Jules Rubadoux, whose wife was a patient of Carter's nine years ago, comes into the ER with heart problems, wanting nothing to do with Carter, who he feels is responsible for his wife's death. Anspaugh and Kayson advise Ruby to have surgery, but Abby tries to get him to consider the alternatives. Finally, Carter tells Ruby the truth. Pratt asks Olivia from Ceasefire out. When he shows up at her office to pick him up, he's ambushed into speaking at an anti-violence meeting. Susan meets with the tenure committee. Sam is in her own world all day, and buys a pregnancy test. Ray tries to stop the Chadwick sisters from leaving without having been seen by social services. Since there's nobody better, Morris may end up with the chief resident job.