Ever wonder how Seattle Grace’s own Addison Montgomery got her start in a Private Practice? Well, that’s why the world has crossover episodes!
Addison takes a leave of absence from Seattle Grace to visit her old friends Naomi (Audra McDonald) and Sam (Taye Diggs) at the Oceanside Wellness Group in sunny Santa Monica, California. Naomi tells Addy that she and Sam, now a bestselling medical guru, got divorced but they still work together. Sound familiar? Addison tells Naomi, a fertility specialist, that she wants to have a baby. She's finally realized the men in her life aren't going to come through for her in that department.
Sam treats a woman, Kathy, with her fourth sports-related injury in three months. She confides that she needs an outlet because her husband, Paul, hasn't had sex with her in 18 months. He refers them to the co-op's therapist, Violet (Amy Brenneman), who tells Paul to just have sex with her already. It doesn't fly and now Paul is crying and Kathy is sorely tempted to just cheat on him.
Violet has to pick up Cooper (Paul Adelstein), a pediatrician at Oceanside Wellness whose Internet date stole his car, a common problem for him. Violet runs into her ex, Alan, with his new bride of eight weeks. She tells a colleague she's a lousy therapist since she can't even get over her ex after six months.
A surrogate mother, Lisa, had sex with three men (her own husband, the adoptive mother Carol's ex and Carol's new husband) before undergoing embryo implantation. Now everyone is fighting over who the father is. The entire staff consults on the case and Addison is concerned because Lisa's had no prenatal care.
Addison discovers that the baby is Lisa's own, not Carol's. There's a problem: an abnormality with the placenta that could make delivery dangerous for both mother and baby. When Lisa insists that Addison stay on as her doctor, the other docs exchange hopeful glances. The group's last OB/GYN left suddenly. They imply it was the fault of acupuncturist Pete (Tim Daly), a hot guy Addison met in the elevator, who is quite the womanizer.
Addison's plans for a baby are dashed when Naomi tells her that she's now infertile. Addison can't believe it: She put off having a baby with Derek to focus on her career and then she didn't have Mark's baby because he wasn't the right guy. Now she has no guy and no baby! Think it may be time for a life-changing decision?
Back in Seattle, Mark is upset to find that Addison is gone. He tells Alex he drove her away. (Actually, she drove herself away in a flashy red convertible.) Speaking of leaving, George has requested to be transferred to another hospital. It’s his way of getting away from Izzie.
Cristina wakes up to find her mom and Burke's mother in her kitchen. They’ve dubbed themselves Cristina’s personal wedding planners. They follow her to the hospital, where she has no choice but to ask a reluctant Callie to be one of her bridesmaids. Overwhelmed by the moms, Cristina pages Burke and demands to know what happened to her wishes for a small, justice-of-the-peace-type wedding. He thought she was joking and says he wants a big, traditional wedding. Come on, Preston! Even we know Cristina doesn’t joke.
Meredith tells Derek that now is not the time to give up on her, since her near-death experience has made her a different person, one who now has hope. Later, Meredith's stepmother, Susan, comes into the hospital with hiccups that won't stop. They treat her with an endoscopy. Thatcher is very worried about the procedure, so Meredith sits with him and reassures him everything will be okay.
In L.A., Addison tries to come to terms with the news that she's infertile. Naomi and Violet show her their form of depression therapy: admiring the physique of the Oceanside Wellness Group's young receptionist, Dell (Chris Lowell), as he walks by in just his shorts on his way out to surf away his lunch hour. You really shouldn’t skip meals like that.
Lisa, the pregnant would-be surrogate, goes into labor a month early. The baby isn't crying when it's born and Lisa is bleeding badly. She needs surgery. Addison is able to save both mother and baby, but all Carol and the others want to know is who the father is. Addison is appalled. Lisa and the baby almost died and she was too busy saving their lives to determine the paternity. "What's wrong with you people?" she asks. Tell ‘em, Addy!
Carol seeks out Addison and assures her they're not terrible people, but that she just wanted a baby so badly, she lost sight of everything else. The baby will be fine and Addison has the paternity results. Lisa says she doesn't want to know who the father is. She gives the baby to Carol and the three potential fathers decide they'll raise the baby together, as an extended family. That kid’s gonna score big-time on birthdays!
Sam determines that his impotent client Paul's low libido is due to a tumor on his adrenal gland, Kathy is astonished to realize that Paul wasn't rejecting her, he was just ill. She apologizes profusely for yelling at him and tells him how much she loves him. The tumor is advanced, but there's still hope. To Violet, Kathy confesses that she slept with another man and doesn't know what to do now. "Love your husband," Violet tells her.
Pete finds Addison crying in the stairwell and she blurts out all her troubles, including that she's barren and "dried up." He tells her he's going to kiss her and she says "Okay." When she asks why, he says it's to remind her that she's a long way from dried up. You think maybe Pete did his internship at Seattle Grace?
Naomi is working late and Dell asks if she wants to get something to eat. She tells him she's already eaten, so he asks about the next night. She turns him down, saying he's far too young for her. Addison wants to know why Sam is warning her against Pete. He tells her Pete's a good guy, but ever since his wife died eight years ago, he hasn't been able to connect with any one woman for long. Sam also tells her he woke up one day and realized he couldn't be with Naomi any longer, even though he's still not sure why.
Before Addison leaves to go back to Seattle, Naomi reminds her there's an empty office there if she wants it. Pete joins her in the elevator. He asks if she got what she came for and she says she isn't sure. He offers to kiss her again but she says no. Too bad. We liked the first one. A lot!
Back in Seattle, Jane Doe, who now officially goes by Ava, has bleeding on the brain. To fix it, they'll have to do a surgery where she remains awake throughout. Derek can map her brain while they work, which could help her memory. She agrees because she is more motivated than ever to regain her memory now that she's a mother.
During the surgery, as Derek touches different points of her brain, she speaks in Spanish, French and German. She starts to crash and they have to put her under. When she comes to after the surgery, the bleeding is under control, but she's devastated to realize that her memory still hasn't come back. Alex tries to tell her that maybe this is a blessing, having a clean slate, and she wonders how he can be so kind to her and yet run away from someone he has feelings for. Yeah, we’ve been wondering that, too.
Burke accuses his mother of having secret doubts about his and Cristina's relationship. He knows marriage is a big step for Cristina but he's confident she will be happy someday. His mother wants to know, if he's so sure about this, why he's yelling at her. Cristina tells Burke she's finally picked a dress. "Are you happy?" he asks her, and after a pause, she answers. "Yes." He tells her he's happy, too.
Callie asks Izzie about working together without George if he transfers to Mercy West. Izzie insists it’s all good. Alone with George in the elevator, Izzie protests it's not fair that he's transferring and she's losing her best friend because of what happened between them. They start to kiss and he tells her, "We can't." The door opens and Callie is there. She can't help but pick up on the tension.
Susan comes back to the hospital with a fever and a murmur and later has cramps. Meredith thinks it may be a bad reaction to the antibiotics and reassures Thatcher that everything is okay. But then Susan becomes septic and they have to rush her into surgery. Thatcher paces anxiously in the waiting room and Meredith comes out to tell him they did everything they could, but that Susan is dead.
In a move we didn’t see coming, Thatcher slaps Meredith across the face. "She had the hiccups!" he says over and over. "I trusted you." Derek tries to grab Meredith before she runs off, but he can’t stop her. Derek goes by Meredith's house later. He sees her knocking back tequila shots with Izzie and Alex. We can only assume that Derek feels like he doesn’t belong there, and that’s why he just walks away.