Andy, as the acting department head while Dr. Jordan is away, must make his first tough decision when the wife of a man in need of a kidney transplant is found not to be his match. Miranda explains to her that she is a match for another patient. She now wants to offer her kidney to the other patient in order to begin a "Daisy Chain", when people who are not matches for their own family members can donate an organ to a patient they do match in a chain until their family member finds their exact match. The woman believes this will lead to her husband receiving the kidney he needs. When Miranda tells the couple that UNOS has found a kidney for him, the woman still wants to go through with the procedure and help save several more lives knowing that if she pulls out of the chain, only her husband will receive the transplant while the others will continue to suffer. Scott (episode #104) returns to Three Rivers for a check-up after his heart transplant six weeks prior. Andy sees signs that Scott's body may be rejecting the heart and after further testing realizes that Scott needs another transplant. Pam is dealing with a seemingly healthy young woman that is having severe cardiac arrhythmia and mysteriously high levels of digoxin, a heart medication, in her system. The team finds that she is being poisoned by an academic colleague seeking revenge after the colleague blamed the young woman when she was passed over for tenure.
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