The time has finally come for Alex to say goodbye to Charlie. After Alex removes his breathing tube, Charlie's ex Dawn stops by to apologize again for the difficult circumstances. Alex asks Dawn to leave in order to give Charlie one final kiss in privacy. Charlie's spirit hovers over Alex, confident he still has some life in him. "I'm not ready to go," Charlie says. "I won't go." Afterwards, Charlie is stunned to bump into his mentor, former Chief of Surgery Dr. Mack Macilreath. Mack died months ago, so why is he here? Mack explains that he dedicated his body to science, and it was just delivered to the morgue today. When Charlie mentions that Dawn just pulled his plug, Mack assumes Charlie's only got a few hours left, which must be why he's come. He's going to help Charlie cross over.
With Charlie still breathing, Alex is encouraged once again to do all she can to prolong his life. She asks Melanda if any of her patients have tried to reverse a judge's DNR ruling in the past. When Melanda admits she only knows of one family who's been successful, Alex asks for their lawyer's number. It's not long before Martha Sykes, a very expensive lawyer, is in the ICU to check out Charlie. She's going to work from the case from the hospital and file their appeal ASAP. Although the odds aren't the best, Martha assures Alex that all it takes is one small legal mistake in the proceedings for the appeal to be successful. Meanwhile, Joel meets with Dana to discuss his broken hand. Joel insists he's fine. His cast will come off in two weeks, but in the meantime, he wants to work, consulting and diagnosing - even if he just lost a patient to suicide.
Alex receives an urgent page, calling her to consult on Bea, a former patient and "special case," who has returned for a physical. Alex flashes back four years ago on to her first day as a resident, when Bea came to the hospital suffering from difficulty breathing. Just as Alex admits she has no experience with obstructed and spasming airways, Charlie steps in to talk her through an exploratory procedure on Bea. It marks the beginning of a long relationship for the two doctors. We then head back to the present where Bea requests an annual physical before going on a year-long vacation with her boyfriend. Thrilled to see Bea, Alex orders a chest CT and blood work because of her past health problems.
Mack and Charlie stand over Charlie's body - he's still breathing. Charlie insists it's not his time to die; he's not ready. Mack finds Charlie's thinking to be arrogant, but allows that it does sound like there's something Charlie needs to figure out before he dies. Gavin finds Maggie in the lounge, studying for her boards. When he gifts her with coffee and a snack, Maggie says, "This is not on." What she means is that their kiss was a mistake. Even though they've been good friends for five years, she's not in love, and she's seeing Joel, after all. Gavin leaves her be, but it's clear he's not entirely sure she's telling the truth - or at least the truth he wants to hear.
Zach pages Joel to consult on a new patient, paraplegic Nadia Bird, who fell out of her wheelchair and broke her arm at choir practice. After Zach resets the bone, Joel checks Nadia's legs, surprised when she registers pain in her foot - which should be impossible. Is she faking the discomfort or is there something more?
Four years ago, Charlie, Mac and Dawn puzzle over Bea's X-rays and test results, which indicate a mysterious fluid and lymphoma, as Alex looks on. When Alex suggests draining the fluid, Dawn dismisses her, but Mack and Charlie have to admit Alex is right; it could help, and they could do a biopsy at the same time. Now it's time for Alex to step up and perform her first surgery. "I'm not sure that I'm ready to do this," a hyperventilating Alex tells Charlie seconds before making the first cut. Reminding her that Hope-Zee is a teaching hospital, Charlie asks, "You think just a pretty face will cut it here?" After a few missteps, Alex removes two liters of fluid from Bea's stomach (way more than expected), and her first surgery is a success!
Charlie joins Mack in the coffee shop for a discussion about death. Mack wants to understand why Charlie insists it's not his time to die. Maybe it's because he wants to find peace with someone from his past - could it be Dawn? Annoyed, Charlie is just telling Mack to give it a rest, when he notices Bea at the counter. Bea asks for "a large telephone with a shot of vanilla," and seems completely unaware that she's repeatedly asking for a telephone instead of a latte. Charlie figures Bea is dysphasic, which could mean she has a brain tumor - and is going to die if someone doesn't figure out what's going on. Charlie and Mack conclude they misdiagnosed Bea with lymphoma four years ago. Now no one will think to do a brain CT to check for a tumor. Now Charlie wonders if Mack could have been sent to him for a reason other than chaperoning him to the promised land.
