When Addison's patient and the life of the three unborn babies she is carrying as a surrogate hang in the balance, Sam's new girlfriend, Vanessa, and Addison are sharply divided on the course of treatment. Meanwhile Cooper seeks Sheldon's help with a young patient, but their personal quarrels over Charlotte get in the way, and Naomi has a dilemma of her own between William and an unexpectedly charming Dr. Fife.

A husband's decision to pull the plug on his pregnant wife is overruled by a judge, forcing the hospital to keep her on life support until the fetuses she is carrying as a surrogate are able to survive. Meanwhile, Naomi feels betrayed after learning of Sam and Addison's feelings for one another, and she turns to Dr. Fife for support while William is away on business. And unable to cope with the tension, Addison takes the day off with Pete and Lucas.

When famed neurosurgeon Dr. Ginsberg and her team pay a visit to St. Ambrose to save the life of Kayla, Addison is shocked to see Amelia Shepherd - Derek's younger sister on the team. But Amelia's presence causes strife between Addison, Sam and Pete when she claims she can save Kayla's life after Dr. Ginsberg declares nothing can be done. Meanwhile Charlotte seeks from Cooper's with a sex education seminar for the elderly that only leads to more tension between the two, as they try to figure out how to work together.