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Alongside the veteran doctors, the episode introduces a new crop of medical residents and students experiencing "firsts"—including their initial interactions with patient deaths, and navigating the incredibly steep, often heartbreaking learning curve of emergency medicine.

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Unfortunately—in classic Pitt family fashion—the woman they hire turns out to be a severely unhinged, psychotic woman from Bob's past. The nanny was actually Bob’s high school prom date, whom he famously stood up the moment he realized he had feelings for Liz. Having successfully infiltrated the home under the guise of child care, the spurned ex-lover launches a wild, cartoonish campaign to sabotage Liz and claim the title of the new Mrs. Pitt. Alongside the veteran doctors, the episode introduces a