On their way to their first shift since their vacation, Dr. Alex Reid (Erica Durance) and Dr. Charlie Harris (Michael Shanks) are caught in the middle of a shooting. They quickly attend to the victims and arrive back at Hope Zion Hospital - for Charlie's first shift back since being in his coma.
Charlie is ready to get back into his scrubs and into the O.R. to start saving lives, as Alex is quickly swept away to deal with a suicidal teen girl and her own conflicting feelings surrounding a person's will to live. Through compassion and understanding, Alex saves the girl's life, giving her a second chance. In another O.R., Joel (who is now Chief of Surgery), works alongside Dr. Dawn Bell (Charlie's ex-wife played by Michelle Nolden) to perform an intense surgery on a woman with a travelling bullet in her from the shooting.
Meanwhile, Charlie is caught off guard when he quickly realizes that he's still able to see his patient's spirits once he's back in Hope Zion -- a fallout from being in his coma. Charlie still has the capability to help his victim's spirit in order for them to be released from their liminal state - something he was not prepared to deal with. It's an emotional and action packed first day back, where at the end of the day, Alex and Charlie are feeling pretty lucky to be alive and together.