Kate returns to duty and finds that her reinstatement comes with a cut in title, salary, staff, and office; Jack replaces the hip of an older man who has opinions on everything, including how Jack should live his life; Aaron has mixed emotions when Grace comes up with a much-needed improvement for a surgical shunt he's been developing; Kate is humbled when a young couple whose daughter needs a heart transplant chooses another doctor after they discover her change in status; Tommy thinks it would be a good idea for the hospital to advertise, and hires a publicist who manages to get under everyone's skin as she creates a commercial that ends up looking strangely familiar.