Watters' old romantic rival checks into the hospital in need of a heart transplant. When a heart finally arrives, Austin performs the transplant against her will, believing that the wealthy patient bribed the donor family. Aaron and McNeil work together to help a man with a rare disease that is causing his muscles to contract. Wilkes is affected when a gang member violently shoots up the ER. Billy officially asks Diane to marry him. It's mentioned that Nyland is gone, it doesn't say how or why.