Gates (John Stamos) works on a young teen brought in with alcohol poisoning after playing a deadly drinking game with friends. Dr. Carter (guest star Noah Wyle) opens a new medical facility for the underprivileged in Chicago and some old friends from County General all come to show their support. It's Sam's (Linda Cardellini) birthday and Alex (Dominic Janes) and Gates surprise her with a special gift. Meanwhile, Carter works with an intern to save a mother in labor with twins.