Frank tells Sam that someone named Kelly called for her, but Sam instantly gets busy. When Gates offers to help, she points him towards a proverbial lost condom case. Meanwhile, Chuny almost snags Brenner and Neela sharing a tender moment in the break room -- there's a trauma case coming in.
In the ambulance bay, Morris consults Gates: after dating Claudia three times, he's just not sure if she's into him. Gates admits he's not the one to ask, just as a disoriented old man falls into Grady's arms. Oliver knows his name, and that he's at the hospital, but has no wallet or ID. Morris thinks Oliver has been mugged and has Chuny call the police. Oliver experiences everything in muted tones, seeing the ER as it would have appeared in 1968.
Morris wants to order all kinds of tests. Gates insists Oliver's problem is metabolic -- he needs fluids -- so Morris tasks him with escorting Oliver to his scans. Gates smashes into Sam on her way in with Donna, who's suffering shortness of breath after a recent lung cancer diagnosis. Her son Dylan has her medical records in hand. They're hoping that surgery followed by chemo and radiation will prolong Donna's life. Since Donna's too sick to move, Brenner decides to consult surgery.
Despite her condition, Donna insists that Dylan make his audition in a few hours. Officer Hollis comes in looking for Oliver. He's aware that Morris has been seeing Claudia, a fellow cop, and warns him not to break her heart. Gates returns with Oliver, who's still locked in 1968. Oliver is dry as a bone and needs to be carefully rehydrated. Sam calls Morris to see Damien, who arrives in the ER in a negative pressure ventilator with his wife Corazon, an RN.
Damien's lungs were damaged by a case of polio at three years old, and now Corazon thinks he has appendicitis. Sam and Gates aren't sure how to go about their tests; Damien indicates hand ports on the side of his tank. Sam and Gates exchange looks as Corazon informs them that Damien spends 18 hours a day in his ventilator, and they've spent 45 happy years together.
Brenner consults Neela on Donna's case. Neela digresses -- Yale is pressing her for letters of recommendation, and she's unsure that Dubenko wants her to stay at County. Dubenko walks up, shocked to see Donna's screens, and immediately asks to see her. Dubenko tells Donna and Dylan that her tumor is far too advanced for surgery, and her body is riddled with cancer, which has progressed into the bone.
Brenner tries to pull Dubenko back, but he asks Donna if she's thought about life support. Donna informs him that she signed a DNR ten years ago. When Dubenko suggests she explore hospice, Brenner finally pulls him into the hall. He asked for a surgical opinion, not the grim reaper. Dubenko demands to know whether Brenner wants him to lie. Caught in the middle, Neela offers the idea of a thoracentesis as a way to offer Donna some positive relief.
Sexy Kelly makes herself at home in the break room, making coffee and flirting with Gates. He's just turned down her offer of dinner when Sam enters, stunned to see her long lost little sister. Sam promises take a break so they can catch up, as soon as she ties up a few loose ends. She heads off to attend Neela, who's draining pink fluid out of Donna's back with a catheter.
Feeling much better, Donna insists that Dylan leave for his audition. He plays English horn, and this is his one chance to get into Juilliard. Dubenko advises Dylan to stay -- Donna's condition could plummet at any time. Brenner claims this is unlikely, but mother and son are scared. Gates discovers that Oliver has gone missing, just as Dubenko calls Sam to Damien's consult and Morris sends her on an EMT run. Kelly will have to wait.
Sitting in the ambulance bay, Oliver continues to see things via 1968, as April is brought in, having passed out when arrested for shoplifting make-up. Meanwhile, Neela performs an ultrasound on Damien; he'll need an appendectomy, which will mean cutting into the abdominal muscles he needs to breathe. Damien's scared that he'll risk being traked for life; Dubenko promises they'll do their best.
Neela plugs NOTES, an experimental non-invasive surgical technique used by a Dr. Horta, which would entail removing Damien's appendix through his mouth. Skeptical and sarcastic, Dubenko dares Neela to call Horta and set it up for today. Officer Jeffries watches while Morris and Gates explain that April passed out because her diabetes went out of control. April tells Jeffries that she's innocent. She needs to be home for her very pregnant daughter Kendra, who's been put on bed rest.
