Carter, Pratt, Kovac and Abby are dealing with a woman and her three children who've jumped from a three floor apartment trying to escape from the father. Meanwhile Dr. Lewis becomes Chief of Emergency Medicine, Howard quits his internship and Dr. Corday is facing dismissal.

Neela starts a new job in the emergency room after working at the convenience store near the hospital. On Neela's first day, Pratt expects the interns, Abby, Ray and Neela, to take on a large patient load during their shifts. Pratt turns processing the patients into a competition, in which Ray is clearly going to be the winner.