It's night in Toronto, and Hope Zion Hospital's Chief Surgeon Charlie Harris is sitting in the back of a cab with his fiancee and fellow surgeon Alex Reid. Charlie wants to go around the block one more time, but Alex reminds him of their impending wedding - their guests are waiting for them at the hotel suite! Suddenly, the cab is rear-ended. Despite a good knock to the head, Charlie quickly emerges from the car to tend to the other driver, who has sustained a collapsed lung. Luckily, Alex has a pair of scissors and a tampon in her purse, which Charlie uses patch up the lung. With the initial shock of the crash over, Charlie feels pain in his head, then falls to his knees and passes out.
Neurosurgeon Dr. Shahir Hamza meets the ambulance at Hope-Zee as Alex rushes Charlie's gurney into a trauma bay. Although he's passed out, Charlie's spirit is present, commenting on what's happening around him. Since he was lucid before he passed out, he's probably got an epidural bleed; Alex suspects the same thing. When Alex states that Charlie has been unconscious for 37 minutes, he finally realizes something fishy is going on. Still dressed in his tuxedo, Charlie watches as Alex, Shahir and the trauma team work on him. He can see them, but they can't see or hear him. Now he belongs to the hospital... and all he can do is hope.
Twelve hours earlier, Charlie stands in front of a large lecture hall, asking his young residents how to manage soft tissue sarcoma in upper limbs. Even though she's not an orthopedic surgeon, Alex is the only one with an answer: she would save the arm. Sure of himself, Charlie disagrees. After class, Alex and Charlie enjoy a quickie in his office when her phone rings - another page from anxious young surgical resident Maggie Lin. Charlie steps into a consult with pre-op patient Shawn Price. Afghanistan veteran Price is suffering from a tumor in his right arm, and it must be amputated. Charlie autographs the arm that will be removed and promises to see Price in half an hour for surgery. Meanwhile, Alex and Maggie check out Angela Mesner, who's attended by her boyfriend Mitchell. Angela's overweight and has been experiencing abdominal cramping. After encouraging Maggie to act more confidently, Alex orders blood work and a CT scan.
An urgent call comes in: a casino bus has flipped over. Alex is surprised to see her ex, Hope Zion's new orthopedic surgeon Joel Goran, riding in on a gurney while massaging a patient's heart back to life. Later, Charlie and Alex scrub in for surgery on the bus crash victim, aka John Doe. His liver has been lacerated and his spleen is pretty much mush. Charlie turns the conversation personal - how many kids does Alex want to have? After the surgery, Charlie bumps into Joel and congratulates him on his first day at the hospital. Neurosurgeon Shahir introduces himself briefly, then heads into surgery, as Joel catches up with Alex. Since she didn't invite him to the wedding, she must still be in love with him. Claiming she didn't know he would be around, Alex extends an invitation for the wedding, later that night at the Park Regency Hotel.
Charlie stops by Price's room to cancel the surgery. The bus crash has pre-empted all the operating rooms so the surgery will be rescheduled for tomorrow, first thing. Price freaks out, demanding his arm be removed now. When Charlie explains that it's a short wait, Price settles down, claiming he's all good. That night, Alex and Charlie dress for the wedding in his office. They won't be able to get away for a honeymoon until next month. Alex wants to get off the grid, but Charlie's thinking Paris. Just before leaving, Alex gets yet another text from Maggie, who had to stop the CT because her patient Angela is pregnant. Alex sends Mitchell off to get a juice, then talks turkey with Angela. Is she sure she didn't know she was pregnant? Angela admits she didn't say anything because she didn't want Mitchell to dump her. Alex decides to keep Angela hooked up to a fetal monitor overnight in preparation for an OB/GYN consult in the morning.
Flash-forward to the trauma bay, where Alex and Shahir work feverishly on Charlie after the cab accident. Charlie is in danger of "coning" which means pressure from the bleed could crush his brain into his spinal cord. When Shahir tells Alex there's nothing she can do, Alex refuses to leave Charlie. Standing in the hallway in his tux watching himself on the gurney, Charlie is more than a little freaked out to contemplate his possible death, as the surgeons wheel him off for a brain scan. Nevertheless, Charlie admits he would do the same thing if the tables were turned. Later Alex's best friend and ICU doctor Melanda Tolliver finds Alex crying in her bloody dress. Everyone keeps telling her to go home, but what is she supposed to do? Melanda advises Alex to suit up and get to work.
The next day, Alex finds Shahir already at Charlie's bedside. According to Shahir, Charlie is relatively stable, and they won't need to operate unless things change. Watching this exchange, Charlie's stunned to see a man who can see and hear him - John Doe. Charlie explains that he's in a coma, but John Doe has died. They puzzle over their current state; neither of them can touch anything or anyone in the hospital around them. When Charlie explains the staff labeled John Doe as a John Doe, he laughs. When he gambles he usually doesn't bring his wallet so he doesn't go over his limit. John isn't dealing with death very well. Just before disappearing, he admits that he's lonely. Charlie can relate.
