Alex (Erica Durance) is taking a cardiac course in the pig lab, led by Charlie's ex-wife Dawn (Michelle Nolden), when her nerves end up getting the best of her. Dawn is quick to capitalize on the opportunity to call Alex out, which doesn't set them off straight for the rest of the episode.
It's only when they end up sharing a patient with cardiac problems that Alex must swallow her pride, be the better person, and figure out how she can not only work with Dawn - but learn from her as well, for the interest of their patient. Similarly, Joel (Daniel Gillies) finds himself still learning to tread water as Chief of Surgery at Hope Zion Hospital.
At first, his ego wins out, but near the end Joel looks to Charlie (Michael Shanks) for advice on a patient with an extremely rare bone disease. Meanwhile, Charlie connects with a comatose patient who is seemingly never waking up. Through dealing with the patient's spirit and getting some helpful advice from Gavin (Kristopher Turner), Charlie helps his patient beat all odds.