It's Sam's birthday, but she finds it hard to be away from her son Alex. Meanwhile, Sam meets a photographer taking pictures of a terminal patient and she gives Sam a new perspective on life. Dubenko's new surgical intern unsettles Neela during a trauma; Gates is shadowed by a new and nerdy intern and later must tell Sarah the truth that he may be her biological father. Also, Morris and Hope annoy Kovac and Abby when they try to help with their wedding preparations.

What is suppose to be a departmental dinner organized by Kovac turns out to be the surprise of a lifetime for Abby when she soon learns it's a surprise wedding, secretly planned by the eager groom. Meanwhile, at the wedding, ER staffers enjoy themselves with music and booze while Neela finds herself the center of unexpected attention between Gates and Ray, which leads to a drunken fight and a shocking conclusion.

Dr. Kevin Moretti, an ICU specialist bent on change, joins the ER team. Change comes elsewhere as Luka and Abby adjust to being husband and wife, Pratt tries to be a new man to his lady friend, Morris and Hope take things to the next level, and Ray goes missing. Later on, Luka gets a troubling phone call.

Two wounded police auxiliary officers present challenges in the ER. Neela settles in with Abby as she recovers, while Pratt and Bettina consider their relationship. Gates tries to get a patient on a drug trial, with Dubenko's help. And Morris is in a funk that not even a pretty woman can help.

Morris and Pratt cram for their medical boards when Morretti brings in a new attending physician to help with the load. Sam and Abby work on an attention-hungry patient who comes into the ER with elusive symptoms.

Pratt and a new doctor on the scene disagree on how to teach the interns. Gates treats a young woman with serious heart problems. Abby heads to Croatia, and ponders whether and how to tell Luka about her unfortunate choices. Sam discovers that Julia has moved on in more ways than one.

There's been a jewelry robbery in town, and Neela finds out that one of her patients might have had something to do with it. Pratt makes an effort to save his relationship with Bettina, and Abby worries about her marriage, sensing that Luka may have given up on it.