On Halloween night, Greene escorts an arrogant candidate for chief of emergency services, Dr. David Litvak (PHILIP CASNOFF - "Sinatra"), around the emergency room. Greene later divulges to Weaver that, even though Greene voted for her, Litvak has been elected as chief. Greene neglects to order a pregnancy test on an unmedicated schizophrenic mother-to-be, Coco (recurring guest star SHEILA KELLEY - "L.A. Law"), and administers a drug that can cause birth defects. To add to his terrible day, Greene discovers that his ex-wife, Jennifer (recurring guest star CHRISTINE HARNOS), and his daughter, Rachel, plan to relocate to St. Louis, Missouri. Greene realizes he's become very devoted to Rachel in the summer she has been with him.

Ross enacts strict policy procedures for the pediatric emergency room that become impossible to enforce due to the huge volume of patients. Ross relents and allows Weaver to work on some of his patients. Weaver asks Carter to give a presentation the following day on one of his former cases. Carter shares responsibility for Lucy's inability to start an IV and is no longer mad at her. He places Lucy in charge of the Halloween party at the dormitory so he can do research for his presentation. But trouble occurs when two medical students take drugs with alcohol and almost die. Once again, Carter is disappointed in Lucy.

Test results surprise Benton, Romano and Dale when Corday reports that the little girl they are operating on is genetically a boy. Later, Corday, anxious to celebrate Halloween, gets a pleasant surprise from Benton, who dresses like the '70s film character John Shaft for a special date.