Dr. Connor Rhodes gets on the El.
Sharon Goodwin introduces Rahm Emanuel at the opening of the new ER.
Rhodes is reading a Spanish language newspaper when the train abruptly stops. Rhodes moves through the cars checking on the injured. When he gets to the front car, he sees more train cars derailed over a ledge.
Will Halstead gets a page as the ribbon is cut on the new ER. Other pagers start going off as well. Emanuel is escorted out and the staff jumps into action.
Nurse Maggie runs triage as the docs attend to patients and Sharon handles logistical aspects of handling so many incoming injured.
Connor is unable to intubate the patient he is riding in with, and he and the EMT switch to CPR. He runs down the patients stats as they arrive. Will tries to take over the patient, but Connor insists on continuing treatment. Will doesn't know who Connor is--he postures that he is the senior resident, and Connor replies that he is the new trauma fellow.
Brett brings in a crying girl who is concerned about her father, and April reassures her.
Connor performs a cricothyrotomy and instructs 4th year student Sarah Reeves to assist him. She moves too slowly for him, and has trouble finding a vein, prompting him to intervene. The patient is shocked back into rhythm.
April and Dr. Natalie Manning treat the little girl, calling for xray.
Will and Dr. Ethan Choi treat a woman who is scoring low on the Glasgow Coma Scale and is also pregnant.
Sharon welcomes Connor to the ER and a young man with cystic fibrosis comes in. The staff know him, and Sharon asks Connor to treat him. She then asks Maggie to let Dr. Daniel Charles know that the boy, Jamie, has come in. April and Connor run down Jamie's condition with him, and prepare a course of treatment.
Natalie goes to get her next patient, and Maggie tries to get her to take a break. April tells Natalie that she and Maggie are throwing her a "crib party" that weekend to help her prepare for her baby.
The neurology attending complains about the new safety rules limiting resident hours as places a shunt in the pregnant woman, Gina. A Ms Donahue arrives -- Gina is carrying her baby. Ms. Donahue is concerned for both of her and the baby; Gina has been living with them and is like family. Will tells her not to give up on either of them, and that Gina could be kept on life support until the baby is larger if necessary.
April finds Connor stitching himself up. They share some personal background with each other -- Connor spent some time in Riyadh during his travels, and April's family is from Brazil.
Dr. Charles questions Sharon about Connor, remarking that he'll stir up trouble amongst the women. He then asks after Jamie.
Natalie takes the little girl's mother to her. The girl is fine, with a broken leg, but the father is in critical condition at another hospital.
Choi performs an ultrasound for the parents, and they think that Gina is reacting. Halstad orders some tests after testing her pain reflexes.
Jamie and Charles are talking about the Fast and Furious movies when Connor comes in. Charles reveals that he's known Jamie since he was a kid. The test results aren't good and Connor wants to intubate him. Jamie refuses, and Charles looks concerned.
In the break room, Will is flummoxed by his patient, and complains about Connors arrogance to Natalie.
April brings the patients girlfriend to Connor, and is shocked when he explains the mans condition to her in Spanish.
Herman shows up with a box of stuff from the crash site to give to Maggie.
Connor takes the girlfriend into Jorge's room; she is upset.
The Donahue's read The Little Engine That Could to the baby. Natalie and Will check on Gina, but her ICP is rising. They plan to treat her first with medication in the hopes to avoid surgery, which would be dangerous for Gina and the baby.
Connor asks for Charles help getting Jamie to accept the ventilator. Charles insists that Jamie has the right to decide his own treatment. He reveals that Jamie has been in and out of foster care after his father left and his mother developed alcohol problems. Connor tells him that Jamie will be put on a ventilator when he loses consciousness anyway, but that it will be too late at that point to do any good.
Sarah checks on the little girl with the broken leg. She gives Rachel a comfort bear and is updating the mother on the fathers condition when Rachel passes out, and Sarah can't find a pulse.
Choi tells Sarah she needs to compress harder, and they get her rhythm back. Natalie leaves with Rachel, and Sarah stays behind upset that she had to hurt the girl to help her.
Charles counsels Jamie on his treatment options. Jamie is resigned to death, and Charles tries to convince him to keep fighting. Jamie agrees to the ventilator.
Maggie brings Marianna Jorge's backpack. There was an engament ring inside.
Sharon questions Natalie about what happened to Rachel and she explains that there was an undiagnosed cardiac contusion.
Will questions Connor about his treat of Jorge and about his past. He is surprised to find that says he comes from a nice part of Chicago, but went to med school in Guadalajara.
Will and Natalie aren't happy with Gina's response to the drug regimen. The Donahue's are reluctant to provide consent for surgery since it will endanger the baby.
Jorge crashes and Connor and Choi rush to bring him back.
Sharon and Will meet with a hospital lawyer to decide on how to proceed with Gina's case. The lawyer tells them the contract is ironclad and that if they go forward with the surgery, the hospital will be sued. Sharon suggests calling the ethics comittee.
Connor explains to Marianna that Jorge is braindead. Sharon and a program coordinator from the organ donation group come in to speak to Marianna.
Natalie introduces herself to Connor on one of the roof top terraces. She consoles him about his patient and he asks about her husband, surprised that she is single. She leaves to visit Rachel and her mother with a Skype call from the girl's father.
Sharon consuls Mrs. Donahue on what to do about Gina. The surgery goes forward. The fetal heartbeat starts to drop mid procedure, and the doctors rush to help.
Charles watches a Fast and Furious movie while he sits vigil over Jamie. Connor comes with the news that Jorge is a match for Jamie, but that Marianna hasn't yet given consent.
Will updates the Donahue's on Gina and the baby -- both came through the surgery fine.
Charles has Marianna visit Jamie, and Connor translates. As they leave the room, she agrees to organ donation.
Sarah practices central lines on the medical dummy, and Connor applauds her efforts to practice. She tells him that she wouldn't have taken the ER rotation if it wasn't required, that she's more of a lab person. He tells her it's just teh nerves that all med students go through.
April finds Natalie in the locker room, crying over her dead fiance's photo.
Charles is at Molly's when Connor walks in. Charles reveals more of his background with Jamie. He heads back to the hospital to wait for the surgery to end and Connor goes with him.
Montage of the day's patients being released or moved while the docs treat new incoming patients.
Charles watches over Jamie's bedside.