Addison takes a leave of absence to visit her old friends Naomi and Sam in Los Angeles, a couple who work at the Oceanside Wellness Group. She immediately thinks of Seattle Grace when the first person she encounters at the co op is a hot guy in the elevator.
However, Naomi isn't exactly pleased to see her since it's been more than a year since they talked. Addison says she's had a lot going on, such as the divorce, and Naomi tells her she and Sam are also divorced. Sam is now a medical guru with a best selling book. Addison is surprised to find that they still work together.
Addison tells Naomi, a fertility specialist, that she's come to see her because she wants to have a baby; she's finally decided that 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, who tells Paul to just have sex with her already. That doesn't work and now Paul is crying and Kathy is sorely tempted to just cheat on him already.
Violet has to go pick up Cooper, a pediatrician at Oceanside Wellness whose internet date stole his car, a common problem for him, apparently. 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.
Everyone at the co op comes to help when a patient visit of Cooper's turns violent. A surrogate mother, Lisa, had sex with three men her own husband, the adoptive mother Carol's ex (who was the sperm donor) 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 says that she's concerned that Lisa's had no prenatal care.
They mention that the group's last OB/GYN left suddenly, implying that it was all the fault of acupuncturist Pete, the hot guy Addison already met in the elevator, who is evidently quite the womanizer.
Addison offers to examine Lisa and finds that the baby is Lisa's own and not Carol's. And also that there's a problem: an abnormality with the placenta that could make delivery dangerous for both mother and baby. Cooper wants her to tell Lisa since his people skills are so bad. When Lisa hears of her life threatening condition, she insists that Addison stay on as her doctor. The other doctors exchange hopeful glances.
Pete tells Sam they should ask Addison to take over the empty slot at the co op but Sam tells him he's only saying that because he finds Addison attractive. Pete advises Sam to move on with his life and start dating after his divorce.
Over dinner at Naomi's, Addison looks over potential sperm donors. She says how much she envies Naomi, who "did everything right" by getting married young and having a child. Naomi tells her she thought she'd done everything right too, until the day Sam came home and asked for a divorce. When she looks at her family photos, what she sees are missed opportunities.
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 and now she has no guy and no baby.
Back in Seattle, Mark is upset to find that Addison has taken a leave of absence. He finds Alex and tells him it's all his fault for driving her away. Mark asks Derek why Addison's gone to Los Angeles and he surmises it was to visit Naomi and Sam. Mark confesses that he thought Addison wanted him, but he caught her with someone else. Derek finds the irony very amusing.
Cristina wakes up to find her mother and Burke's mother in her kitchen. They're here to plan her wedding, they tell her. They follow her to the hospital, where she has no choice but to ask a reluctant Callie to be one of her bridesmaids.
Izzie is very excited about Cristina's wedding and doesn't understand why Cristina isn't. She's also surprised to hear that Callie's a bridesmaid, but she instantly feigns enthusiasm. Overwhelmed by the mothers at the bridal dress shop, Cristina pages Burke and demands to know what happened to her wishes for a small, justice of the peace type wedding. To her dismay, he thought she was joking and says he wants a big, traditional wedding.
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.
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. He asks how she's doing and she says she knows that Susan is pressuring him to reach out to her.
George has requested to be transferred to another hospital. He tells Izzie he's not the cheating type and she wonders if that means he would be tempted to cheat with her again if he sees her everyday.
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, as he walks by in just his shorts on his way out to surf every lunch hour.
Pete wants to show Addison that he's not a quack, so he does some acupuncture to relieve her stress. He tells her that she's blocking some serious emotion and that the acupuncture will give her a rush of emotion. He leaves the room and she lies there, insisting she doesn't feel anything, until she starts to cry.
Lisa, the pregnant would be surrogate, goes into labor a month early and Addison scrubs in at the local hospital. Carol and the three possible fathers clamor to know her condition and Addison snaps at them to back off, since their arguing has just made everything worse. The baby isn't crying when it's born and Lisa is bleeding badly and 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 yells at them that Lisa and the baby almost died and that she was too busy saving their lives to determine the paternity. "What's wrong with you people?" she asks them.
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. She asks if the baby will be okay and Addison says she will be. Addison has the paternity results but Lisa says she doesn't want to know who the father is. She gives the baby to Carol after all and the three potential fathers decide they'll raise the baby together as an extended family.
Sam determines that his impotent client Paul's hormones are out of whack, which may take more time to diagnose than his wife Kathy is willing to wait. Kathy tells Paul she had a chance to cheat, but didn't. When they learn that 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 Sam promises there's still hope. To Violet, Kathy confesses that she did sleep with another man and that she doesn't know what to do now. "Love your husband," Violet tells her.
Violet advises Cooper to stop picking up young women over the Internet and to try to meet a woman his own age in the real world. When they all go out for drinks, she tells Cooper about running into her ex and he tries to kiss her. She rebuffs him, telling him she didn't mean for him to hit on his friends.
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.
Naomi is working late and Dell asks if she wanst 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.
Jane Doe, who prefers to go by Ava now, has bleeding on the brain. To fix it, they'll have to do a surgery where she remains awake throughout. That means Derek can map her brain while they work, which could help jog 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.
At the clinic, George asks Miranda if she ever had any doubts about her marriage. She's too busy to answer but when Burke also tries to get marriage advice from her, she orders the two of them to talk to each other about their problems and not to her. Burke wants to know if George was more ready than Callie to get married and George says it just seemed like a good idea at the time. George suggests that maybe it's better to know someone really well, like Burke and Cristina do, before getting married. He asks Burke if you can love two people at the same time and Burke replies that he's still working on trying to love just one person.Burke accuses his mother of having secret doubts about his and Cristina's relationship. He tells her he's always had to lead Cristina and that she eventually follows. 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 if George has told her he wants to transfer to Mercy West and Izzie says he has. "We're fine, right?" Callie asks Izzie about working together without George and she insists they are.
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, waiting for George. She can't help but pick up on the tension between George and Izzie.
Susan comes back to the hospital with a fever and a murmur, which could be a result of the treatment for her hiccups. They keep her overnight and put her on antibiotics. When Derek inquires about Susan's condition, Meredith tells him it's weird that she and her father are talking now. The next day Susan starts having cramps. Meredith thinks it might be a bad reaction to the antibiotics and reassures Thatcher that everything will be 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. Thatcher slaps her. "She had the hiccups!" he says over and over. "I trusted you." Derek tries to grab Meredith before she runs off but she won't stop.
Derek goes by Meredith's house later. He sees her knocking back tequila shots with Izzie and Alex and just walks away.