Jules Rubadoux, whose wife was a patient of Carter's nine years ago, comes into the ER with heart problems and wanting nothing to do with Carter, whom he feels is responsible for his wife's death. Anspaugh and Kayson advise Ruby to have surgery, but Abby tries to get him to consider the alternatives. In the end, Ruby allows Carter to tell him the truth about his chances. Pratt asks Olivia from Ceasefire out. When he shows up at her office to pick her up, he's ambushed into speaking at an anti-violence meeting. Susan meets with the tenure committee. Sam is in her own world all day, and buys a pregnancy test. Ray tries to stop the Chadwick sisters from leaving without having been seen by social services. Morris may end up becoming Chief Resident.