Dr. Shaun Murphy and Dr. Claire Browne devise an experimental procedure that can save the leg and life of a young groom, that is if his bride-to-be and parents can learn to work together. Meanwhile, Jared struggles to emotionally connect with his patient whose scars may prove too deep to overcome.
The episode opens with Shaun, Claire, and Jared working graveyard shift when a mass casualty is directed to St. Bonaventure. Controlled chaos erupts in the waiting room when the ambulances arrive, and it's all hands on deck to treat patients.
Among the injured are Sonia and Marco, a couple on the way to their wedding. Sonia has only minor injuries, but Marco arrives in critical condition, close to bleeding out and with one leg crushed. Though Shaun seems initially unresponsive, he soon hits on the idea of making a REBOA to stabilize Marco while they decide on a treatment that will last the long-term. Neil Melendez approaches Marco's family to explain the leg must be amputated, and they break down in tears.
After a difficult start to the evening, including freezing up several times during triage, Claire speaks to Shaun about Marco's leg. She suggests 3D printing a femur out of titanium to replace Marco's shattered one. His family responds with indecision: Sonia stresses the importance of saving the leg, while Marco's parents would prefer amputation because it doesn't carry a risk of death. Melendez points out the parents are next of kin, as Sonia and Marco are not married yet; however, Jessica files an injunction. A judge arrives to determine who gets to make the decision.
After some discussion, Sonia reveals Marco is a reformed addict who turned to sports to conquer his drinking problem. The judge calls Shaun in to testify, but before he can, he realizes Marco's leg is out of time. At the judge's order, they go with Sonia's preference of replacing the femur. Marco's surgery is successful, and he thanks them for saving his leg.
Noomi, Claire's patient, wakes from surgery and immediately asks about her wife Jenna's condition. Claire checks, but is unable to locate anyone named Jenna in the hospital. She realizes Jenna must have been ejected from the bus and never brought to the hospital.
Several emergency vehicles make it back to the crash site, where Claire locates Jenna. She administers first aid before they hurry back to St. Bonaventure. Jenna undergoes a long surgery, but is ultimately pronounced dead.
Meanwhile, Jared has been assigned to Celez, a victim with severe burns on her upper body. He struggles with poor bedside manner, leading to her chastising him several times. Later, Jared learns about an experimental treatment being done at San Diego Community Hospital, where tilapia skins are used in place of skin grafts. He makes a large donation in exchange for including Celez in the trial. After six months of wearing the fish skins, she should be able to have them removed.
Aaron Glassman calls Claire over to reveal the true reason Jenna died: a fatal mistake during intubation. He reassures her it was an honest mistake, but gives her strict instructions not to speak to anyone outside the hospital, or Noomi, about what happened.
As the shift ends, Jessica requests for Neil to sign a form making him her healthcare proxy. Glassman goes outside to find Shaun, and the two discuss love. Shaun affirms that he doesn't want love after experiencing the deaths of Steve and his rabbit, then accepts Glassman's invitation to get breakfast.
- The episode title is a reference to Marco's titanium femur. Throughout the episode, several characters refer to it as a "fake" bone, to which Shaun argues it's very real.