Sam evaluates Natalie's neurological function when she wakes up with a traumatic brain injury sustained while being attacked in Will's car by Tim Burke. In a rare moment of affection, he tells her that he is happy that she is doing well. He proposes performing brain surgery on a young boy with an apparent tumor, but he is talked out of it by Ethan, who believes the abnormality is brought on by hypothyroidism and doesn't need surgery.
Sam is believed to have been in a plane crash upon returning from a conference in Honolulu. When a patient who is severely burned beyond recognition is brought into the hospital, his colleagues fear and assume that it is him. His wife Michelle, perceived by many as a "trophy wife" because of her young age and good looks, pushes to take Abrams off life support, citing that he would not want to live this way. The doctors delay the decision as long as possible, as they believe Michelle just wants to cash in on his life insurance.
Towards the end of the episode, the real Dr. Abrams returns to the hospital in casual Hawaiian attire, informing everyone that he had decided to stay in Hawaii a few more days, and therefore he was not on the plane that crashed. The burned patient turns out to be a sales representative who was also at the conference. He admonishes his colleagues for not having taken his presumed body off life support earlier, saying that Michelle was absolutely correct to convey that he would not want to be kept alive artificially. He also reveals that Michelle is not the "trophy wife" everyone assumes her to be, and that he is actually the "trophy husband", Michelle having become a millionaire through her dietary supplements company.