After a long night of being on call, Neela dreams in the surgical call room, musing about the nature of her profession; the hard part is making the best decisions possible and letting go of what you can't control. Neela's pager and phone go off at 5:00 a.m., waking her up. After wishing Ray a happy birthday, Neela runs to the bedside of sickle cell patient Anastasia, who's had a bad night.
Dubenko wants to remove the source of Anastasia's infection -- her gall bladder -- right away. Neela is about to suggest a less risky alternative, but checks herself, earning a lecture from Dubenko on decisions being the hardest part of the job. Neela runs off to schedule the OR, bypassing new tech Ned and the elevator for the stairs, where she passes a monk.
Neela notices Banfield injecting herself in the break room, but doesn't say anything. Gates and Morris tend to Nick Vasquez, who has fallen out a window. Nick is a dream walker; his brain chemistry is off, so he acts out his dreams while asleep and has frequent mishaps. His abdomen is studded with chunks of glass, but Neela doesn't have time to investigate thoroughly. As she leaves, Sam gives Gates a pair of Blackhawk tickets that he bought when they were still together.
Wondering why Banfield is acting so erratically, Morris wishes Neela luck on the attending interviews at the country's top trauma centers that she has scheduled for the afternoon. Jerry has rebuilt Morris' father's Triumph, and insists that Morris take a ride, which ends when Morris is catapulted into a dumpster. Neela promises Anastasia that she'll stay for the duration of her surgery, since she cancelled her interviews, upsetting Dubenko, who pulled strings to set them up.
Banfield lays into Sam for being "nurse-y." Sam points out that patient Nick is stable, and her shift ended an hour ago, and leaves to clock in for her clinical hours as nurse anesthetist. Having just nicked Anastasia's bile duct, Neela isn't happy when Sam steps in -- the risky surgery demands an experienced anesthetist. Dubenko threatens to throw them both out, as Anastasia yanks out her breathing tube and wakes up. Looking at her splayed gut, Anastasia screams her head off.
Once Sam is cleared of fault for Anastasia's wakening, Neela has a newfound appreciation for her competence. Nick crashes and the ER calls for a surgeon, but Neela can't leave Anastasia, who's also crashing. Banfield insists on taking Nick for an angio, when his case seems to call for a CT. Despite repeated shocks, both patients die on their respective tables. Morris lays into Banfield for missing Nick's belly bleed, and Neela kicks herself for not fighting to keep Anastasia out of surgery.
Neela steps into the elevator as Morris lays into Banfield, accusing her of refusing to be part of the team. If Banfield wants to be queen, she should go back to private practice or quit. Banfield tosses Jerry her badge and tells him to turn it in to HR -- she's quitting. Neela chases Banfield into the parking lot, asking her what's really happening. Does this have something to do with the injection? Wanting to be left alone, Banfield stalks off.
Neela's phone rings: will she come sign Anastasia's death certificate? Hanging up, Neela throws her phone to the ground, landing at Brenner's feet. Brenner is overjoyed to see Neela after returning from his Australian vacation, but even his offer of a mini didgeridoo can't cheer her up. Explaining that Banfield just quit and she helped kill two patients, Neela slumps off.
Just as in the opening scene, Neela sleeps in the surgical call room when Ray calls and her pager goes off at 5:00 a.m. But this morning is different. Instead of backing off, Neela asks Dubenko to wait one more day before Anastasia's surgery. Maybe she can beat her infection. Neela's surprised when Dubenko agrees, explaining that now that she's about to become an attending, he needs to start listening to her.
Neela takes the elevator with Ned, who offers Zen wisdom: sometimes choosing inaction is an action. Neela confronts Banfield in the break room -- what is she injecting herself with? Banfield claims it's none of Neela's business, but Neela insists that any drug Banfield takes is her business; they're on the same team. Banfield admits that she's injecting hormones, which is making her erratic and nastier than usual. Fed up with hormones, Banfield wonders if she should quit the ER.