Gates wheels Oliver back to his bed, having found him outside, barely conscious. Gates and Morris prepare to intubate as Sam helps Donna, who is short of breath. Kelly interrupts -- she can't wait on Sam any longer. Gates introduces Sam's sister to the crew and tells her to take a break. Hollis walks in, having busted a mugger with an empty wallet and a retirement watch from County. Maybe Oliver used to work in the hospital.
Sam and Kelly catch up. It's been 15 years since Sam left home at 15. Having just sold her clothing collection for $2 million, Kelly's schedule is about to get very hectic and she needs to talk about their mother, who's just had a stroke. Since she'll be traveling a lot, Kelly wants to move mom to assisted living in Chicago. She'll pay for everything, all Sam has to do is visit. Sam wants no part of Kelly's plan.
Both Oliver and Donna take a turn for the worse. Morris and Gates opt to intubate Oliver, and Brenner wants to intubate Donna. Furious, Dubenko counsels against intubation, citing Donna's DNR. Since Donna's condition isn't surgical, Dubenko grabs Neela and leaves Brenner to do a non-invasive procedure on his own. Brenner is just deciding to intubate anyway when Dr. Horta arrives to operate on Damien.
April explains herself to Sam and Morris. Ever since she got laid off, she's had no money for insulin, since she's trying to buy stuff for Kendra's baby. Thus she steals make-up from the drug store, then returns it for store credit so she can buy her insulin. Morris calls Claudia, who informs him that shoplifting may carry a six-month sentence. Sam lays into Jeffries for arresting a decent lady.
Oliver becomes agitated while watching Donna's intubation, spying a swollen lymph node behind her ear. He motions for paper to write Gates a note: "TB." Realizing that tuberculosis could explain all Donna's symptoms, Brenner and Gates rush to test her. Dr. Morgenstern arrives to identify Oliver as Oliver Kostin, a granddaddy of emergency medicine, who was named head of the ER in 1968.
Oliver's proxy, Morgenstern informs that he has multi-infarct dementia and is fading fast. Since Oliver is DNR, Morris realizes they should take out his breathing tube and move him to a private room. Morgenstern suggests moving Oliver to Trauma One, since he designed and built all the trauma rooms in the hospital. Horta and Neela ask Dubenko to attend Damien's surgery, but he claims he's too busy.
Kendra shows up at the hospital to berate her mother for shoplifting. Sam tries to step in as April's alarms sound and Kendra goes into contractions. Donna's TB test comes back positive, so the entire ER has been exposed. Brenner goes ahead with intubation as Morris prepares to test everyone. As Gates takes the tube out of Oliver, he finally recognizes Morgenstern, asking him when they start rounds.
Kelly lays into Sam for abandoning her 15 years ago. Why didn't she call or write? Sam sets the record straight: she didn't leave, their mother kicked her out when she got pregnant, and she did call and write. The sisters bond over their remembrances of the past, and Sam softens on the topic of their mother, who doesn't have long to live.
Having rocked his audition, Dylan returns to the ER, overjoyed to learn that his mother has tuberculosis and not cancer. Kendra is given medication to stop her contractions. As Jeffries takes April off to jail, Kendra demands to know why she shoplifted. April stays mum, so Sam pulls Kendra into an elevator to explain that April was trying to help her daughter and grandchild. Kendra should be grateful for what she has.
Brenner and Dubenko watch as Neela and Horta operate successfully on Damien. Brenner puts in a good word for Neela, but all Dubenko will say is that competition for the attending position is fierce. Neela and Brenner proceed to Trauma One, where everyone is gathered around Oliver as he slowly passes out of this world. In a kind of eulogy, Morgenstern reminds everyone that when Oliver became head of the ER in 1968, there was no 911, no paramedics, and if you needed an ambulance, you called a funeral home. Oliver changed all that, and everyone is there because of his good work.
