Getting On Episode 2.04 The 7th Annual Christmas Card Competition

Patsy kicks off the annual Mount Palms Christmas Card Competition to benefit the children's oncology ward -- staff can make their own original card or use an app for help getting started. Dr. James stops by the nurses' station to brag that she's been invited to participate in a study on perianal augmentation to treat female fecal incontinence. She explains the procedure is a lot like collagen injections for lips, except for the interior anal sphincter.

Patsy and Dawn's strained relationship reaches a breaking point following Dawn's blighted ovum. She treated them to a weekend at the La Hoya Four Seasons to help ease the transition from "a couple with a baby to a couple without" to no avail and worries that Patsy is going to break up with her. When Dawn confronts Patsy about his cold shoulder, he admits that he has "not positive" feelings towards her. 

On rounds, Dr. James meets Denya Thorpe, a patient in her mid-50s suffering from ovarian cancer. She's been transferred to hospice after learning she only has six months to live.

DiDi, hoping to win, works on her Christmas card for the competition, but is interrupted by Dr. James and Dr. Cesario who commandeer her computer to  upload large format vulva pictures from Dr. James' study. A short while later, Patsy confronts Dawn about an obscene picture that was sent to the Christmas card competition -- he thinks it's one of the "intimate selfies" she took during their stay at the Four Seasons. Dawn balks at the suggestion; the vulva in question is clearly that of an 80-year-old and she's offended that he's unable to tell the difference. After scrutinizing the picture, Dr. James identifies the "owner" as Birdy Lamb; union rep Paula Pepperell forces Dr. James to apologize or face legal action. Birdy is tickled by the attention and jokingly denies the picture is of her vagina, noting that hers is "as big as a bucket!"

Dr. James is upset to discover that TVs -- bought with her hospice money -- are being installed in patients' rooms. She confronts Dr. Paul Stickley on the issue who downplays her need for money, suggesting all her research is "too ambitious" and she should stick to geriatrics. "We plump up our lips with collagen to give better blow jobs and make ourselves more kissable," she yells, "but for us to use that same material in tissue that is infinitely more meaningful to us, our anal sphincters, is to live out our lives with dignity!"

Denya meets with Dr. James to request a "quickened ending." She suggests her morphine be upped to "hasten things along," but Dr. James explains that won't be possible as every patient death is reviewed by a nurses' panel. Denya grabs the hand of Dr. James, who is forced to listen to her life story. To drive home her right to die, Denya draws comparisons to the way animals are allowed to wander off when their time is up.

DiDi walks in on Denya with her chemo cap off. "I didn't mind when my hair fell out," Denya says. "But it killed me when I lost my eyebrows." Inspired to give Denya a makeover, DiDi asks Dawn to come with her to the beauty shop to collect supplies. Dawn insists they take the stairs to avoid a confrontation with Patsy, but he follows them anyway, and after a fight, Dawn breaks up with him. To prove her indifference, she attempts to slide down the banister, only to fall and injure herself.

That night, Dr. James sits with Denya and informs her that an abdominal scan showed new lesions on her kidney and spleen; she believes the original, six month timeline is over-optimistic. Dr. James offers Denya a choice: She can either stay in hospice or go home, where she will be provided with a morphine pump to be adjusted to her level of pain. "You would be in charge of making yourself more comfortable," Dr. James explains. "Do you understand?" With tears in her eyes, Denya thanks her.