After having a nipple bitten off by her dog, Shari Noble comes in to have it reconstructed before her husband returns from Iraq. Julia meets a breast-feeding expert. Christian and Liz hit a lesbian bar where Christian tries to attract one of the women there but she's attracted to Liz instead. Sean and Christian meet with a kidney specialist for one of their patients.
At McNamara/Troy, Christian is taking a break. Sean comes in, wanting to talk. Christian, not wanting any hassle about being late for Conor’s birth, beats him to the punch by calling himself shallow, insensitive and ‘a disappointment as a friend’. Rather than being angry, Sean apologises and admits he did sleep with Monica Wilder then fixed her nose to stop her from telling Julia. Christian sympathises then, when Sean admits to wanting to sleep with Monica again, deletes her number from Sean’s phone, saying that ‘some men can’t handle temptation, some men can.’
At Christian’s apartment, he and Michelle have champagne and Michelle invites him to take Burt’s place at a charity fundraiser. When Michelle asks why there are only two places set at dinner, Christian tells him Sean can’t make it. Michelle reveals she went to medical school and wanted to specialize in reconstructive surgery but had to drop out, as her mother was ill. Christian tries it on with her, but Michelle slaps him. Christian tells her she should either give in to the mutual attraction or sell the business back to him. Michelle tells him flatly that, if he’s uncomfortable around him, he should leave because she’s not going anywhere.
Julia is having problems breast-feeding Conor and snaps at a nurse who attempts to help him. Sean tries to help her understand the benefits of breast-feeding to the baby, especially in light of the surgeries, but Julia also snaps at him, accusing him of judging her an thinking she’s a bad mother. She believes she may be suffering from post-partum depression and perhaps should be on some kind of medication to help her with it. Meanwhile, Christian is in a consult with Shari Noble, a woman whose dog (a pit-bull mix) has bitten her nipple off. She is very insistent that it should look like nothing has happened as her husband is coming back from Iraq and will put the dog down if he finds out about the attack
As Liz and Christian prepare for surgery on Shari, Michelle comes in to see him. He makes a lewd comment to Michelle and Michelle responds by rescinding her offer for Christian to take her to the fundraiser, as Burt is feeling better. Whilst in surgery, Christian and Liz bond over their mutual attraction to Michelle. Liz mentions the ‘gaming’ that goes on in lesbian bars and admits that it’s been a year and a half since she last had a date. Christian offers to coach her and asks what she’s doing Saturday night.
At the McNamara house, new night-nurse Marlowe Sawyer is busy doing a mural in Conor’s room of Adam and Eve. Julia asks if he thinks it’s the most appropriate thing for a nursery, but Sawyer ensures her it’ll be ‘full of magic and colour’ and, if she still doesn’t like it, he’ll paint over it. Julia tells Sawyer about her possible post-partum depression but Sawyer makes an observation that she seems to feel responsible for everything. As Julia tries to nurse again, Sawyer puts a warm washcloth on her breast to help encourage the milk to flow. But Sean is watching from the doorway and doesn’t look too happy…
At the lesbian bar, Liz and Christian discuss the various women there, and Liz classifies herself as a ‘six’. Across the bar, a spectacularly beautiful woman- a ‘ten’- is looking over at Liz. Christian believes the woman is looking at him and goes in for the kill, only to get roundly rebuffed when she calls him an asshole. Christian comes back, complaining that lesbians have no sense of humour. The bartender gives Liz a drink, saying it’s from the very attractive woman, and asks how soon she can ditch ‘the fairy’? Christian looks offended, but Liz looks ecstatic. Liz goes home with the woman for more drinks and some heavy petting… the next morning, Liz wakes up with a cell-phone taped to her hand. A very polite phone-call informs her that she’s had one kidney removed.
Christian and Sean arrive at the hospital to see Liz. They find out from the consultant nephrologist that Liz is the latest victim in a series of organ thefts that have been happening in Miami since Christmas, and the police thing an organised crime ring has moved into the city. They go to see Liz, and she tells them she’ll be out of commission for four to six weeks but then gets upset when she realises she hasn’t got anyone to take care of her. But Sean tells her she’s wrong: they’ll be there for her. Christian tells her they’ll be taking her back to McNamara/Troy as soon as she’s fit to be moved.
