At the clinic, Dr. Xavier Rush is asked by a middle-aged woman to euthanize her late mother’s healthy four-year-old dog because the mother “would have wanted it.” Despite arguing that the dog can bond with someone else, Xavier learns the woman’s husband would otherwise shoot the dog to save money. Xavier quotes an inflated euthanasia price, takes the dog, and instead secretly spares it, planning to pass off cremated remains from a deceased rescue to the owner.

In the back room, vet techs Tina and Maggie realize Xavier has saved the dog. They fawn over him while he warns them about the legal risk and orders the dog groomed to look different. They agree to keep the secret and fabricate ashes from a previous cremation, promising absolute discretion.

Xavier moves to his next appointment: an abandoned kitten found in a wood pile. He meets Samantha Diaz, who has been keeping the kitten warm tucked into her bra. Xavier conducts an exam and, after imaging, discovers the kitten has atresia ani, lacking a functional anus and rectum, with a rectovaginal fistula allowing watery stool to pass.

Xavier explains the prognosis: without specialized surgery costing $5,000–$10,000, the kitten will likely suffer from impaction or infection and die. He recommends immediate euthanasia. Samantha, who works from home and is emotionally attached, rejects euthanasia and asks about rescues or fundraising, though Xavier says rescues are overwhelmed during kitten season and unlikely to help.

Frustrated, Xavier challenges Samantha’s plan and accuses her of choosing suffering. Internally embittered by frequent human irresponsibility, he delivers a harsh ultimatum to return when the kitten deteriorates. Samantha criticizes his bedside manner; Xavier admits others have said the same and walks out.

In the hallway, Samantha asserts that people will help and she can fundraise. Xavier counters that people are inherently “assholes.” Samantha retorts that he is too. Despite the friction, Xavier notes an immediate physical attraction before retreating to his office and closing the door.