When Dr. Jack Gallagher arrives for his first day as Director of Psychiatric Services at Los Angeles' Wharton Memorial Hospital, his unique style is evident from the start as he employs an unusual tactic to gain a delusional patient's trust. Meanwhile, Jack must reconcile his effective, yet highly unorthodox treatment methods with not only his new colleagues but also his conservative boss, hospital administrator Nora Skoff, a woman with whom he shares a romantic past.

Director of Psychiatric Services Dr. Jack Gallagher and psychiatrist Dr. Veronica Hayden-Jones are called to the ER for a psych consult where they meet Melissa Ranier (guest star Nicholle Tom), a woman presenting as seven months pregnant. However, the doctors are informed by the ER physician that the patient's ultrasound did not reveal a baby. When the woman's husband (and OB/GYN) arrives, they find he, too, is under the delusion that his wife is pregnant. Jack must take drastic measures to get to the bottom of the case and help bring the couple back to reality. Meanwhile, Jack searches for his mentally ill sister, Becky, whom he believes is homeless and wandering the streets of Los Angeles.

Jack fights a battle of wits and wills with a famous professor, author and philosopher, Gideon Graham (guest star David Carradine), who lapsed into a non-responsive catatonic state after suffering a lightning strike that crippled him and killed his wife. Determined to bring Gideon back to the real world, Jack attempts a highly unorthodox treatment that carries great risk to the patient. Meanwhile, a growing physical attraction between Jack and the patient's daughter complicates the situation.

An 8-year-old bipolar boy whose life is consumed by a video game he plays in his head is admitted to Wharton Memorial for an accident involving a knife. When it turns out the accident was really a suicide attempt, Jack must try to get inside the little boy’s head to find out what is triggering his life-threatening rages. But when the boy bolts from the psych ward, Jack must try to save him by engaging him in his own mind game. Meanwhile, Nora discovers her teenage daughter is posting provocative pictures of herself on the Internet, and Jack continues to search for his mentally ill sister who he believes is living on the streets of L.A.

Movie star Liam McBride is brought into the psych ward after suffering a mental breakdown on a nationally televised talk show. Liam insists he faked the psychotic episode in order to publicize an upcoming movie in which he plays a mental patient. This leads Jack to believe Liam has a serious psychiatric condition and refuses to let him go until he can face his problem head-on. Meanwhile, Nora and Veronica share confessions during a girls' night out, and their romantic pasts with certain familiar faces at Wharton Memorial are revealed.

When Leonard Steinberg (guest star Garson), a gambling addict seriously in debt, threatens to jump off the roof of Wharton Memorial, Jack tries to talk him down in order to get to the bottom of his suicidal tendencies. Later, Jack goes to court to testify on behalf of a mentally incapable patient charged with manslaughter by prosecutor Marcie Crane (guest star Lori Heuring), a high-profile attorney who has never lost a case. In a surprising twist of events, Jack's expertise is needed more than ever as the case turns out to be much more complicated than it originally appeared. Meanwhile, Jack and the team meet for a poker game after work, and sparks continue to fly between Rylan (guest star Warren Cole) and Veronica.