A fisherman lobbies Dr. Westphall to let his brother die in peace and dignity; Fiscus substitutes for Ehrlich on a date with Shirley Daniels; and Helen's stress mounts as the hospital suffers computer glitches and she faces a radical mastectomy. Peter celebrates his birthday and runs into Myra and a gentleman friend.

Dr. Craig performs the transplant amidst a publicity barrage; Morrison tries to adjust to his loss; Luther and Fiscus split an investment in silver futures; and Rosenthal counsels a group on breast cancer.

Mrs. Wegener returns to find both her ex-husband and her daughter near death; Clancy moves in with Morrison after a burglary; Martin gives Fiscus a letter concerning Daniels; and Lizzie returns from Vassar with a boyfriend.

Dr. Westphall helps a terminally ill teenager reach his parents; Griffin plays Birch and Novino off against each other to escape blame in a patient's death; Morrison calls Chandler on it when Dr. Turner gets involved in a dispute involving a sick child; and Dr. Craig tries to start his memoirs.

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!