Jesse's bother is involved in an accident at work, bringing him and his work friend into the ER. While Jose is being treated for his injuries, Leanne picks up on another issue -- congestive heart failure. Jesse's brother didn't have long to live before he was crushed by pallets at the warehouse. As Jesse struggles to tell his brother and nieces the diagnosis, he also finds out that his brother's co-worker was more than just a friend. Mama is shocked that his brother is dating, much less in a serious relationship, less than a year after losing his beloved wife. Jesse tries to protect everyone at first, telling his family that Jose is going to be fine and refusing to update Nora on Jose's condition. But as Jose's imminent demise becomes clearer, Jesse comes clean. The girls are upset that their father has been dating and refuse to accept Nora. But Jesse sees how happy she's made his brother and brings everybody around.
Pepper's back and helping Ethan and Rox on the ambo rig. After rescuing Jesse's brother, they're called out to a porn shoot, where a couple is stuck mid-coitus. They end up having to take the actors in to the ER, but they cause a penile fracture during separation. The case is handed off to Will and Angus in the OR.
Ariel continues with her candy-stripping duties and meets a cute boy in the cafeteria. Later, she sees him in the chemo ward, but he brushes off her questions about what he's doing at Angel's. Ariel struggles with how to introduce Leanne to her new friend, leading Leanne to offer that Ariel can just refer to her as a friend. This upsets Ariel, leaving her in a bad mood all day. Leanne eventually understands what's going on, and makes amends, reassuring Ariel that they're family.
A couple is brought in after getting into a brawl at the baseball game. Their devotion to one another inspires Jesse to take Nora to Jose.