You know how this show has been sort of all over the place this season? And yet it's gone nowhere? Well, that continues right up until the end of the season. The episode picks up right where the last one ended, with Maya in the hospital and Sam operating on the guy who hit her and Dell's car. Little Shephard is called in when it looks like Maya has a broken back (she does), Charlotte's called in from her date with Sheldon. Basically, the gang's all here. They have to operate on Maya and the baby, but can't remove the baby without paralyzing Maya so it's a complicated procedure involving Addison and Little Shephard (and Fife, who offers up the brilliant suggestion to use hypothermia). While this all happens, Dink shows up, Naomi apologizes to Addison, Sheldon acts insecure, Cooper proposes and Charlotte accepts, Violet shows everyone pictures of Pete and Lucas, and Dell feels bad for what happened but everyone mostly ignores him.
In the end, Dell ends up passed out in the waiting area, and Little Shephard has to rush from surgery on Maya to try to save his life. She doesn't. Addison saves Maya and the baby though, so there's good news and bad. Mostly bad, though, because Little Shephard has to tell Addison (tears), then they have to tell everyone else (tears) and Pete tells Betsey (TEARS). She's going to live with her aunt in Portland (read: gone from this show forever). Then Addison offers Violet to Pete on a silver platter, saying they'll always be friends but he loves Violet. Charlotte and Cooper decide to wait until tomorrow to get engaged, since this was a totally crappy day. Addison and Sheldon talk about their sad-sack situations, and he tells her to go after Sam, since he loves him and life is short. So, she stands on a beach, then walks into Sam's and asks him if she makes him happy. She does. And he makes her happy too. So she strips off her clothes right there in front of him, no foreplay or getting cozy or anything, and then sits on his lap. Was that supposed to be love? Because it looked like lust to me. Thankfully, the season's over, but why oh why would they kill the show's most consistently likeable character?
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When we open, Sam's starting to operate on the guy who hit Dell and Maya with his car -- only Sam doesn't know about any of that yet, just that this guy needs surgery. The guy tells Sam that God's pissed off at him for crashing the car and screwing up, but Sam says everyone screws up and God must know what he's doing to put the guy on Sam's table. Sheldon and Charlotte show up at the hospital, since she was called in. He's insecure that she faked the helicopter, but he says she would fake a headache to get out of a date. Sheldon's going to stick around in case this is quick. Charlotte finds Maya in the hospital bed and Dell's there too, being checked out. Addison and Charlotte make him sit down, but he's worried about Maya, who says she feels better since the epidural. Dell says she hasn't had one, which probably means her back's broken. Addison tells Charlotte that Naomi knows nothing yet. Title card.
Charlotte fills Violet, Sheldon and Pete in on everything that happened. She puts Violet on telling-Naomi duty and then tells Pete that Sam's operating on someone and she has a new cardiac surgeon on the way, but he won't be here for a half-hour. I don't know what this meant to Pete, but he takes off like she just gave him a chore. Cooper accosts Charlotte in the hospital (how did he know she would be there when she was supposed to be on a date?). He tells her he wants to talk, but she asks Sheldon to please fill him in. Sheldon doesn't want to, but Charlotte leaves them alone. Cooper asks him what the hell.
Naomi comes into the hospital and won't stop talking about how happy she is about Maya's baby, despite all of her misgivings. And she feels like the universe is good today, since William's going to take Fife's ALS treatment. Violet finally interrupts her and tells her something's happened to Maya. She rushes in to Maya's room, where Dell apologizes and she just looks at him, so Violet steps in and tells him this isn't his fault. Maya asks Naomi where her daddy is, and Addison tells her they're going to have this baby. They wheel her out. Speaking of her daddy, Pete interrupts his surgery and asks him to consult for a minute. Sam says it could be awhile, since this guy did something bad with his pulmonary artery. He tells him he smashed his Beemer and rib cage. Pete storms out and asks Charlotte if that's the guy who hit Maya and Dell. She says he is, but he has to keep working until the other surgeon gets here, because "We can't just duct-tape him closed." What? I thought that's how it worked.