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With Addison's help, Sam is now in charge of Oceanside. He's taken over, running it more like a business, not a touchy-feely practice.
Addison is missing her best friend Naomi, who has grown distant. She tries to get Naomi to talk, mostly about Kevin, who hasn't called.
There's a ditzy (but cute) temp working at Dell's desk, and a big giant whiteboard in the breakroom, marking who has appointments booked when.
Violet feels it's a "Board of Shame," pointing out who is bringing in the most money, as Oceanside was never about the money.
Pete has a new machine that will break down fat, supposedly. Violet finds it repulsive, but Pete's new clients seem really into it.
Sam's day is booked with a corporation he partnered with to do physicals. The head of the corp, Charlie, knows Sam - his son, Kirk, is a patient.
Kirk is chronically ill, but he's done with it all, and asks Sam to let him die. His dad, however, wants to try everything to keep Kirk alive.
Kirk won't be 18 for another month, so Charlie gets the final say. Pete and Cooper take opposing sides - Pete thinks Kirk's wishes should be honored, and Cooper believes no 17-year-old should make that call.
Violet tries to get Cooper to tell her about Charlotte, but Cooper isn't spilling the beans. He does begin to understand, though, that choosing Charlotte over Violet will more then likely end their friendship.
A new couple come to see Naomi and Addison.
They're young, but are having trouble getting pregnant.
They've been best friends since junior high, and that they're exactly alike - same allergies, likes, dislikes, head over heels for each other.
Naomi takes them on as a client, and after a quick DNA scan, Addison and Naomi realize that the lucky couple are siblings.
Addison finds out that the same sperm donor was used 25 years ago for both of them. Naomi and Addison struggle with how to break to them.
In the end they don't care. After a few moments alone, they tell Naomi and Addison they're still soulmates and still want a baby.
Addison and Naomi explain to them that they're unable, morally, to help, and that adoption or sperm donation are also out. Addison also says that sex is off the table because no birth control is 100 percent safe.
Lisa then asks Addison to tie her tubes. The ethical dilemmas promised this season are coming to fruition, that's for sure.
Later, Lisa meets with Addison alone, and explains that Brian is all she has, and is all she's ever had. Addison starts to think about doing the surgery, but Naomi doesn't agree.
Brian blurts out that it doesn't matter to him now, just like it didn't matter to him when he found out, that he still married Lisa.
Kirk lands in the hospital, and Sam tries to explain to Charlie that Kirk is dying. Charlie threatens to take his (big) business elsewhere.
Sam ends up intubating Kirk against his wishes, even restraining him to keep him from pulling out the tube. Pete calls him out on it, telling him that he chose to ignore his own patient's wishes in order to make a profit.
Sam pulls rank him, belittling Pete's efforts, and Pete throws it back to him that the patient shouldn't suffer for the good of the practice.
Cooper really isn't going to talk to her about it, but Violet's self-esteem issue flares up, and she goes under Pete's fat machine.
Later, Cooper comes to her, needing her help. It seems he's come down with head lice at a health fair he attended to drum up new clients.
Cooper ends up telling her about Charlotte, and admitting it's not just a physical thing, even if Charlotte forbade him to tell his BFF.
In the end, Pete removes all of his appointments from the board and Violet confronts Sam on their practice's theories and spirit. Sam asks for faith while he tries to get through it.
He then heads to the hospital and tells Charlie that prolonging things with Kirk isn't the kind of doctor he needs to be. He explains that the care of Kirk can't be all about business and nothing else.
Sam removes the breathing tube, and Kirk passes away.
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