No. overall No. in season Title Directed by Written by Original air date US viewers (millions) 36 "Recoil '' Marisol Adler Brian Anthony June 22, 2017 (2017 - 06 - 22) 3.59 After an explosion, TC finds himself in Syria. He meets a local doctor, Amira, and deals with finding Syd who has been kidnapped by the rebels. In San Antonio, Julian threatens to close off the E.R. due to its costs. Jordan and Drew narrowly rescue Mac from the mountain fire, and Jordan and Julian blackmail each other for his treatment. They finally reach a deal: all personnel will return to their jobs, with Jordan as head, and the hospital will work treating vets for the DOD to balance costs. Meanwhile, Paul deals with the fallout from he and Topher being fired by his father, Julian, and Kenny butts heads with Cain Diaz (Mark Consuelos), a new traveling nurse, when treating a patient who overdosed on PCP and swears he did n't take it. Cain is the only who believes him, and turns out he was dosed by his neighbour. 37 "Off the Rails '' Oz Scott Tom Garrigus June 29, 2017 (2017 - 06 - 29) 4.15 Following on from the last episode, Drew and Paul tend to a roller coaster accident and soon discover that one of the victims is pregnant, despite having gotten an abortion, while the other has taken cocaine. Drew bonds with the victim 's mother, who is also a soldier. Meanwhile, TC continues his quest to save Syd, and Jordan tries to get along with Julian while also trying to get Paul reinstated. She finally tricks him into returning and he deals a truce with his father. After saving Syd, TC decides to stay in Syria to help. Shannon discovers that nurse Cain was a doctor in Mexico and Jordan, after being forced to fire him for overstepping his duties as a nurse, hires him as a resident doctor. Scott finds a way to keep Julian happy while returning the hospital to some kind of normalcy. Later on, Jordan receives shocking news about Topher: he and his daughter were killed in a car accident. 38 "Do No Harm '' Marisol Adler Milla Bell - Hart July 6, 2017 (2017 - 07 - 06) 4.24 Everyone grieves the loss of Topher. TC goes to extreme measures when treating a Syrian child, butting heads with Amira in the process. Jordan and Cain go out to a mine accident, and Jordan adjusts to her professional relationship with him. Meanwhile, Drew, Scott and Paul struggle to treat a patient with multiple symptoms, who may lose a hand, until they finally discover the cause to be lead poisoning. Also, Scott receives a surprise visit from ex-girlfriend Annie (guest star Sarah Jane Morris), when she brings in a patient who used to be Scott 's Alcoholics Anonymous sponsor, helping them make peace. After patching things up with Scott and Jordan, she goes on a hike, where she jumps off a bridge into a flowing creek with a hiking bag full of rocks strapped to her back. The result of Annie 's suicide attempt is not shown before then end of the 4th, and final, season of the show. 39 "Control '' Oz Scott Joe Hortua July 13, 2017 (2017 - 07 - 13) 4.41 Scott attempts to treat a young patient with a large facial tumor, but the patient 's grandfather -- a devout Jehovah 's Witness -- refuses to allow her to have surgery. She cuts herself to force the surgery, but in the OR things get complicated quickly, and only Scott 's persistence saves her. Drew struggles with the demands of being a new parent while also dealing with a patient who provided false information. He turns out to be an actor working for a customer 's service evaluation company, but he later helps Drew reconnect with his mother. Meanwhile, TC joins a rescue mission in Syria, with one soldier missing as a result of the information given by the mother of his previous patient; Jordan and Cain try to help a wounded veteran come to terms with Post Traumatic Stress Disorder with Mac 's help. 40 5 "Turbulence '' Timothy Busfield Alan McElroy July 20, 2017 (2017 - 07 - 20) 4.23 While on a flight home with his mom and Rick (guest star Luke MacFarlane), Drew deals with a plane full of sick passengers and a pregnant woman needing an emergency C - section. Meanwhile, Jordan, Shannon, Paul and Kenny compete against the staff of other hospital shifts at a charity ' Ninja Warrior ' challenge. Also, TC performs a dangerous surgery to remove a live bomb from a soldier. 41 6 "Family Matters '' Eoin Macken Tom Garrigus July 27, 2017 (2017 - 07 - 27) 4.45 Kenny 's career is put on the line when he participates in one of Drew 's MMA classes and severely injures his spine. Mac defends the ex-soldier who caused the injury, while Drew digs deeper and finds out the truth about the ex-soldier's past. Jordan and Cain treat victims from a hotel fire, and Shannon bonds with one of the victims who has a mysterious past. Meanwhile, Paul 's urologist sister, Dr. Bella Cummings, visits the hospital, and TC returns home from Syria to handle some of Topher 's legal affairs. 42 7 "Keep the Faith '' Timothy Busfield Brian Anthony August 10, 2017 (2017 - 08 - 10) 3.09 Following a protest at Mac 's funeral, a fight breaks out outside and injures several veterans, sending them to San Antonio Memorial. TC, Scott and Drew disagree on how to treat a U.S. Senator who is also an Army Veteran. TC and Drew later discover that the Senator has not been entirely truthful. Meanwhile, Shannon and Paul deal with a patient struggling with PTSD and later, Jordan confronts TC about whether or not he is back for good. This episode - written and directed by, and guest starring real veterans - was dedicated to all the United States Armed Forces. 43 8 "R3B0OT '' Terrell Clegg Tom Garrigus & Shannon Sommers August 17, 2017 (2017 - 08 - 17) 3.52 Chaos hits San Antonio Memorial when an expert criminal hacks into the hospital 's computer system, shutting down the power, taking over computerized devices, and putting patients at risk while demanding a ransom. After receiving negative performance review comments from Jordan about her demeanor with patients, Shannon has to treat a returning patient whom she previously mouthed off to. Meanwhile, TC joins Rick on a ride - along, but is forced to think quickly on his feet when one of Rick 's men is seriously wounded. Also, Paul is shocked to learn that his sister and Kenny are dating. 44 9 "Land of the Free '' Gabe Sachs Francesca Butler August 24, 2017 (2017 - 08 - 24) 3.72 TC accompanies SWAT on a raid at an ICE detention center, where several of those deterred have become ill. He later discovers that one detainee has murderous intentions and escapes within the hospital. Kenny asks Paul for his sister 's hand in marriage after only one month of dating. Meanwhile, Jordan receives shocking news that Cain fled town without notice. Also, Scott tries to keep a high profile to impress Colonel Parnell (Rob Estes) in his bid to get a Combat Medical Training Program in San Antonio. TC and Syd are expected to attend the presentation but Syd ca n't make it, so TC calls in Dr. Amira. 45 10 "Resurgence '' Jeff Judah Brian Anthony August 31, 2017 (2017 - 08 - 31) 3.08 Scott begins a new training program with military members that all of the doctors take part in. Shannon and Paul discover a young girl with a rare heart disorder. A shooting at a nearby college sends the staff into panic mode. Jordan and Amira get caught by an armed protester, but are saved by Rick. Drew, TC, and a recruit deal with a college professor who is shot in the leg and has another underlying condition. Scott 's new training program angers Julian, and also makes Shannon and Paul question their spots at the hospital. Amira confides to Jordan that her treatment is failing, and she and TC are returning to Syria. During Jordan 's toast to Kenny and Bella at their engagement party, it 's revealed that Shannon returns to her hometown clinic, while Amira returns to Syria -- with Paul instead of TC. Drew attends Army Ranger school with Rick 's blessing. His spot in the combat training program is replaced by TC, who tells Jordan he is not ready to leave.
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"Family Matters ''