The Craigs' reconciliation faces its first test; Drs. Auschlander and Gideon struggle together to save St. Eligius when Weigert decides to get out; Novino pushes Morrison to decide between her and Joanne; Griffin places his future in God's hands; Ehrlich returns from his odyssey; and Fiscus' last E.R. patient is a lady from the opera... But is it really over? The jaw-dropping climax culminates in a blue-collared dad placing his young autistic son Tommy Westphall's miniature St. Eligius snow globe on the living room TV set, having summoned him to dinner. ""St. Elsewhere's"" entire six-year saga had all been a figment of little Tommy's imagination!
An ebullient Novino pursues Morrison; Fiscus tries to revitalize his mother's life; Rosenthal returns to duty; Wade tries to help a dying child deal with her bitterly divided parents; Griffin tests positive for AIDS; Dr. Turner returns and helps Chandler come to a decision about his future; and the Oseranskys return to take Lucy to the ""Doctor of the Year"" dinner, which ends in a flaming disaster.
Dr. Craig, Ellen, Lizzie and Novino drive to Peterborough, New Hampshire to visit Dr. Westphall on his birthday; Ellen tries to deal with changes to her hometown; Novino stirs up a lady carpenter; Lizzie finally expresses her resentment; and Dr. Craig almost destroys his friendship with Dr. Westphall.
Phil returns from a training course at the Weigert home office; someone takes a shot at Dr. Gideon; Dr. Craig loses Flash during a rescue attempt by animal activists; the new security cameras upset Rosenthal, who continues to lose control; Novino tries to correct a misdiagnosis made 60 years ago, and a show is performed in the children's ward.
Judge Farnham checks into the hospital with an inoperable cancer (and asking for Floyd the Barber); Rosenthal takes Bobby Caldwell's death very hard; Dr. Craig searches for a date for a skating rink opening; Dr. Kiem is in the middle when she saves the life of a young black man shot by a Vietnamese gang member; Griffin befriends the new chaplain, who's a descendant of the hospital founder, Father McCabe; Novino and Luther compete on the ER simulator and Ehrlich tries to find his elusive parents.
Mr. Bevine returns for foreskin reconstruction; Dr. Auschlander seeks an alternative for a fellow cancer patient; Novino frets over Pee-Wee and tests Lucy, who has trouble telling Victor the news; Fiscus returns to work. but has trouble putting his father's death behind him; Morrison's false confidence as `Dr. Adam Logan' evaporates when Pete is rejected by an exclusive private school.
A man claiming to be the true inventor of the Craig 9000 kidnaps Ehrlich; AIDS patient Brett Johnston's rib injuries have led to pneumonia and he is now determined to break with his lover; Dr. Kiem helps Amy Jeffries, a lonely St. Eligius neighbor; Griffin treats a driven young broker determined to make a million before he dies; Lucy worries that she might be pregnant; Helen returns to work; the company that owns the hospital finds itself sued for infringement and Mrs. Spooner ends her husband's suffering.
Craig proceeds with his artificial heart implant despite some questions about his choice of candidates; Morrison tries to deal with the departure of Joanne for Seattle and Dr. Craig becomes suspicious about the relationship between Ellen and Dr. Gideon. AIDS patient, Brett Johnston, and his lover are victims of gay bashing and as a result of his injuries, Brett is readmitted into the hospital.