Standing beside Charlie in the ICU, Alex and her co-worker Shahir still can't believe the progress being made on his health. What began as a diffuse axonal injury has completely resolved. Alex has complete faith Charlie will be on an upward spiral for quite some time. The ghost of Charlie, however, thinks otherwise. He doesn't want Alex to settle and demands she dig deeper into his physical condition to find out why he's not waking up. Meanwhile, Dana is busy working when Bryan Travers, the hospital's administrator, visits to discuss Charlie's future role at the hospital. Since there's no reason to think he'll wake up any time soon, it's time to find a replacement chief of surgery. Bryan tells Dana to apply, saying the hospital board wants her "in the mix." When Dana asks if applying is merely a formality, Bryan will only say, "It's a process."
It's especially busy in the emergency room as Maggie and Zach receive Kendra, a TV therapist and host, who's unconscious. According to her assistant Kate, Kendra is a very spiritual person who wanted to expand her mind. Her mistake was thinking she could grow her mind with the help of mushrooms. Even though she has heavy bleeding on her forehead, doctors are most concerned about Kendra's potential liver failure, and send a sample of the mushrooms off to a mycologist for identification. When Kendra starts seizing, the doctors fight to save her life as her spirit walks through the hospital, where she meets Charlie. It's the start of a long "trip" for two patients struggling to survive.
Joel is about to perform another surgery, with Dana and Victor ready to assist. Before he makes the first incision, he drops his tool to the ground and realizes he simply can't perform the operation. He walks out of the operating theater, visibly upset that his broken hand is cramping up and not completely healed. Luckily, another surgeon is able to step in to complete the procedure. Soon after the surgery, Dana invites Joel to her annual CME, a learning conference for surgeons in her hometown of Elsinore. She argues it could be a good road trip for the both of them, and a much-needed break for Joel.
Alex appears to be handling her demotion better than expected. After having a professional conversation with Dana, she runs into Reycraft and congratulates him on his promotion. He thanks her for the kind words but surprises Alex with his arrogance. The workday continues. Alex meets with Doug after his gastric bypass for a routine checkup. Doug is elated to have lost 125 pounds, but his boyfriend, Richard wants him to explain a recent weight-lifting accident. Doug claims a bar fell on his chest at the gym awhile back, causing a bit of swelling and discomfort. After spying nipple discharge, Alex seeks Zach's opinion, then asks Doug if he's been using steroids. Defensive and agitated, Doug swears he's clean. Taking his word for it, Alex asks to run more tests and Doug agrees.
Joel runs into Maggie on his way to meet up with Dana for the road trip. Understandably, Maggie questions the reasons behind the road trip. Is it really a work-related vacation or does Dana want the newly posted chief of surgery job? Joel smiles, kisses Maggie, and heads off. On the drive, Joel and Dana discuss the chief surgery position. Joel thinks it was wrong of the hospital to post the position; by rights it should go to Dana, who's been doing a great job. When the road trippers arrive in the small town of Elsinore, they're greeted by Dana's old friend Stephanie, and Dr. Ronnie McBride, who mistakes Joel for Dana. The awkwardness goes away quickly when Dana claims this happens to her all the time, since her name can go both ways.
The spirit of Kendra is shocked to discover she is in fact dead from her reaction to eating mushrooms. She asks Charlie what will happen once she wakes up from this experience in 12 hours or so? Charlie assures her that she won't wake up, but since she's sticking around, there must be a reason why. Upset and ashamed, Kendra tries to explain why she tried the deadly mushrooms. She was unhappy about the direction of her show; no one was taking her seriously as a psychiatrist. The last straw was when one of her most recent shows was dedicated to celebrity baby names - which seemed so far away from her original intention of helping people. Suddenly a light goes off. Kendra pivots her attention to Charlie's brain injury. Perhaps he too has unresolved issues...
Back in Elsinore, Joel helps Dana with her surgery lecture and case studies. Dana is surprised at the fact that only one female is a part of the hospital. In addition, one male doctor tries to challenge Dana during her presentation, but proves to be unsuccessful. During a break, Dana confronts Ronnie about why there are so few women on his staff. Ronnie claims he wants his surgeons to stay on the job for many years. He explains that it's hard to recruit women to a rural hospital. Besides, women want to have kids, and once they do, they don't return to work. Unconvinced, Dana reminds him she has two kids of her own and makes it work, accusing Ronnie of discrimination. Ronnie insists Dana doesn't understand, and ends the conversation after receiving an emergency phone call. When Dana inquires about what happened, Ronnie invites her and Joel to assist at the scene of an accident downtown.
On Elsinore's Main Street, a woman lies trapped and bleeding under a tow truck. As Dana walks up to the woman, who's struggling to breathe, she's shocked to recognize her good friend Stephanie. The nearest ambulance is expected to arrive in 15 long minutes, which is way too long. Joel remarks that the heavy truck is acting as a tourniquet, preventing Stephanie from bleeding out, and Dana calls for a crane to move it. The doctors race to perform a needle crike (intubating Stephanie's throat with oxygen) in order to buy her 20 minutes, just as Joel realizes that one of her legs has already been partially amputated by the truck. In an unexpected twist, Emma, Stephanie's teenaged daughter, rides up on her bike shocked to find her mom struggling to survive.
