Sam's ex-husband shows up and wants to take Alex on a trip. Gallant is back and Neela hopes to see him before he goes back to Iraq.

Jules 'Ruby' Rubadoux is back in the ER. He's still angry with Carter about the death of his wife.

Luka has a very bad day: New nurse manager Eve Peyton notices he doesn't want to work with Sam and tells him so. At the end of the day he's drunk and Abby takes him home.

A new attending, Dr. Victor Clemente, comes aboard and quickly makes a stir on the ER. Abby's breast cancer patient convinces her to take a long awaited test. Luka befriends a young woman who awakes from a six-year coma. Also, Weaver shows Clemente who runs the ER.