Patients include a 17 year old teenager who wants to die against his selfish father's wishes and a couple whose genetic secret reveals itself to Addison and Naomi. Pete does his share to generate business for the Practice and Violet wonders why her friendship with Cooper is falling apart.
- Addison calls Naomi, telling her not to hang up. She does.
Sam tries. Same result.
Cooper gets out of bed with Charlotte to make it to a Sam-led meeting, making plans for lunch.
Violet stares at Sam's new patient board, disliking it. Naomi says hi to Sam and Addison, explaining that she will talk to them professionally, but not socially.
Sam explains the dots on the board represent people's schedules, but Violet thinks it's a board of shame to point out who isn't booked enough. She thinks Sam and Add pulled off a coup.
Cooper comes in late, missing the meeting. Violet tells him he can tell her anything, but he keeps Charlotte to himself - per her orders.
Add and Naomi meet with a young couple who are soul mates and each others' best friends. They have lots of stuff in common, like allergies and music tastes. Naomi keeps up the not talking to Add.
Sam meets with a dad whose 17-year-old son has a chronic lung condition. They hear a crash from inside the exam room, Kirk is on the floor.
Add has the DNA results for Ryan and Lisa. She doesn't know why they can't get pregnant, but knows why they shouldn't: They're brother and sister. (You knew that was coming. You saw it last season on "House.")
Pete unloads his new cellulite machine, which Violet calls the "de-fatilator." He's really missing Dell, who has been replaced by a pretty young thing.
Sam briefs Kirk's dad on his status. Kirk wakes up and hears the treatment he's in for. He yanks his intubation tube out of his throat and says he doesn't want treatment. He won't let Sam put the tube back in. He asks Sam to let him die.
Naomi learns that Ryan and Lisa are the products of the same sperm donor. They bring in Violet to game plan how to tell them. Carefully.
Violet catches Cooper making calls, trolling for patients. She asks if he wants to get lunch, but he says no because he has plans with "a friend." Violet tells him she knows he's lying, and he knows it. So why? He says nothing.
Pete and Sam talk about Kirk, who won't be 18 until next month. His dad Charlie won't let him go. His wife died two years ago. Pete thinks Sam should listen to the patient.
Naomi and Add break the brother and sister lovers the really bad, gross news. They walk out and give the sibling lovers a minute. Add tries to get Naomi to tell her what to do about the fact Kevin the cop still hasn't called.
Ryan and Lisa walk out. They still want to get pregnant. They're "soul mates" and aren't splitting up.
Lisa defends it by saying "cousins get married all the time." Sperm donation is out because Naomi won't do it and an adoption agency would look at their records and get tipped off. Ryan comforts his sister. Add says they can't have sex because no birth control is perfect and a child would have 300 times the chance of having a birth defect. Lisa, pragmatically, asks them to tie her tubes so she can keep on, you know, knocking boots with her bro.
Sam is late for the health fair. Pretty Young Receptionist forgot to remind him. She tells him the company that sold them their ultrasounds is coming to pick them up because they haven't paid in three months. He tries to get Cooper to cover for him. Violet enjoys Cooper's refusal to disclose his lunch plans. He cancels with Charlotte via text to go charm potential new patients.
Sam stays behind to hide the machines. Add carps about the fact Naomi won't talk to her. Then she starts talking about Kevin the cop, trying to get him to stand in for Naomi. He fails, but suggest she try calling him.
Cooper returns from the health fair to find a very angry Charlotte, complaining about getting her needs met. The receptionist takes a message for Sam. It's Charlie calling from the hospital. They miss Dell. (And this must be the writers' attempt to make us miss him, too.)
At the hospital, Sam tries to tell Charlie that Kirk is getting very sick. Charlie threatens to take all of his company's business. Kirk needs the tube put back in to live. Charlie tells him to restrain his son if necessary.
Lisa visits Add alone. She talks about her deep, deep, icky love for her husband/brother. She begs Add to do the surgery.
Pete accuses Sam of going against his patient's wishes because the practice needs Charlie's company's money.
Naomi, Add and Violet discuss the sibling lovers. Naomi is against tying her tubes. Cooper comes in and asks how Hansel and Gretl are doing. They all turn to see them making out in another room, which never happened in the fairy tale.
Naomi stares Sam down. She tells him she would have fixed things, she needed a little faith. She thinks he's running it like a factory.
Pete hits on the receptionist, Violet comes over and judges. He calls her a judger. She responds by trying out his defatilator, which somehow leads to a total breakdown over easy fixes during which Pete grabs her butt. Also, Cooper gets lice from a patient, which Charlotte is sure to find very sexy.
Naomi confronts Add, telling her somethings just can't be undone.
They meet with the sibling-lovers, who say it doesn't matter that they know. Ryan says it didn't matter when he found out, he still married her. He knew. He realized all their similarities and looked into it. Lisa freaks out, realizing her brother has knowingly been doing her.
Cooper goes to Violet for lice help. She scrubs his head. "In monkeys it's a sign of affection," he says. She complains about how things are at work now and how he lies. He takes a deep breath and tells her about Charlotte. He says he didn't tell Violet because Charlotte forbade him and also because he was worried what she would think. He might love her, despite the fact she's mean and bossy and would burn him alive if he came near her with lice. He says it's killing him not telling Violet. She doesn't say anything, just keeps picking and rinsing, then says thank you.
Add checks in with bitter Naomi. Ryan's staying at a hotel. He still doesn't understand what he did wrong. In his mind they were best friends and that's all that mattered, Add says pointedly. Naomi responds by walking away.
Addison takes Sam's man advice and calls Kevin, leaving a really awkward horrible message in which she uses the "maybe I missed your call" line. She starts crying and says she thinks she just lost her best friend and he seems like a nice guy and she needs someone to talk to. She realizes how this sounds and finally, mercifully, hangs up.
Violet leads a meeting in which Pete gives up the defatilator and Cooper swears off health fairs. Sam says he just needs a little faith, looking at Naomi.
Sam goes to the hospital to talk to Charlie, telling him he only treated Kirk because he was worried about losing Charlie's business. He tells him you can't throw everything at this problem like is business, because you end up losing something along the way. (Hello, episode theme!)
Add holds the elevator for Naomi, who doesn't get on.
Sam takes the restraints off Kirk and takes the tube out as Charlie holds his hand. Kirk quietly takes his last breaths as Charlie cries over him.
Cooper goes to Charlotte's. She tells him it's not a good night, he tells her he told Violet, which he wouldn't have done if she didn't matter. Off to bed they go.
Pete has massage table sex with the young receptionist, who summarizes that she didn't know sex with "old guys" could be that good. Pete's glow fades quickly.
Addison and Sam drink on their respective porches, consoling each other. Naomi walks up to see Sam. She's angry, but he pulls her inside. She warns him that she's going to be furious for a very long time. They engage in some good old fashioned hate sex.