Greene's 37-year-old Down's syndrome patient, Louise (LOUISE C. BROWN), needs a heart transplant. In the past, hospital therapist and transplant committee member Dr. Nina Pomerantz recommended not to put Louise on a waiting list. Greene argues with Pomerantz, but the patient's elderly mother supports the decision because she does not want her daughter to outlive her and be left alone.

Meanwhile, Jeanie wants to do something spontaneous and asks Fischer to attend an opera with her. He treats her to a picnic in very cold weather. He suggests they make love, but Jeanie wants to let the relationship develop slowly.

Cystic fibrosis patient Jad Houston signs a "do not resuscitate" order upon reaching age 18. Ross removes him from the respirator, and Jad survives. Also, Carter disagrees with Anspaugh's diagnosis and is proven correct, impressing Anspaugh.