Matt (guest-star Barry Watson) and Sarah (guest-star Sarah Danielle Madison) begin their student rotation in the ER, but get off to a bad start by arriving late and angering Dr. Norton (guest-star Dennis Boutsikaris), the attending ER physician. Matt and Sarah's relationship is tested when Matt quickly demonstrates an aptitude for the work, but Sarah accuses him of trying to make himself look better than the other students, especially her. However, Matt ends up looking foolish when he can't figure out how to turn off the ringer on his cell phone and he gets stuck fielding calls from his family. Matt's day ends tragically, leaving him to question his destiny.

This episode featured four parent-child pairs competing as teams.

Horrified to discover that Ephram and Madison are involved, Dr. Brown stops short of firing her, but Madison decides to quit leaving the Browns to a very unhappy holiday, especially when Delia discovers another troubling relationship - between her father and Linda Abbott. Stressed by Thanksgiving with his cantankerous mother-in-law (guest star Betty White), Dr. Abbott reacts badly when Amy brings Tommy (Paul Wasilewski) to Thanksgiving dinner. Finally pushed to the breaking point, Amy runs away from home.

In an attempt to prove that he is a family man, Charlie invites Lisa over for Thanksgiving dinner

A young woman is attacked by a shark and later dies, but it's discovered that she was shot first. The case becomes even more difficult for the CSIs when one of their coworkers becomes a leading suspect. The dead woman worked for a private-investigation agency that specializes in luring and entrapping married men suspected of infidelity.

Tiring of the failure of his minions, Aku decides to engage Jack in one-on-one combat to settle matters between them once and for all.

Jess finds out that her father has been sleeping in his office and she insists that he stays with her. Ric defends Kath from the board who want to suspend her and she is arrested.