Alex meets with Doug to discuss a possible diagnosis of his condition: breast cancer. The next step is a tissue biopsy. Since breast cancer is usually found late in males, they need to move as quickly as possible. Once he hears that he's tested positively for the most common form of male breast cancer and will need a mastectomy at the very least, Doug questions whether or not Richard will stay with him. After 10 years of working out to try to win Richard's heart, Doug is certain that he'll walk away now. Nevertheless, Alex and Doug agree to move forward with the mastectomy immediately. In the meantime, the friction between Alex and Reycraft increases after she finds him yelling at a doctor for being five minutes late to work. When she suggests Reycraft do his scolding in private, Reycraft walks off, demanding Alex not to tell him how to do his job.
Charlie continues his walk with Kendra, who wants to talk on a much deeper, emotional level. Clearly, he's never experienced therapy before, and as a surgeon, he thinks the reason he won't wake up is solely due to his brain injury. When talking doesn't seem to reveal any answers as to why Charlie is stuck in between life and death, Kendra suggests bio-energetics, a body-based therapy, and begins pushing Charlie in the chest in hopes of getting him to dig deeper. After a few hard slaps, Charlie confesses in a loud, angry voice that he may not want to wake up. It's the breakthrough Kendra has been looking for. The next step, however, is to find out why.
The ambulance finally arrives on the scene, but it's going to take another 45 minutes for a crane to arrive to lift the truck to release Stephanie's lower legs. As Stephanie loses consciousness and starts bleeding out from God knows where, Dana isn't sure what to do in this unique situation. After consulting with Joel and Ronnie, Dana decides they have to amputate her friend's legs in order to save her life. When everyone starts arguing, Dana insists hers is the right course of action, and she's making the call. She's not about to let a woman she's known her entire life die on the street. In order to amputate Stephanie's leg, the final step is to cut the femur. Once Dana finds out a saw isn't available, she orders Joel to find something elseâ�¦ quickly! Joel returns with a set of bolt cutters and steadies himself to make the final cut. It's a success, and Stephanie is rushed into the waiting ambulance.
After a long, stressful day, Joel and Dana head to a local bar to unwind. Dana's thrilled when Ronnie calls with the good news that Stephanie will survive, but the whole business has prompted her to question her various life roles. Dana knows she's a good mother and surgeon, but what about a good friend? She wanted to call Stephanie earlier in the day, but wasn't able to. And while she was the only one able to make the tough call in today's emergency - what does it get her besides a reputation as a ball buster? Joel interrupts and tells her what she did was inspiring. He moves in closer and confides that what she did was monumental, dangerous and actually very sexy. With little hesitation, Joel leans in for a passionate kiss, and the couple heads for the hotel... together.
On the drive home from Elsinore, the mood is awkward as Dana and Joel keep quiet after their sexy evening. Joel strikes up a conversation and says what happened the night before was great, but likely only a one-night event. Dana shakes her head and agrees to move on. Joel does, however, thank her for the trip. When Dana also thanks Joel, he asks for what reason. She simply smiles and continues driving. Back at the hospital, Joel is reunited with Maggie, who asks about the trip. Joel tells her about the leg he helped amputate, but omits the juicy details. They share a quick kiss and head back to work.
Alex visits Doug to check on his surgical wound. But just as she's lifting off his bandages, Richard shows up. Doug tells Alex he doesn't want Richard to see his breast, but Richard reassures him, promising he'll never leave Doug no matter how sick he gets. Later, Alex runs into Tom, who's cleaning surgical lube out of his shoes. He admits most of his co-workers hate him now. Compared to his usual confident, cocky self, Reycraft seems discouraged, so Alex offers her advice. As boss, Reycraft has been laying it on too heavily. If Reycraft wants to buy Alex a cup of coffee, she has more wisdom to impart, and no, this doesn't mean she's ready to turn over the chief resident position to him forever.
Bryan is in with Dana to see how her application is coming along for the chief of surgery position. Dana shocks Bryan - she's not applying for a job that she's already doing, and doing really well. She reminds him that she's worked her ass off at Hope-Zee for 15 years. He can consider her application to be her performance as interim chief of surgery over the last three months. And if that doesn't work for him, Dana says, then good luck finding someone to replace her.
Kendra acknowledges that she has unresolved business to attend to before moving on, then begs him to submit to another attempt at therapy. What is Charlie afraid of? What's the source of all his pain? Charlie flashes back to a night spent in bed with Alex. After she promises never to leave him, Charlie opens up about losing his parents in a car accident when he was only six years old. For one year after the tragedy, he shut down, and didn't utter a single word. As his heart begins to beat faster, Alex assures Charlie she isn't going anywhere. After hearing this story, Kendra explains that if his mind doesn't want to wake up, he needs to fight it, and figure out why. He's got to open up and be brave, look at the parts of himself that he's hidden to keep himself safe. When Charlie thanks Kendra, admitting she's helped him, she disappears into the light.