Lewis has a rough day: Chuck proposes having kids with her, she misses an appointment with an auditor, and Ben Hollander commits suicide. Pratt receives an unfavorable review from Romano and also treats a con who was raped in prison. Abby, on her ER rotation, agrees to study with Neela. Gallant makes a decision that results in the death of a young girl with leukemia. Sam's son Alex spends the day in the ER, following Luka around for most of it, ending with Luka X-raying his head. Chen gets a call from the Chinese embassy and heads for a plane as her vacationing parents were in an accident. Sam unscrews Romano's hand and Lewis locks it up for the rest of the shift.