The episode begins with Charlotte throwing up while at work. A doctor named James Peterson arrives at her office. The two discuss how they both grew up in the South. She tells James she wants him at St. Ambrose, although she knows he is a hotshot doctor. She assures him the advantage he would get by working in St. Ambrose is that, he would be running a department. She then adds, what she is saying wont happy immediately, but eventually, and it would be much sooner than he thinks. She then rushes out to throw up again. At home, Addison and Jake are busy cozying up on the couch. It then suddenly begins to rain and Addison assumes there would be landslides and accidents.
Just then the both of them receive calls from the E.R. At the hospital, a man is brought in who has fallen on his head and somehow isn’t able to move his legs, as a result. James attends to him. The man’s wife too is pregnant and she is rushed to an E.R room, same as the man’s. A man comes in and asks to speak to a doctor. He then faints in James’s arms. Stephanie and Sam are busy making out in a supply room at the hospital. Cooper and James have a difference of opinion about a patient. James later attends to Todd the man who hit his head and was unable to move his legs. Addison says Todd develops sympathetic symptoms every time his wife is pregnant.
As it’s seen, Todd is now able to move his legs, but had developed symptoms 4 times earlier, when his wife was pregnant. “I’d still like to get a neuro council” James says. Sheldon arrives to attend to Nick, who had earlier passed out in James’s arms. Turns out, Nick had adverse reaction to the drugs Sheldon gave him. Sheldon says the reactions are common, when starting a new drug, and that the dosage would have to be alternated. Sheldon assures Nick, he is making progress. Stephanie while attending to Todd’s wife discovers that, Sam and Addison were seeing each other. She seems visibly disturbed by it.
The little girl named Sarah, about who Cooper and James are having the difference of opinion, is agitated when both her parents who are separated, fight at the hospital over her. Sarah comes in often with an injury and James feels the parents might be hurting her. Cooper though, is of the opinion that Sarah has hurt herself playing and nothing more, he seems sure of it because he knows Sarah’s family for a long time. Violet is called in to talk to Sarah. Violet talks to Sarah who tells her how it bothers her when both her parents fight. She then asks to talk to both of Sarah’s parents separately. James asks Sheldon to send Nick home because he can’t be helped, as he is a sexual deviant and a menace to society. Sheldon is shocked at James’s lack of empathy.
Stephanie is even more shocked when, while talking to Addison about Sam, she finds out that Addison is his neighbor. Stephanie reveals to Addison, Sam has told her “absolutely nothing” about Addison. The father tells Violet “I may have screwed up my marriage, but I will never hurt my child; you have to believe me Dr. Turner”. Addison meets up with Sam at the hospital cafeteria and tells him how Stephanie might be mad at him, because of the conversation her and Stephanie had. Sam leaves the cafeteria in a huff, to remedy the situation. Jake comes in just then and Addison and he discuss about a patient of his. Addison feels Jake is giving his patient false hope, but Jake doesn’t seem to agree. Sarah parents come to see her and don’t find her at her bed. Cooper tells them, he thought she was with them.
Dana, Sarah’s mother, begins searching for her frantically. Charlotte immediately calls the security. Later, Charlotte assures both the parents, every inch of the building will be searched by the security. James finds something wrong with Todd’s CT scan and shows it to Amelia. The two then conclude that he needs to be rushed to surgery. He is then taken away in a hurry, just as his wife is informed that, a C-section would have to be performed on her. Sheldon is informed by Charlotte “little girl Cooper’s patient she’s missing”. Sheldon immediately rushes to where Nick is, and sees him sitting alone on his bed. Nick figures out the doubt Sheldon had about him. Sam tries explaining himself to Stephanie but is at a loss for words. “Save it Sam I am working” she says, visibly irritated.
Addison and Jake once again discuss Jake’s patient. Jake in the end tells her “I didn’t ask you for your opinion and I don’t want it”. Sarah’s parents are informed by a cop that, Sarah’s jacket was found on a bench in front of the hospital. “I’m sorry she is not here, security has turned the case over to the police” Charlotte tells Sarah’s parents. “As of now Sarah is missing person” Charlotte adds. Both her parents are shocked and mortified on hearing this. Later, Charlotte tells James “you did good”. James tells her how he might have “pissed off” a few people. She informs him, the doctor he has replaced in other words Pete, also used to piss off people, but she never held that against him, she adds. Sam again has a talk with Stephanie.
Stephanie assures Sam she is “not the jealous type”, but adds “I just don’t like being played”. “How did you think, it would make me feel when I found out?” Stephanie asks Sam, after bringing up the things Addison told her. Sam says he didn’t think it would matter, as their relationship has ended. “Why did it end?” Stephanie asks. “I proposed to her and she turned me down” Sam says, after a bit of hesitation. Stephanie is visibly bothered to hear this. Sam on his part does his best to assure her, he and Addison are done. She feels Sam is on the rebound and she is sad because, she had thought Sam is the “one”. Sam tires apologizing to Stephanie and says “I really do like you”. She though, walks up to him, kisses him on the cheek and says “bye Sam” and then walks away.
Jake takes Addison’s advice and has a talk with his patient. Addison shows Todd his newborn. Addison informs him that it’s a girl. In the morning while leaving for home, Amelia tells James “that was good catch” referring to Todd’s condition that James rightly diagnosed. Amelia also thanks James for the credit that he gave her, instead of taking it for himself. But, she requests him to not do so in the future, as she stands by the calls she makes, given the evidence at hand. “You followed your instincts which I respect, but you take you take your credit I will take mine ok” she says.
James then asks Amelia out to a drink, but she turns him down and basically tells him about her baby that she had to give away. Sarah parents are still waiting for Sarah at the hospital. Violet asks them to go home by making them aware of the harsh reality that, “Sarah is not going to walk through that door”. The episode ends.