We start out at Seattle Grace -- Webber just found out Addison's resigning, and he's angry. But she can't wait to get started on her big life change: new job, new city, new colleagues, new home. We join her dancing naked in front of a window in said home; Sam, her neighbor and fellow Oceanside Wellness Clinic doc, is surprised to see her in town, nude or clothed. It seems Naomi didn't tell him she hired Addison. In fact, as Addison learns when she shows up at the clinic, Naomi didn't bother consulting anybody. She shrugs off the other doctors' protests and gives Addison the office tour. Addison learns she'll be delivering babies in a "birthing suite," with no staff to help, at a rate of maybe one patient per day. Talk about change.
Happy couple Ken and Leslie have come to Oceanside to get pregnant via artificial insemination, but before Ken can make his, er, donation, he has a stroke. They rush him to a real hospital, where bitchy chief of surgery Charlotte King pronounces him dead. Leslie insists that they extract his sperm for her; Dr. King refuses, so Sam sics Naomi on her. Just when Naomi has convinced the hospital to give in to Leslie's demands, another woman shows up and introduces herself as Ken's wife. Whom Leslie forgot to mention. And now she wants the sperm.
At the clinic, Cooper frets about the woman he had "internet sex" with last night, and Violet gets touchy when he calls her a "stalker" just because she keeps calling her now-married ex-boyfriend and then hanging up without saying anything. Violet gets a page and has to rush out to a Target-like store, where one of her patients, Jenny, is in the middle of a psychotic episode.
Addison's first patient is Lucy, a young woman whose dad is angry she's pregnant at all, let alone in labor. Addison surprises herself by making an emotional connection with the distraught mom-to-be, and by actually needing the assistance of midwife-in-training receptionist Dell and holistic doc Pete. There are complications with the labor (of course). Addison calls for an ambulance when Lucy's heart starts to give out, but slow L.A. traffic forces her to do a C-section on the spot. With no anesthesia. Pete the quack says he can "treat [Lucy] so she doesn't feel any pain," and fortunately for Lucy, he turns out to be right! The baby is delivered safely; Lucy flatlines, but the defibrillator brings her back. And Lucy's dad can't stay mad while he's holding his new granddaughter.
At the real hospital, Naomi and Sam go from discussing Ken's sperm to arguing about their own divorce: Naomi's still mad that he walked out, but Sam thinks she didn't fight hard enough. Naomi then has a heart-to-heart with Ken's jilted widow, who agrees to let go of her dead, unfaithful husband and his sperm. Naomi extracts said sperm for Leslie.
Violet needs Cooper's help to figure out what set Jenny off -- turns out she once lost a son to brain cancer (and never mentioned it in therapy). The docs tag-team Jenny, snapping her out of her trance by going over her son's medical history. Everybody cries.
Post-surgery, Pete and Addison flirt; meanwhile, Violet and Cooper patch things up. Over cheesecake, Addison grills Naomi about why she didn't tell the other docs about hiring her. Naomi admits that she's lonely and needs a friend nearby. The other docs summon Naomi and Addison to the conference room, insisting on a vote over Addison's joining the practice. But Addison won't have it: she really loved having just one patient, they need her skills, and she's staying. She celebrates with another nude dance – but this time she remembers to close the curtains.
We open on the concrete exterior of Seattle Grace, but instead of Meredith's vapid narration unspooling over footage of the various docs starting their days, we get immediate action. Angry Chief Webber storms into the surgery-prep area, where Addison is scrubbing in (or possibly out). He wants to know what's up with the letter of resignation on his desk, and he's not trying to hear any of this private practice/medical co-op/moving to L.A. stuff. "This is not my Addison," he says. "My Addison is a world-class neonatal surgeon." (And non-Grey's fans are now completely up to speed.) At this moment Addison certainly looks the part, in her scrubs and everything. But she fires back, "Your Addison would have been promoted to chief of surgery, so stop Addisoning me." (Incidentally, spell-check suggests that she meant to say "Stop radioing me" or "Stop disowning me.") Webber protests, "You don't know anything about those people!" and Addison proves him wrong with a quick character breakdown: There's fertility specialist Naomi, her best friend from med school -- "She's an amazing woman," Addison declares, as we see Naomi slumped on the floor of her bathroom, sobbing and eating an entire carrot cake right out of the box. Then there's Naomi's ex-husband, internist Sam: "You wish you had his people skills," says Addy, and we see Sam in bed, having an emotional conversation with...his teeny-tiny, pillow-destroying dog. Hee. Addy moves on to psychiatrist Violet, who's "grounded" and "strong" -- and, at the moment, dialing her ex-boyfriend, who picks up and says, "Hello? ...Hello? ...Violet, you have to stop calling here. I'm married now!" She hangs up, with an appropriate amount of self-loathing. On to Cooper, the pediatrician -- by this point I'm wondering why Webber hasn't interrupted, but whatever. Addison calls Cooper "a pro," and we note that one of his professional-level skills is making terrible choices when it comes to sexual partners. We can tell because he's spread-eagle on his bed, chained to the frame with fuzzy handcuffs and trying to sweet-talk his unseen paramour, whose name he can't remember, and who walks out without even tossing him the key. (We never find out how he frees himself, thank God for small favors.) Finally, there's alternative-medicine practitioner Pete; Addison is still skeptical of his work, of course, but as we revisit their face-sucking from last season's pi-not, she recalls, "The man is a healer." These, she insists, are the people she wants to work with.