Maggie pages cute psych resident Gavin Murphy to consult on the case of teenaged Tara, who's got a nasal-gastric tube up her nose. Maggie can't figure out why Tara would have swallowed a highly toxic daffodil bulb. After her tube is removed, Tara admits she didn't know the daffodil bulb was toxic. Far from being suicidal, she's hungry, and the daffodil was an ingredient in a love potion, which she drank and gave to a boy she likes. Joel stops into Price's room to explain that he'll be performing the amputation since Charlie is unavailable. Price isn't very happy, especially when Joel asks if anyone has discussed limb-sparing surgery with him. It's no guarantee, but it could save his arm. Price admits that he did discuss it with Charlie and demands to know what's going on. Are they postponing surgery again? All Joel will say is, "I don't know."
Alex checks in on Angela, only to find her crowning. Neither Maggie nor Angela is ready for the birth, but Alex jumps right in: Angela's having her baby right now. Angela's baby boy may be tiny, but other than that, he looks perfect. Mitchell is stunned. Afterwards, Alex proceeds to Charlie's room to cancel their hotel suite. Feeling awkward, Alex addresses Charlie; she knows she should talk to him. Just then, Charlie flat lines, going into full code. Joel steps in, orders Alex to step aside and shocks Charlie's heart back to life. Joel orders an immediate craniotomy. They have to reduce the pressure on Charlie's brain, or he's going to die. Charlie observes his own craniotomy, which entails drilling holes into the skull, what he describes as "fun stuff." When Alex asks Shahir if her presence is making him nervous, he explains, "I don't get nervous." As Charlie reaches out to touch Alex on the shoulder, she runs from the room.
Gavin and resident Stuart Yu call Maggie for a consult. Another teen, Misha, has been admitted with symptoms that are alarmingly similar to Tara's. Right off the bat, Maggie recognizes daffodil poisoning, stunning Stuart. Maggie orders a stomach pump and sets up a meeting for later in cubicle three, where she intends to put Tara and Misha together. Joel finds Price in the hospital garden with news that he did schedule the surgery, but he has questions about Price's time in Afghanistan. Why is a decorated veteran with an engineering degree working at a gas station? Could it be post-traumatic stress? Survivor's guilt? Price admits he already talked to a psychiatrist at the VA hospital, who gave him five prescriptions and diagnosed his cancer. He just wants his tumor dealt with.
When Angela finally wakes up, she asks Mitchell to get the baby some diapers and clothing. Just as she's asking Mitchell if he loves her, alarms sound, and Alex comes running. Mitchell watches as the doctors try and fail to revive Angela. He doesn't understand - how can she be dead? Alex explains a massive pulmonary embolism travelled into her lung, and they tried everything they could. But right now they have to think about the baby - someone needs to make decisions for him. Mitchell wants to know if he can put the baby up for adoption. The baby killed Angela, so he doesn't want anything to do with it.
Charlie sits on a bed, while a tearful Mitchell packs up Angela's belongings. Charlie remarks that when things go bad, doctors always say they did all they could. But then there's nothing more to say, and you're alone. Later, an EMT drops by to give Alex a box she found when cleaning out the ambulance - it contains Alex's wedding ring. Moments later, Alex finds Shahir checking on Charlie, who has stabilized since his craniotomy. Shahir wants to talk about how far Alex wants to go; this could be the first of many interventions, and since Charlie's parents are dead, Alex will have to make the call. Despite the imminent threat of repeated code situations, Alex refuses to have "the talk" about resuscitation and DNRs.
Later, Joel finds Alex in Charlie's office, tearfully contemplating her wedding ring. Joel tries to assure her that everything will be okay; Charlie's not going to die. Why not be positive? After all, they don't really know what's going on with Charlie. When he describes the situation with Price, Alex starts arguing, comparing Joel to Charlie, who's twice the surgeon Joel will ever be. Joel needs to amputate Price's arm, just like Charlie would have. When it comes to life and death, you have to be aggressive.
Gavin catches up with Joel in the hall, to report back on his consult with Price, who clearly has PTSD. Gavin agrees; Joel should not amputate Price's arm. But Joel has decided to schedule the surgery anyway. Joel waxes philosophic: does being a doctor make you smarter than the patient? Price wants to get rid of his arm; maybe he's not totally wrong. Meanwhile, Charlie reports from the spirit world, as Joel preps for surgery. As a doctor, you have to be smarter than your patient; otherwise, you couldn't do it. It might be the patient's body, but the doctor is the one who ultimately makes the decisions.
After the surgery, Joel checks in with Price, who's disgusted that his arm is still attached to his body. Joel admits that in all truth, he just couldn't amputate and performed the limb-sparing surgery instead. He can't watch Price punish himself for surviving a war. He was going to perform the amputation because it's what Charlie was going to do and he felt guilty. But he doesn't owe Charlie anything, just as Price doesn't owe his fallen comrades anything. When Price threatens to sue, Joel admits he'll probably win. Walking the halls, Charlie notices Angela, now dead, on her way out of the hospital. Meanwhile, Mitchell has had a change of heart. Alex walks him through his first time touching his son in the incubator.
Late that night, Alex finds a nurse, Janet, in Charlie's room. Janet encourages Alex to get into bed with Charlie, just like Alex encouraged Mitchell to touch his son. Alex climbs into bed and freaks out, jumping out of the bed and asking Janet to leave. She talks to Charlie about her terrible day, losing a patient. Asking, "What will I do without you?" Alex crawls back into bed and cries. Charlie watches the whole scene unfold, telling Alex not to give up on him. "I'm still here," he says.