This week, our patients of the week consist of a pregnant woman who needs a new heart -- and a new husband, after hers suddenly dies of an "accidental" insulin overdose. Addison thinks his brother, who just happens to be in love with his wife, did it. But either way, she gets his heart, so that's a good thing, right? Addison works with Noah on the patient, and they save her together. Addison tells Noah this is a line that can't be crossed, and he realizes she's angry about the rainy kiss. She's blaming him, but she's really mad at herself for kissing back.
Pete breaks up with Taye Diggs' wife after telling her Violet might be carrying her baby. He wants to be there for Violet instead. But, because this show is completely infuriating when it comes to relationships, right as Pete's gazing at Violet through her office window, Sheldon barges in, confesses his love, and PROPOSES to her. They leave us hanging on that, as if there's any way in hell she would ever say yes. Pete also helps Dell sort through his issues, sort of. Mostly Dell cries about how much he loves Betsy and wants her back. All he knows is St. Louis, and where Heather works. Which you'd think would be enough, but apparently Dell's not that bright. He is cute, though, so he probably doesn't need to be all that smart, anyway.
Sam's patient is a teacher who's having sex with her 17-year-old student. She was driven to it after her husband was cheating with lots of young women. She felt old, and turned to the new kid who loves her. She loves him, too, but ultimately Cooper and Sam convince her how wrong this is and she tells him goodbye, and she doesn't love him. He doesn't believe it, but Sam gives a speech about how you have to move on from loving someone if you know it's wrong. Then he proceeds to tell Naomi they can't be friends, he needs distance, because he needs to actually move on. Which is sort of perfect, because Naomi's being courted by Bill Buchanan to run some new-fangled medical practice. We find out at the end that he owns the practice Charlotte's running, so we might find Naomi working for the competition in no time. Damn Sam and his need for distance!
The show returns with a slightly off-color flashback of Addison's kiss with Noah, which leads directly to Violet and Cooper doing some sort of way-too-intimate Lamaze activity in which he's sitting behind her holding her belly to get her to breathe. Charlotte comes out and says she didn't sleep over to wake up to an empty pillow. Violet laughs that she can leave, but Charlotte says she agreed to adult sleepovers here because she gets her itches scratched when the sun comes up. Keep in mind that someone actually got paid to write that bit of dialogue. And then try not to kill yourself. She says she's going back to the room, and if he's not there by the time she's naked... but she doesn't finish. He tells Violet she's bluffing, but then a piece of clothing comes flying in and he takes off to follow her.
Addison greets a patient, who's there with a guy (Keith from Six Feet Under, actually) who apparently isn't her husband. Addison asks where he is, and she says it's not his thing. She says it's okay, though, because Malcolm's better at it. Keith (that's Malcolm) says the good thing about being a nurse is it's easy for him to fill in. Dell comes in late, and Addison scolds him in front of the patients, which seems weird. Dell greets Malcolm, who says if Addison fires him, they'll take their business elsewhere. Well, Malcolm, it's technically not your business at all. Addison asks the mom if she's tired. She is, and she wonders if it has to do with Phillip (the father) and his diabetes -- if it's gestational diabetes or something. Addison says there's no association. Malcolm tells the woman she's beautiful. Addison listens to the mom's lungs and then tells Dell to get an ambulance. She hears fluid in her lungs, which could be a problem with the heart. There's a lot of exposition in this scene for what comes later in the episode, which annoys me on second viewing because now I see how cheesy and blatant it all is. At the hospital, Noah greets Addison. She's annoyed that, with forty heart patients, he's the one on the case. They look at the scans of her heart, and realize both the mom and baby could die because of her heart problem, but he'll do everything he can to save them. He walks off.
Bill Buchanan jumped straight from his death on 24 to dinner with Naomi. They are talking about HMOs, and she's blunt about how much she hates them. He loves that she's honest, because most people won't say that to his face. Um, most people won't tell him they hate HMOs? If he has ten minutes, I can find him at least 100 people. I'm just saying. She tells him she can't figure out what he wants from her since her practice will never be part of an HMO. He agrees with her decision, and tells her he got out of the HMO. He took the money and ran. He watched his friend die of ALS, and it changed him. He wants to change the way medicine works, with a state-of-the-art medical facility. He's not at liberty to discuss details (hmmm; why would that be, I wonder?), but he wants her to run it. He knows all about Naomi: how great she is at fertility, that her practice is dealing with financial stuff and that she's not even running it now, so it's not really her practice anymore. She says it's still her practice. He asks her what if she had access to cutting-edge technology, and the best doctors and specialists all under one roof. She says she has the best now. She seems to forget we all know who she works with. He tells her to think bigger. She says she and her ex-husband built their practice, and she wouldn't entertain leaving it. He tells her to entertain it now, because he's offering the chance of a lifetime. Sunny opening.