Already in a bad mood, Kinney tracks Joel down in the hallway. She's just gotten off the phone with Hope Zion's lawyer, who just settled the lawsuit with Shawn Price, Joel's first patient at the hospital; it cost the hospital a lot of money. So even though Joel was trying to make the best decision for his patient - saving his arm - in future he is to consult Kinney before making any such controversial decisions. Charlie sits by as Alex and Shahir argue over his prognosis. Alex pushes for experimental deep brain stimulation, which Shahir has performed successfully in the past on patients with Parkinson's, creating a wakeful state. Maybe this technique could help Charlie wake up? Shahir admits it's possible; however, the process could cause brain damage. Nevertheless, Alex is confident it will work and asks Shahir to book an OR.
In the ER, Reycraft introduces Joel to patient Stacey Harrison, a jockey injured in a fall at the racetrack. Stacey's used to breaking bones, so she already knows her pelvic ring is fractured. After some morphine, Reycraft helps Joel stabilize Stacey's pelvis, an agonizing procedure, then sends her upstairs for a scan. In the ICU, Charlie talks to his comatose body. It's Hail Mary time. After deep brain stimulation, there's nothing left to try.
Gavin and his mentor, Dr. Druckerman, interview elderly Ester and Roy Goldbach. Roy's feisty, but he's suffering from Alzheimer's, and it's time to take his driver's license away. Roy's not happy because he believes he's still working at his downtown clothing store, and Ester doesn't drive. When Gavin suggests giving the Goldbachs more therapy time and using alternative techniques, Druckerman won't hear of it. If Gavin really wants to help, he'll call the Goldbachs a taxi. On the way out of the hospital, Gavin and the Goldbachs run into Maggie, who puts a spark in Roy's eye. Gavin decides to go against protocol and give the Goldbachs his personal phone number. When Maggie asks why, Gavin explains, "Last time I checked, it wasn't against the rules to care."
With Charlie in traction in the OR, Alex watches Shahir bore a hole into his skull. Later, Maggie's sitting in the break room, listening to Gavin flirt with another woman on the phone. Maggie immediately assumes he's talking to his new girlfriend and starts giving him the third degree. Gavin's phone rings again. It's Ester. When they got home from the hospital, Roy decided he needed to drive to work, so Ester hid the car keys. Now Roy's going crazy, and Ester doesn't know what to do. Gavin advises her to return to the hospital, but Ester doesn't think she can manage Roy and hangs up. Gavin's first impulse is to go to the Goldbachs' home, but he's still on shift and not supposed to leave the hospital. But when Maggie encourages him to go, he does, and she decides to go with him.
Joel visits Stacey to confirm what she already knew: she has a bad pelvic fracture. He advises her to go conservative, with six months of physiotherapy, but she's got a big money race coming up in two months, and wants the surgery that will put her back on the track in six weeks. And she doesn't care about the risks - if she misses six months, her career will be over. Joel finally caves to her pressure and books an OR. Ester is thrilled to open her door and find Gavin, who suggests trying a new technique: letting Roy believe what he says is true. Meanwhile, Shahir has inserted a rod into Charlie's thalamus and is ready to begin stimulating it. He tells Alex to get lost while the "brain nerds" do their thing; this is going to take a while.
The brain stimulation prompts Charlie to flash back to his childhood, just after the accident that killed his parents. Concerned that he has stopped talking, his aunt and uncle take him to the doctor, who assures them Charlie has no physical problems. Later, Charlie hides in a barn during his parents' funeral party. When his aunt and uncle come looking for him, Charlie eavesdrops on their conversation. Charlie's uncle in particular is concerned that young Charlie is a weirdo whom they won't be able to take care of.
Ester agrees to play along with Gavin. Since Roy used to own a clothing store, Gavin pretends to need a new suit. Roy responds instantly. Playing along, Esther claims that another employee is holding down the store - it's Roy's day off. Pretty soon, everyone's laughing and enjoying coffee - until Roy suddenly blanks out in the middle of the conversation and starts looking for his car keys once again. Ester is devastated when he doesn't recognize her. Telling Gavin she can't pretend any longer, she grabs Roy and reminds him they've been married for 50 years. Roy becomes agitated, knocking Ester to the floor. Maggie quickly realizes Ester has a broken hip, and Gavin calls 911.