Banfield stuns Neela with news that Dubenko is whining at the prospect of losing her, even if he did set up her interviews. According to Banfield, Dubenko has been grooming Neela for a faculty position. Neela scans Nick's belly, but finds no sign of internal injury. She tells Dubenko that she wants to cancel her interviews. And if he wanted her to stay at County, why didn't he ask? Dubenko claims they can't talk seriously until Neela is aware of all of her opportunities.
Dressed in a suit, Neela runs into Gates at the Jumbo Mart. She admits to feeling badly for underestimating Sam; Gates should never have broken up with her. Gates explains that he's trying to lay low, then picks up a call from Daria. Neela's phone falls at Brenner's feet. Neela confesses that she has no idea what she wants from life; it's hardly the time for job interviews. Brenner maintains that Neela doesn't have to know where she's going; she just has to keep moving forward.
Neela opens a door to interview for a position at Duke University and is surprised to behold Corday. As the interview gets underway, it's clear that Neela's goals for the future aren't well defined. Corday advises her to leave County; at some level the faculty will never take her seriously. When Neela's pager goes off, she cuts the interview short. Clearly, her heart is back at the hospital with Anastasia.
As Neela runs back to the hospital, both Nick and Anastasia take drastic turns for the worse. Morris is just insisting that Banfield send Nick for a CT when Neela runs by, confirming Morris' diagnosis. Dubenko is performing CPR on Anastasia when Neela arrives at her bedside. As mom Sheila begs Anastasia to hold on, Neela takes over compressions. Nick goes into full arrest in the scanner, and Anastasia fails to resuscitate.
Neela begins her day at 5:00 a.m. for the third time. Her dreams tell her that sometimes there's nothing you can do for a patient, no matter how hard you try. Again, Neela meets Dubenko at Anastasia's bedside to plan gall bladder removal. Neela offers a third strategy. Percutaneous drainage is an unlikely solution, but it might help Anastasia beat her infection without surgery. Dubenko immediately agrees; he needs to start listening to Neela.
Finally remembering to call Ray on his birthday, Neela runs into the break room, failing to notice Banfield injecting herself with hormones. Gates calls Neela onto Nick's case. Neela opts to do a quick procedure, which identifies Nick's internal bleeding, and makes her late for Anastasia's procedure. After agreeing to schedule Nick's surgery, Gates asks Sam if he can take Alex to the Blackhawks game. Sam agrees to think about it.
Anastasia's procedure goes well. Dubenko insists that Neela cut out early to attend her interviews. After weighing her options, he hopes she'll accept an assistant professor position at County -- her official letter will arrive in a few weeks. Speechless, Neela leaves when Dubenko advises her to shut up and go. Neela bumps into Gates on the street, and advises him to give Nick another ultrasound.
Neela drops her phone at Brenner's feet, just as Jerry presents Morris with his refurbished Triumph. Brenner borrows the motorcycle to escort Neela to her interviews. Outside the hotel, he admits to missing her and moves in for a kiss. Neela lingers for a hot moment then runs into the hotel, admitting that she missed Brenner, too.
An hour before his surgery, Nick passes out. After a great interview, Corday escorts Neela through the hotel lobby to meet Brenner. Corday advises Brenner to take Neela out for champagne, but he has other ideas, and a room key. Neela and Brenner enjoy a little afternoon delight as...
Gates performs CPR on a crashing Nick. In a fit of hormones, Banfield calls for a thoracotomy tray, refusing to lose another patient for want of an OR. She intends to clamp his aorta herself. Shocked, Gates and Morris fall in line to assist. Neela dresses to return to the hospital to check on Anastasia. Brenner advises her to have an intern do it, and pulls her down for another snog.
Neela runs to the hospital just as Nick is bleeding out. She tells everyone to meet her in the OR and rushes off. Sam thanks Gates for offering to take Alex to the hockey game. Relieved to find Anastasia cheerful and awake, Neela finally allows Anastasia to tell her future -- actions are the seeds of fate. Suddenly, Neela's phone rings at 5:00 a.m., waking her up for another day in the ER...
