It's Christmas Eve, and Dr. Mark Greene (ANTHONY EDWARDS) is desperately trying to leave the hospital for a few minutes to buy gifts for his wife and daughter. Dr. Susan Lewis (SHERRY STRINGFIELD) agrees to tend to his patients while he's away.

Unfortunately, Greene's shopping plans are postponed when a young boy (CURTIS BLANCK) who almost drowned while fishing is wheeled in with his praying father (MICHAEL BOWEN).

Meanwhile, Dr. Peter Benton (ERIQ LA SALLE) tries to save Teddy, the victim of a head-on collision. However, when Teddy is diagnosed as brain dead, Benton prematurely calls in expensive organ-salvage teams because Teddy signed an organ donor card. But Benton has neglected to get the required permission from Teddy's wife (CYNTHIA ETTINGER), putting Benton in a precarious situation after she initially refuses his request.

Back again is Madame X (ROSEMARY CLOONEY), a confused patient who wanders the halls singing holiday songs, while John Carter (NOAH WYLE) tries to save a sick Santa (JASON EDWARDS). Carter later comforts Dr. Lewis about her romantic problems. Lewis' lover, Dr. Cvetic (JOHN TERRY) is still missing. Lewis also contends with an older patient who is unexpectedly pregnant and learns that her sister, Chloe (KATHLEEN WILHOITE), is pregnant too.

Finally, at Nurse Carol Hathaway (JULIANNA MARGULIES) and Dr. Taglieri's (RICK ROSSOVICH) formal engagement party, an uninvited Ross shows up and behaves foolishly.

MALGOSCHA GEBEL ("Schindler's List") guest stars again as Bob.