Nadia's MRI reveals that she has no spinal injury, puzzling Joel and Zach. Two years ago, Nadia was diagnosed with paralysis from the waist down after the car accident that killed her husband. When Nadia's choir starts singing, annoying Joel, Zach wonders if the feeling in Nadia's legs could be some kind of miracle. Meanwhile, Maggie hangs out with Alex at Charlie's bedside. When Maggie remarks on the special love they share, Alex admits Charlie was her best friend. From the moment they met, he's been the only guy she ever wanted to hang out with. This prompts Maggie to think about her best friend Gavin, just as Charlie begins struggling to breathe.
Joel confronts Nadia with her test results from the time of the car crash. At the time, she had a spinal decompression and everything healed up fine - yet she was still paralyzed - and now she can wiggle her toes. What's the deal - why didn't she get a second opinion? Nadia explains, "I put my faith in the Lord and now he's healing me." Unconvinced, Joel reminds her that it's his responsibility to deliver an accurate diagnosis, which includes figuring out what's really going on with her paralysis.
Alex is happy to report that Bea is healthy and ready to take her trip. Charlie, however, stands in the room and pleads with Alex that something is still not right with Bea's health. Bea admits she has headaches but attributes them to stress and all the vaccinations she's received for her vacation. Alex agrees with her assumptions. Charlie continues to will Alex to ask for a brain scan with no result, just as Bea asks about Charlie's condition. Alex explains that he was in a car accident with no mention of his comatose condition. Bea is just walking out of the hospital when Charlie yells at her to stop - and she does. He talks nonstop, hoping his spirit and energy will propel her to return to Alex. Suddenly, Bea turns on her heel and heads back upstairs to Alex's office. Could this be the break Charlie hoped for?
Finding Alex at Charlie's bedside, Martha delivers devastating news. The judge wouldn't even consider her appeal; they don't care that Charlie's breathing on his own. Having overheard this conversation, Dana asks Alex how she can help. Full of anger, Alex demands Dana take the DNR - which Charlie never believed in - off his chart. When Dana merely shrugs, Alex tells her to go to hell. Alex is crumpled and crying on Charlie's chest when Bea pops in to bring Charlie flowers - which Bea calls shoes. Suddenly, it's perfectly clear to Alex that Bea is dysphasic. After reviewing Bea's test results with Shahir, Alex figures she was misdiagnosed and orders a brain scan, stat. Meanwhile, Dana offers Alex's chief resident job to Reycraft, explaining that Alex is going to need time off to grieve; Reycraft can start immediately.
In a move to keep her friendship with Gavin intact, Maggie invites him to go tray sledding on their next break. Gavin reminds her of the kiss she called a mistake and tells her he "can't do this anymore." Meanwhile, Joel meets with Nadia to discuss her future. After numerous tests, research and consults, Joel has decided that Nadia likely has conversion disorder. After losing her husband in a car accident, Nadia may have processed her grief and trauma in an unusual way, masking their root cause with imagined paralysis. Did she ever talk to a professional about it? "I talked to God every day," Nadia says before breaking down. Joel warns that getting her legs backs won't be easy physically or emotionally. She can however turn to Gavin for support with her emotional issues. And she can take Joel's hand for support when taking her very first step in two years.
Alex and Shahir tell Bea she has brain cancer; her trip around the world will have to be postponed. Heartbroken and shocked, Bea finds little comfort in the fact that with treatment now, she will beat the tumor. Mack and Charlie watch the conversation, and Mack is especially upset with the news. As the oncologist who first diagnosed Bea, he can't believe his mistake. He might have signed Bea's death warrant if it weren't for Charlie! When the lights flicker, Mack knows it's time - for him to move into the light. He's accomplished what he came to Hope Zion to do. Now Mack wants Charlie to push past familiar thinking. Just because his ventilator is off doesn't mean he has to quit breathing. When Charlie asks why this all happened today, Mack insists that it was Charlie's turn to help him, then heads off into the light.
Dawn finds Alex with Charlie in the ICU. A reluctant Dawn caves to Alex's repeated requests to put her hand on Charlie's chest to hear his heartbeat. It has been a full 24 hours since he was taken off the ventilator, and his breathing has changed - it's now strong and steady! Dawn flashes back to four years ago when Alex began her residency. Dawn eavesdrops on a tender moment as Charlie congratulates Alex on a surgery well done. Does it register on Dawn that something more than a teaching relationship is developing? Back in the present, Dawn promises to do whatever it takes legally to prolong Charlie's life, regardless of the mediator's past decision. After kissing Charlie's hand, Dawn tells Alex to take care of him, and Alex promises to do just that. Later, Alex tells Shahir about her new theory - what if they misdiagnosed Charlie, just like Bea was misdiagnosed?