"Derek, I need you." Those are four words we never thought we'd hear Dr. Addison Montgomery say ever again.
But, to get to that point, let's flash back to 14 hours earlier:
Naomi and Addison's brother Archer wake up in each other's arms. Archer begins to get a little randy-much to Naomi's pleasure!-but the good time quickly turns into a nightmare when Archer suddenly has a seizure. He shakes violently and falls to the floor.
Thinking quickly, Naomi dials 911. In the hospital ER, Archer sits up, claims he's perfectly fine, that it was just a random seizure. But then, he asks the impossible: Can Naomi keep the seizure secret from Addison? She has to tell her best friend, right? We would.
At Oceanside, Addison mentors Dell during a mildly complicated delivery. The baby won't come out, so Addison calmly orders him to perform a vacuum-assisted delivery. Dell applies the device. The mother, Maggie, gives one last push. And Dell helps pull the baby out! The newborn has a slight bruise on her head, but she's fine.
Naomi struggles to keep her secret from Addison. She confronts Archer again whereupon he levels the truth on her. He has an inoperable brain tumor and there's nothing anybody can do to save him.
Now, this is a secret Naomi can't keep any longer. About time! Finally, she runs to Addison and tells her the whole truth. Rather than take the news lying down, Addison jumps on the horn to get Archer's medical records to see how she can save her brother.
After a flurry of phone calls and emails, Addison finally tracks down her brother's brain scans. There's a tumor growing right in the center of his brain. Addison calls all her friends and her brother into her office to hash out the situation.
Removing the tumor would mean taking out half of his brain to get to it; and chemo would burn most of his brain tissue before even reaching the lump.
Regardless, Addison orders another scan, which reveals two things: 1. The tumor has doubled in size in just a few weeks. 2. It's not actually a tumor. It's a sack of parasites that's growing in his brain. OH, ICK! That's just about the grossest thing we've ever heard.
Addison insists Archer have surgery now to cut the parasite sack out before it explodes. But, Archer insists he'll just take anti-parasitic steroids. No matter how much Addison argues with him, ultimately, it's his decision.
Meanwhile, Dell continues to worry about Maggie's baby. He's afraid he's seriously hurt her and wants to order an MRI, but Addison has disappeared. Violet quickly figures out that the MRI is more to calm Dell's nerves than to actually see if the baby is hurt. And, speaking of babies, Violet doubles over with painful cramps.
Dell takes Violet to the ultrasound room. Yep, there's a healthy baby growing inside her. Except, Dell tells her that the cramps aren't from the pregnancy. They're from stress. She has to tell Pete and Sheldon that one of them is the father or her anxiety is only going to harm the baby.
So, Violet finally sits down with both Pete and Sheldon and drops her bomb on them. She also says she doesn't expect them to help her in any way. Rather than act relieved, both men become furious that she has already made their decision for them. Frankly, we don't blame them.
Addison and Archer relax at the beach reminiscing about their childhood, when-oh my god!-Archer has another violent seizure.
She rushes him back to the hospital where paralyzing agents stop his body from shaking. With her brother unconscious, Addison makes the final decision that he needs surgery immediately. And the best man for the job? Derek. She dials the love of her life and asks for his help.
Within minutes, Archer is hustled to a helicopter to be flown up to Seattle Grace. With Addison, Naomi and Sam in tow.