After a major turn of events, Alex is faced with a monumental question: is her life now changed forever? Meanwhile, Joel is in a race against time to save a young patient from rapidly advancing flesh-eating disease.
Following the events of the night before, it's a new game at Hope Zion. The fate of Alex and Charlie's relationship may have now been decided and Alex, with the same spirit that once made her Chief Surgical Resident, takes charge of the situation - pressing onward. But while charting the course of her own life, Alex is faced with the grim task of telling a bride-to-be that she is going to die.
Alex and Shahir bring Charlie to the O.R. for a last resort procedure, but Charlie must first face his past before he can wake up. Meanwhile, Joel performs a risky surgery on a female jockey and Gavin crosses the line when he meets an Alzheimer's patient.
When Shahir tells Alex that Charlie is still a six on the Glasgow Coma Scale, she is not ready to give up the fight. She asks Shahir to perform Deep Brain Stimulation on Charlie - an extremely experimental procedure that could cause brain damage. As the electrodes reach Charlie's thalamus, Shahir begins to crank the voltage - and Charlie finds himself launched into visions of his past.
When a plane is forced to land due to a sick passenger, the patient is taken to Hope Zion where Alex performs emergency surgery and discovers that this passenger may have brought a deadly and contagious virus into the hospital.
When a passenger on a Denver-bound flight becomes seriously ill, the plane is forced to land and the passenger is rushed to Hope Zion. After an emergency surgery, the patient dies. What happens next shocks the staff of Hope Zee: the doctor who accompanied him off the plane starts showing similar symptoms. Alex discovers that these two passengers have brought a deadly and contagious virus into the hospital.
When Joel gets cold feet in the OR, Kinney takes him with her on a Continuing Medical Education assignment in her hometown to help clear his head. During their field trip, a woman gets pinned underneath a truck and Joel and Kinney lead the rescue effort. Meanwhile, Charlie meets a newly deceased therapist who suspects it's an emotional block that is keeping him in his coma. Encouraged by Charlie breathing on his own, Alex continues her rounds and diagnoses a fitness buff with a rare condition.
Returning to the OR for the first time since breaking his hand, Joel lifts the scalpel, leans in and...completely freezes. He leaves the OR, claiming his hand is compromised, but Kinney knows Joel's problem isn't physical. Kinney decides that Joel needs to get away from the hospital, and invites him to come with her on a CME (continuing medical education) expedition to her hometown of Elsinore.
With Charlie removed from his ventilator, all he and Alex can do is wait and ask themselves: is this really it? But when a patient comes in for a routine follow-up, her new symptoms could lead Alex and Charlie to making a discovery about Charlie's coma. Meanwhile, Joel cannot operate after breaking his hand, and Maggie and Gavin deal with the aftermath of their kiss.
Charlie's ex-wife, Dawn, has pulled the plug on his ventilator. All that's left now is to wait for his breathing to stop. Devastated, Alex vows to stay by Charlie's side. Meanwhile, Charlie - resisting his death - bumps into Mack MacIlreath, a recently deceased colleague, who has come to help Charlie die. Alex decides to lawyer up and appeal to the Consent & Capacity Board.