The staff at Holby City A&E are pushed to the limit when a motorway pile-up escalates. A woman on slimming tablets to please her bullying partner has a dizzy spell while driving her car. She skids out of control, and other vehicles crash into her, including a car carrying a quarrelling couple in their thirties who are struggling to maintain their farm; the man is driving a lorry to earn more money when he crashes into the pile-up. The distraught woman wishes she had accepted his proposal of marriage; unfortunately it is too late and he dies due to severe burns.
Mark, George and Sam are with the paramedics attending the injured. Elliot is also along as an observer, and he wants to help. He sees the lorry driver rescue a girl and then fall back into the flames. Elliot and Mark rush through the some and succeed in getting him out, but he's severely burned and dies in resus. When the rescued girl turns out to be seeing Sam’s boyfriend, Eve comforts Sam and the animosity previously between them vanishes.