A railroad engineer with a drug-resistant strain of TB requires surgery that is not performed at Chicago Hope. This necessitates calling in an expert at it, Wilkes' estranged Aunt Odelia. When Keith also tests positive for TB, he is forced to take an experimental drug to which he has a severe reaction. Meanwhile, Dr. Simon is stumped by a patient who has a wide variety of serious physical symptoms that keeps changing. She believes it's God's revenge for turning away from her dying twin sister.