Dr. Grant is now the chief of staff of the St. Jude Regional Transplant Center due to his friend and mentor Bart Jacobs retirement because of poor health. Meanwhile as Kate waits for clearance to remove the organs of a "Jane Doe" murder victim, she spends the day with her daughter Thea who is nervous about an upcoming party. Dr. Grant refuses to perform a living donation for a son who wants to give part of his liver to his dying alcoholic father. The episode also introduces us to Dr. Tom Jonas, who joins St Jude taking Grant's old position.