I'd like to see Max come back and he and Blair get back together.
The show has lost a number of good charateres as of late, so it's needs some fresh blood. Perhaps a new nurse that pulls Michael away from Marcie (I like Michael & Marcie, but I'm thinking of drama)
Bo goes nut's over John being alive and having to comfort Paige, that he becomes an alcoholic and he and Clint get into a huge fight, leaving one of them nearly dead.
Blairs tumor comes back, after surgery she loses her memory and Troy comes back and takes advantage of her (kind of like Desperate Housewibes)
A Mitch look alike becomes the new Pastor.
Joey returns and falls for Dorian again.