The firefighters assist a woman thrown from her motorcycle onto a cactus patch. John, Roy, and the Rampart doctors plan a surprise birthday party for Ms. McCall; when she breaks her ankle while shopping, the party plans and the ER begin to fall apart. Dixie then tells an incompetent nurse that she will have to work the entire shift for the rest of the week when she has been ordered to get some foot therapy. Rescues include two men trapped on the side of a building with a 1/2-ton sign hanging near them; a man trapped in his new sauna after passing out, whom the doctors find to be suffering from Addison's Disease; and an old woman whose apartment building explodes during a gas leak–with John inside. John then suffers a broken foot. While recovering, Dr. Brackett brings along his first surprise for John–the recuperated Dixie, who has brought Gage a cake, while Dr. Early gives John a tape recorder, in honor of his (and DeSoto's) teacher's birthday.

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