for nine years suddenly awakens in the ER and Kovac struggles with whether he should reveal her the truth about her past. Abby comforts Dr. Dubenko after he finds out some troubling news. New Nurse Manager Eve makes waves in the ER as she implements her strict methods.
John Leguizamo joins the cast of ER as Dr Victor Clemente -- Pratt gets a wake-up call when the new attending poses as a patient to test the knowledge of doctors in the ER. Meanwhile, Kovac bonds with the former coma patient and contemplates bending the rules for her. A breast cancer patient convinces Abby to get her first mammogram. Pratt's father Charlie tries to convince his son that he has turned his life around. Kristen Johnson, Laura Innes, Parminder Nagra, Scott Grimes, and Shane West also star.
There is no business like monkey business in the ER.Clemente, Abby and Neela secretly care for a VIP patient while Dubenko tortures the staff via a robotic television camera from home. Sam is coerced into a management role and is given a dreadful task. Meanwhile, Pratt is visited by his half-brother, and emotions from the past remind him of his father's abandonment.
Neela gets all dolled up for Gallant's homecoming and her co-workers seem to take notice but, her plans change when she receives a call from Iraq. Meanwhile, Abby is caught in the middle between Kovac and Clemente when they disagree on how to save a patients life. When a cop and a little girl become victims of a shoot out, Neela is plagued with the decision of whether or not she should save the shooters life.
Neela thinks that she is going on a routine ambulance ride-along with Gates, and soon finds herself in the middle of an emergency, attending to a plane crash site where many are injured and trapped inside a burning building. Meanwhile, the ER opens to trauma victims of the plane crash and Sam struggles with an executive decision that could cost her her job. Neela's bravery has won the respect of her co-workers and especially Gates the ambulance driver but, her day is not over when she receives a surprise.
Back from Iraq, Gallant (Sharif Atkins) surprises Neela (Parminder Nagra) by telling her he wants to take their relationship to the next level. Kovac (Goran Visnjic) and Clemente (John Leguizamo) vie for the same job making the tension between them even thicker. Meanwhile, Sam (Linda Cardellini) convinces a patient's mother to get the medical attention that her son desperately needs. Morris (Scott Grimes) shocks everyone when he stands up to Weaver (Laura Innes) during a medical procedure.
After a little girl is mistakenly shot, Pratt and Weaver desperately try to bring her back to life. Meanwhile, nurse Haleh holds her annual choir tryouts and everyone is surprised at who is chosen to sing the solo. Evecrosses the line with a patient and causes management to get involved. Abby and Kovac exchange Christmas gifts but, Abby's gift to him is bigger than expected.
Abby continues to struggle with the decision of whether or not she is ready to become a mother. Meanwhile, Neela and Kovac help a religious teenager weigh all her pregnancy options. Ray has an opportunity of a lifetime with his band and everyone is shocked at the outcome. Clemente's past is starting to catch up with him when the cops come looking for him in the ER.
WINMIL -- Auld Lang Sine, Damien Rice
-- Cold Water
With Clemente is missing in action, Dr. Dubenko vollunteers to take the dayshift but ends up feeling overwhelmed. Ray is put in a very awkward situation when his young former girlfriend comes into the ER with serious abuse-related injuries. With a baby in their future, Kovac and Abby venture out for some baby shopping. Meanwhile, Neela recieves word that she has been selected for the surgery elective that she had been hoping for.
Songs: Israel Kamakawiwo'ole -- Somewhere Over the Rainbow
Abby has a hard time dealing with the fact that her former medical-school professor and mentor is suffering from Lou Gehrig's disease and has come to the ER with a serious bout of pneumonia. Fran: Ally Walker.
Songs: Israel Kamakawiwo'ole -- Somewhere Over the Rainbow
Dr. Clemente and his girlfriend Jodie seem to be living the highlife together, when they are suddenly interrupted by Jodie's husband Bobby. When Jodie threatens divorce, Bobby takes matters into his own hands. Abby and Dr. Kovac anxiously await the test results determining the health of their unborn baby. Meanwhile, when Dr. Pratt is put on the auction block for a bachelor charity event, everyone is surprised when a man wins the bid.
Songs: Joe Cocker
-- Many Rivers to Cross, The Blue Jays -- White Cliffs of Dover
Dr. Carter is joined by Dr. Dakarai in the Sudanese desert as they work to treat hundreds of disease infested, and famine stricken people. Carter and Dr. Dakarai must spring into action to save a woman who was raped by a militant group. Meanwhile, back at County General, Dr. Clemente returns from New Jersey wounded. Pratt and Neela quickly work to save a 14 year-old involved in a hit and run accident, but Pratt is infuriated when he discovers who hit the young teen.
Dr. Weaver contemplates hip replacement surgery after she finds it hard to do her labor intensive job. Meanwhile, Dr. Kovac tries to ease Abby's fears about raising a child together. Neela decides to attend a support group for military spouses but when she offers her opinions on the war, the meeting turns into a debate. After Sam treats a fainting victim, named Richard Elliot, she finds herself with an intriguing job offer.
Abby and Kovac discuss baptism. Clemente undergoes a drug test. After it, he goes back to work in the ER. Sam and Ray treat a man who comes in the ER claiming he just committed suicide! Neela must give a speech on Medicine at a conference held in a hotel; Dubenko accompanies her for support. He would like her to become a surgical resident. She is hesitant because her life is chaotic: Gallant is in Iraq and she lives with Ray again.
Songs: Sarah McLachlan -- Fumbling Towards Ecstasy, The Blue Jays -- White Cliffs of Dover
Neela, not happy with her living arrangements anymore, starts looking for a new place to stay. Gallant's parents drop by to see Neela. Car crash patients are brought in the ER. Mr. Gallant, who is a colonel, observes Neela while she works. Talking with Mr. Gallant about the life of an officer, opens Neela's eyes to what her life can become. Sam, who has accepted Richard Elliot's offer in episode "Out On A Limb," finds a pale and weak Elliot when she arrives at the mansion. The man doesn't want any treatment since he as about 20 guests over.
Abby has to make a tough decision about letting a 12 year old girl take care of her grandmother who is suffering from dementia or to call social services and split the family apart. Dr. Albright diagnoses a patient as needing surgery, but is embarrassed by Morris, who proves her wrong.
Dr. Pratt is on his way to Darfur. In the airplane he flirts with Fatima, who also gives him an impression on how difficult life will be there.
Dr. Pratt is stunned by the work load in Darfur, but he gets used to the job eventually. Government officials try to arrest a wounded man, who gets treated by Drs. Carter and Dakarai.
Pratt is back from Africa and treats an injured father of two abused boys. The boys don't seem to tell the real story about the injuries of their father. Two U.S. Army officers enter the ER and it doesn't look like they are bringing good news. Clemente acts very strange and doesn't treat some of his patients right. Kovac demands him to take a break.
Songs: Kanye West featuring Jamie Foxx -- Golddigger
On his last day in the ER Morris is recording a film for his own goodbye. Steve and an other prisoner got wounded in a scuffle in the country jail. While they are treated by Abby and Ray in the ER, they commit their plan to escape.