As the new season begins, Cat Black is conflicted about her full term pregnancy, because the father (Nick Kroll) is 6 years old and has advanced aging disease; the doctors remember Lola who still seems to be dead; Chief has more than professional feelings for the new administrator; Glenn cures cancer.
Cat goes into labor with Little Nicky's baby. Little Nicky's advanced aging disease causes him to take on the tendencies of an old man as the disease begins to kill him. Lola Spratt returns from the hospital to explain that she faked her death, but everyone believes she is a ghost. Blake Downs returns to the hospital, following the failure of his private practice/spin-off. New doctor Valerie Flame takes over narrating duties on the show for Cat Black when complications occur in the birth of she and Nicky's child.
Dr. Blake's clown brother comes to visit and borrows money from Dr. Blake to pay off his gambling debts, while telling him it's for an operation. A mascot from a local theme park starts suspiciously, repeatedly bringing in children with broken arms for treatment. The hospital is turned into a youth hostel, and Sy gets conned by an attractive young foreign girl.
An episode of TV news magazine News Readers covering the filming of the final episode of Childrens Hospital, complete with behind the scenes looks at the show. Cutter Spindell (who portrays Blake Downs on the show within the show) interferes to save the series, convincing protesters that they're saving an actual children's hospital.