Victor Stone was a patient of Three Rivers Medical Center, but his decision to be taken off the life support machine so that he can help others with his organs caused him to be a donor. Victor is driving home, talking on a hand free phone, when he swerves to miss something and crashes into a large metal bin. Dr. Sophia Jordan responds to the ER to care for Victor and calls Dr. Andy Yablonski in to consult as he has ALS. They determine that he has torn the sac around his heart and needs surgery. Victor's daughter Laura, who he refers to as "Cookie" arrives at the hospital. They transport Victor upstairs. Kuol stops by Victor's room and they talk about many things, including Kuol's condition, Kuol's love of the Yankees and Victor's love of the Phillies. Kuol asks Victor about his condition and Victor explains that ALS is sometimes referred to as "Lou Gehrig's Disease". Kuol does an impression of Mr. Gehrig's goodbye speech, including the echo. Kuol stops by Victor's room and they talk about many things, including Kuol's condition, Kuol's love of the Yankees and Victor's love of the Phillies. Victor consents to having Andy operate on him. Only to discover that there was a complication, they discovered that his diaphragm was injured as well. Andy explains that he needs to be on a respiratory and this may last for the duration of his life. Victor has decided that he wants to refuse medical treatment and wants to donate his heart to Kuol. Andy is stunned by the revelation, as is the entire hospital staff. Kuol is genuinely surprised and saddened that anyone would do this on his behalf. A staff meeting is held and many of the doctors believe that this is a form of assisted suicide. It is also noted that Victor is a universal donor. Surprisingly the ethics committee does not oppose the decision and the staff votes (except Andy and Miranda), Three Rivers will allow the direct donation. Victor shares his wishes with his daughter who is very upset with her father. Victor tries to explain to her that he is taking back control of his life. As word travels, a mother brings her daughter, Missy, to Victor's room. She notes that her daughter needs a liver and asks him for a direct donation. Dr. David Lee also askes for a direct donation, for Micheal Downing. Victor agrees to both donations. Dr. Jordan is present as Victor is signing the donation papers, noting that this is the first time the donor has actually signed the papers themselves. Laura appears stating she has a power of attorney over her father and tears up the donation papers. Andy is able to convince Laura to accept what her father is doing. As Victor is being wheeled into the OR, many of the families that are benefiting from his donation are lining the hallway, to thank him for his gift. His daughter is there to have a final goodbye.
(To Dr. Andy Yablonski) "I thought I had two options. To fight... or to die. Now I see I have three. I want to terminate life support. I want to donate my heart to Kuol."
(To Laura) "I'm taking back control while I still can, while something good can come out of it. I'm donating my heart to a great young man."
(To Laura) "There's a difference between committing suicide... and choosing to die... with whatever dignity... I have left. Cookie, I am ready."
(To Andy) "Death always wins; it's just a matter of when or how. I can't breathe on my own.; I can't drive; I can't go for a walk; Soon I won't be able to swallow or talk."
"I feel angry if that's how I'm gonna die, and I think if could have gone on top, like I wanted, I could have beat that bastard, ALS, one last time. And a bunch of people will be better off. Can't you see? That's the best death I could have."