Back at the offices, Michelle is confronted by the mystery woman Liz saw her with in the parking lot. The woman, who is known as James, has brought a young woman with her called Annalise and tells Michelle to put Annalise’s name on the books for surgery on her nose and chin to be done that day, as Annalise has been ‘sloppy’ and ‘compromised a client’. Michelle says she only owes James one more payment and won’t do this for her, but James says that the new plastic surgery outfit will be a boon to her. Annalise looks terrified of James yet she agrees to the surgeries, saying that James always knows what’s best. When Michelle says the doctors will turn Annalise down, James smashes Annalise across in the face with a marble paperweight, breaking her nose, then tells Michelle in no uncertain terms to put Annalise on the books. Now.
Annalise goes in for surgery, but Christian argues with Michelle over changing the girl’s features. Michelle says the patient has asked for it in writing and Christian relents. Michelle asks how long the surgeries will take and Christian says he might need some help to get them both done in time. Michelle says she’ll get Sean in but Christian suggests that Michelle helps him instead. She scrubs up and helps him with the operation. Meanwhile, Sean is in his office, firing Sawyer for touching up his wife. Sawyer explains that he was helping Julia’s milk production but Sean doesn’t buy it, thinking that Sawyer is sexually frustrated because he has trouble attracting women. Sawyer sets him straight about that (he has no problem with women) and also about what Julia needs. As they talk, Monica Wilder comes in to see Sean.
Monica tells Sean she is having trouble breathing, so he examines her. She tells him that was just a front so she could get to see him again. She can’t get him out of her mind. Sean tells her it was just a mistake but she asks him to come and see her again that night. As Shari Noble has a follow-up consult with Christian, her husband Mark comes in to see her. She seems very surprised and a little agitated to see him back so early. Mark seems to be very upset that he’s found an open jar of peanut butter by Shari’s bed. It turns out that Shari was using the peanut butter to seduce her dog. Mark has brought his duffel bag with it, which contains the dog’s dead body.
As James waits by Annalise’s bed, the police come to remove the dog’s body. Michelle expresses her regret for what happened to Liz and offers any help she needs. As she leaves, Christian eyes her up but Liz reminds him that there’s a reason certain fruit is forbidden. James comes to look for Michelle but leaves abruptly when Liz tells her that Michelle’s gone to sort out some business. Liz then informs Christian that James was the woman that was with Michelle in the parking lot.
When Sean goes home, he notices that Julia is feeling a lot better. As he gets them both a beer, he notices a pharmacy bag in the trash. Checking in her handbag, he finds a bottle of anti-depressants. Pretty quickly, he’s knocking on Monica Wilder’s door. She’s really happy to see him and offers him some chocolate brownies laced with hash. He eats one and starts to hallucinate. First, Escobar Gallardo (dressed in red) comes in and starts to tempt Sean to have sex with Monica. Then Sean imagines Megan O’Hara (dressed in white) trying to stop him from doing it. Escobar tempts him with an apple from the Tree of Knowledge, but Megan tries to stop him from taking it. Sean looks to the bed and imagines Escobar having sex with Monica then Megan and finally Julia, who admonishes him and asks him if he still loves her. Sean says ‘I love you’ but the bed is empty and Monica turns round to him and says she loves him too. Sean tells her she’s lovely but that he wants to go home. He gets up and leaves.
Michelle comes home to find Burt laughing and joking with Christian. He drops a hint about operating on Annalise, which Michelle doesn’t take. She says she’ll see Christian tomorrow but he reveals that Burt’s invited him to stay for dinner. Michelle goes for a drink in an adjoining room, where Christian asks her flat-out about James. Christian threatens to tell Burt about the operation on a phantom patient (Annalise) unless Michelle comes clean. Facing no option, she asks him to lock the door. She explains that she used to work as an escort for James and thought that she’d paid off the debt towards her, but James won’t let Michelle go. She met Burt after she stopped escorting, and pleads with Christian not to tell him about this. Christian agrees, but only if Michelle will sleep with him.
At the McNamara house, Sawyer has finished painting the Adam and Eve mural. Julia comes in and remarks that it’s perfect. Conor starts to cry and Julia asks Sawyer if he can feed the child, but Sawyer’s hands are covered with paint so he can’t. He tells Julia that the tender things and the painful things in life must come together then tells her that his mother once told him she wished she’d had an abortion. Julia tells him about being in the abortion clinic and all her frustration and bad feelings start to pour out. As she gets these things off her chest, she is finally able to breastfeed her child. Sean comes in to see them. He reminds Julia that she shouldn’t be nursing if she’s taking anti-depressants but she says she hasn’t taken any yet. Sean looks at Sawyer’s mural and says that it’s beautiful, ‘a perfect world before the fall’.