A truck slams into a coffee bar moments after head nurse Carol Hathaway (series star JULIANNA MARGULIES), six months pregnant with twins, leaves it. At Chicago's County General Hospital, attending physician Dr. Mark Greene (series star ANTHONY EDWARDS), gifted British surgeon Dr. Elizabeth Corday (series star ALEX KINGSTON), er surgical trauma fellow Dr. Peter Benton (series star ERIQ LA SALLE), ambitious attending physician Dr. Kerry Weaver (series star LAURA INNES) and senior resident Dr. John Carter (series star NOAH WYLE) treat the accident victims. Rumors circulate that Chief of Staff Dr. Donald Anspaugh (recurring special guest star JOHN AYLWARD) wants to return to performing general surgery and appoint obnoxious Dr. Robert Romano (series star PAUL McCRANE) to replace him. At a meeting with department heads plus Anspaugh and Romano, Greene voices his reservations about Romano as Chief of Staff. But when other department bosses support Romano, Weaver expresses her endorsement as well. Romano gets the job and appoints Weaver as the permanent head of the er.

Because of her new appointment as chief, Weaver tells fourth-year medical student Lucy Knight (series star KELLIE MARTIN) that she can no longer mentor her. She also informs Carter he must move out of her basement apartment. Later, Carter has a rendezvous with Elaine Nichols (recurring special appearance by REBECCA DE MORNAY - "The Hand That Rocks the Cradle"), the former wife of one of Carter's cousins.

Physician Assistant Jeanie Boulet (series star GLORIA REUBEN) and second year pediatric er resident Dr. Cleo Finch (series star MICHAEL MICHELE) treat an end-stage AIDS patient whose 9-month-old son is also HIV positive. Jeanie's boyfriend, police officer Reggie Moore (recurring special guest star CRESS WILLIAMS), proposes marriage. Croatian transplant Dr. Luka Kovac (series star GORAN VISNJIC) impresses Hathaway with the gentle way he treats a young patient. Benton and Carla (recurring special guest star LISA NICOLE CARSON) attend a meeting with a family mediator concerning their son, Reese. Greene's mother dies.