Joel operates on Stacey, surprised to find a ton of scar tissue. Suddenly, he realizes that he has nicked an artery. He immediately calls for massive blood transfusion protocol and has Alex join the team to sew up Stacey's aorta. After the surgery, Alex and Joel proceed to Kinney's office to explain. Stacey had a freak artery in a place they never could have known. The bleed made her hypotensive, and she basically had a "heart attack of the spine," rendering her paralyzed from the waist down. Alex pleads Joel's case, but he acts guilty, taking responsibility for nicking the artery. Kinney angrily demands that Joel clear every single one of his surgical decisions with her for the foreseeable future. Afterwards, Joel tells Alex his instincts have gone down the toilet since he started working at Hope Zee.
Gavin and Maggie escort the Goldbachs to the emergency room. Roy is devastated when reminded that he was the cause of Ester's broken hip. If another guy did something like that, Roy would lock him up, which is pretty much what's about to happen to him. An angry Druckerman orders Gavin to his office on the double, to dress him down for all the rules he broke over the course of a single day. Now he's going to have to tell Ester about the consequences of his actions. Later Gavin thanks Maggie for going with him to visit the Goldbachs, even though it was a disaster. In a total non sequitur, Maggie tells him to dump his girlfriend and gives him a kiss. "We'll be together 60 years!" She promises.
Shahir pages Alex to the OR. It's been hours, and there's been a lot of activity, none of which has made Charlie wake up. In fact, Shahir's not sure what's happening, and he doesn't like it. Alex wants him to try stimulating another area of Charlie's brain - it's their last shot; his life can't be over! Shahir claims it's too dangerous and decides to take the electrodes out. Later, Gavin finds Alex sitting in the atrium, reeling from another failed attempt to resuscitate Charlie. When she claims she has no more fight left, Joel insists that she does. Alex returns to the OR, demanding Shahir keep going - even if there's a chance it could kill Charlie.
Joel stops by Stacey's room, surprised to find her awake. He confesses that he shouldn't have operated on her. Though there is a chance she'll walk again, Stacey is fully aware she'll never ride again. Nevertheless, she doesn't seem to blame Joel for following his instincts. She didn't follow hers during her last race, which is how she got hurt in the first place. Meanwhile, Charlie is still not waking up, despite a dangerous level of stimulation. Dressed in his tux, Charlie finds himself in the barn, asking his younger self, "Why don't you want to wake up?" As he relives his parents' accident yet again, Shahir and Alex notice wildly increased brain activity. Something is happening in Charlie's brain - but what?
Gavin visits Ester to deliver sad news. Roy needs 24-hour care, in order to ensure the safety of both of them. Ester fights - she wants to take Roy home! Gavin explains that the next time something happens, they'll be obliged to call the police, and Ester surely doesn't want to surrender Roy to the system. When Ester begs to spend one last night with her husband, Gavin agrees to break protocol for the umpteenth time today. Later, Maggie finds him to ask if he wants to grab a beer. What Gavin prefers to do is kick off his 60 year life together with Maggie on the best possible foot.
It's late at night when Joel visits Kinney, asking her to let him do his job. If she can't allow him make his own decisions, she should fire him. Kinney refuses to fire him, but she won't let do whatever he wants either. Joel says, "I quit," and walks out. Back in the OR, Shahir keeps upping the voltage on Charlie's brain. Charlie finds himself standing in his tux beside the crashed car his parents died in. A police cruiser pulls up, and Officer Jimmy Howard (who recently committed suicide in the Hope Zion parking garage) gets out, promising to take Charlie "home." Charlie is about to get in the car, when he hears Alex's voice calling - she is Charlie's home. Charlie takes off running. Suddenly, he's back at the hospital, staring at his body on the operating table, just as his eyes finally open, and he utters a single word: "Alex."