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Episode five begins with a standoff between police and a man holding an infant as his hostage. Two officers enter the room he is in and eventually manage to talk him down. Shortly after, however, one of the officers suffers what seems to be a heart attack.

Meanwhile in West Virginia, a man is struck by a truck while running naked from a woman’s house when his wife comes into the house wielding a gun, searching for the unfaithful lover.

When the officer who suffered an apparent heart attack arrives by ambulance to Three Rivers, the female officer accompanies him. We later find out she is Dr. Yablonski’s wife, Rita. After beginning treatment for the officer with the heart problem, Andy orders an x-ray that shows him the man did not suffer a heart attack, but instead suffered an aneurysm in his aorta, causing his heart to bleed internally.

In another part of Three Rivers, Miranda, David and Ryan get word that a troublesome patient whom is waiting for a liver transplant has finally been matched. Jordan decides that Miranda and Ryan will go to West Virginia to get the liver while David stays behind to deal with the patient, an over-dramatic theater professor.

Yablonski begins to operate on the officer who suffered the heart aneurysm by trying a very risky procedure. Although it is successful, the man is far from being out of danger.

When Miranda and Ryan reach the hospital in WV to procure the liver, they find there has been a mix up and a doctor in the hospital thinks the liver is for another patient, one of his own. Ryan immediately gets on the phone with the OPC, but Miranda realizes the doctor is only moments away from taking the liver regardless of what the OPC says.

In the meantime, David is having a hard time connecting with the patient who will be receiving the liver at Three Rivers. He tries time and time again to get out of it, but Jordan tells him it is good for him to actually interact with live patients once in a while.

After the procedure in Three Rivers, we find that Yablonski and wife Rita are currently having problems in their marriage, and aren’t sure how to fix them.

Taking matters into her own hands in W.V., Miranda tries to stop the doctor before he can procure the liver and in the scuffle, breaks the surgeon’s nose – certainly one way to slow him down. Afterward, we find a doctor at the W.V. hospital made a mistake regarding the liver. After finding out about the mix up, the team finds out that the patient at Three Rivers is actually the one to receive the liver and begins preparations to fly it back to Pittsburgh.

After a second procedure, Dr. Yablonski manages to finally repair the officer’s heart, and it looks as if he will live. Later, Andy and Rita discuss seeing a counselor for their marriage issues while outside the hospital. Rita feels like Andy doesn’t have enough time for the relationship, regardless of the promise of help from a counselor. She walks away before any progress is really made between them.

At the end of the episode, David’s patient finally comes to after successfully receiving the new liver. The two make amends and actually begin to connect and respect one another before another busy day at Three Rivers comes to a close and the final credits roll.