In "And In The End", the series finale, Carter used his family fortune to finally open the Joshua Carter Center, a medical clinic for the underprivileged that fit into the plans he announced when his grandmother's will was read. Kem surprised Carter by attending the opening ceremony however she was seemingly uncomfortable around him. In a later conversation she told him how she felt sad in Chicago because it reminded her of their son's death. As she leaves the clinic's opening she okayed Carter to call her to set up breakfast before she flew back to Paris. Carter indicated he might come back to County for good; however, this was potentially contradicted by his earlier idea that he would leave Chicago if that's what it took to save his marriage.