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Season 4

Episode 1: Cindy Plumb
Written and Directed by Ryan Murphy
The season starts off in celebration as Sean and Christian complete their 5000th surgery together; receiving a set of gold-plated surgical knives. Christian furthering the fun with a mother daughter duo while Sean had awkward pregnant sex with Julia. Involving himself with patient Cindy by helping her fix her larynx. Working as a phone sex operator and having claimed sobriety of the last two years, her now mission to go back to work better than ever.
New owners Burt (Larry Hagman) and Michelle Landau (Sanaa Lathan) conference with the Docs about wanting to take him into surgery, a rather vain procedure considering his age. With his wife insisting on watching as she and Christian share a moment with Burt on the operating table. Later visiting with therapist Faith Wolper (Brooke Shields) who suggest the possibility of him possibly being in love with his partner.
Episode 2: Blu Mondae
Written by Lyn Greene & Richard Levine Directed by Michael M. Robin
We find a lot of the characters finding some means to blow off steam from the stresses in their life. Christian, confiding in Blu Mondae, a stripper he intended on operating on so long as she assisted him with a soon to be patient who was willing to throw away his youth at the chance of being some older man’s boy toy.
Annie finding trouble accepting her soon to be brothers diagnosis of Ectrodactyly, taping her dolls fingers together to mimic such. As Matt takes advantage of his gym membership where he runs into Kimber, looking better than last seen and beginning a romance that would show a continued pattern in Matthews life. Putting all his trust and approbation into the women that would enter his life. Only to let them rule over him completely and fall deeply into whatever jaunt they seemed to have themselves surrounded in. The start of Matt and Kimber’s relationship beginning with their entry into Scientology
Discovering Michelle may have a secret parading around McNamara/Troy that Liz planned on getting to the bottom of. Getting fired for such a thought within the next episode or so, standing by what she had seen in the parking garage of with her and another woman.

Episode 3: Monica Wilder
Written by Brad Falchuk Directed by Elodie Keene
Christian doesn’t feel self-conscious about his body until a sex tape is released and the angles don’t’t exactly show him at his best. Just as some competition is introduced in the form of Dr. Mike (Mario Lopez). Fit beyond belief, he attempts to get closer to the young Doc, picking up some helpful hints and eventually having him perform lipo; as a means of trimming up his rough edges.
With interviews beginning for Sean and Julia, who planned to have a full-time nanny around once Conor came. Finally deciding upon Monica (Jennifer Hall) whose sweet demeanor wouldn’t lead on to her obsessive capabilities. Leading to a detour in which Sean strays himself, later performing a nose job before informing her she would no longer be needed. Julia connecting with her own find in Marlowe (Peter Dinklage); suggesting they meet their son before trying to already change him. Sean making it rather clear of his dislike in her choice, though overruled once Julia goes into labor.

Episode 4: Shari Noble
Written by Jennifer Salt Directed by Nelson McCormick
With a new baby in the house, Sean begins to get wondering eyes once again. While McNamara/Troy receives a patient involving a lonely housewife, a jar of peanut butter, and her unfortunate dog which had been used to suffice for her husband being over in Iraq.
Striking out with Michelle, Christian decides to accompany Liz to a gay bar where he’s surprised the hottest “piece of ass” in there just so happened to be sending signals to his partner as opposed to him. Perhaps making a bit more sense the next day as Liz awakens to discover that her kidney had been removed and left within the confines of a tub.
Just as Monica floats back into the picture. Requesting to see Sean again and ensuring a good time was to be had later that night; Sean’s delusions progressing as Escobar and Michelle appear to him; advocating both right and wrong. Accidentally stating ‘I Love you,’ so lost in the moment that it appeared the latter was at the receiving end.

Episode 5: Dawn Budge
Written by Hank Chilton Directed by Elodie Keene
Having recently hit it big, winning over three hundred million in the power ball, Dawn (Rosie O’ Donnell) has decided to remake her entire life. ‘Upgrading’ her family and doing what could, yet catching both her daughter with the step-father in bed together eventually, running off and leaving her extremely rich and oh so bored; a dangerous combination. Agreeing to pay Christian four hundred thousand if he would sleep with her.
The cult, excuse me, members of Scientology associated with Kimber help him in moving Matt out of his house, agreeing that his family was entirely too hostile an environment if he planned on improving himself in any way.
Sean and Julia celebrating at the end after much deliberation on future wedding plans, intended as a renewal with a new baby as indication of a new beginning they didn’t plan on wasting.

Episode 6: Faith Wolper, PhD
Written & Directed by Sean Jablonski
Things with Marlowe hadn’t been going so well, Sean not admiring the relationship he seemed to share with his wife, yet no better as interactions with Monica only deterred from the major issue at hand. His inability to deal with most things head on. Furthering on as he visits with her, once again, as she attempts to pierce her bellybutton. Escobar chiming in with thoughts of killing her, though in the end the deed is done with overwhelming results.
Christian, unaware of the webs constantly weaving, had become involved with Michelle, despite his dreams messing with him as of late. Caught by her husband and presented with an ultimatum. Just as his therapist Faith makes a return with an odd request; asking for he removal of a tattoo. Only to have such replaced with a new notion that she was property of the one and only, Dr. Troy.

Episode 7: Burt Landau
Written by Brad Falchuk Directed by Charles Haid
Burt’s previous threat to his wife doesn’t remain in tact, however upon trying to build back his esteem in the bedroom has a stroke, leaving him paralyzed. Christian believing such to have been done on purpose, though preoccupied with Liz to let it consume him completely. In need of a new kidney, the boys agree to get tested as Sean discovers he was an ‘only’ match. Unable to come to terms with losing a part of him, he hides the truth until discovering his kin had opted to also find if they were a match; more willing than he to part from such.
Dawn makes a return, recently ear jacked, discovering the greatness behind science as they planned to have Vincent (a lab rat) grow a new one for her; wanting to see the entire process behind the tribulation. Deciding twas the season for giving as she makes a new friend in recovery and decides to take a big step forward.

Episode 8: Conor McNamara
Written by Jennifer Salt & Hank Chilton Directed by Patrick McKee
It would seem that the discomfort Sean held for his son Conor being born with some sort of deformity would ring familiar tones within his own childhood. Flashes received of him with his father when younger. Going so far as to get in a fight with another parent after their ignorant child made an inappropriate comment in their direction. Deciding in the end to operate on Conor after hearing of his own distress, having a cleft palette that his father would constantly make him feel an outsider for.
Mrs. Grubman returns, though very brief, with her final surgery being an intimate moment for her and Christian, who attended her funeral to discover that everything had had been left to him. The only person that despite their differences, knew her and accepted her for who she was.

Epsiode 9: Liz Cruz
Written by Lyn Greene & Richard Levine Directed by Richard Levine
Seduction is a dangerous game we adults can play. Having recently started dating Poppi (Alanis Morissette) it seemed Liz was willing to make many a sacrifice in order to keep her attention. Despite a comment made during surgery that the Docs didn’t appreciate.
Meanwhile the flirtatious nature shared between Marlowe and Julia became too much, Sean busy pushing the second operation for their son despite his wife’s hesitation. Feeling closer to the nanny who understand the extremities of being different. As he boldly approached Sean concerning a leg lengthening operation, too much given away as he discovers their recent affair.
As Michele’s grows tired of handling all of James’ (Jacqueline Bisset) dirty deeds, making a mess all her own  once driven to the edge with her husband Burt.

Episode 10: Merrill Bobolit
Written by Sean Jablonski & Brad Falchuk Directed by Charles Haid
It seemed there would be a new McNamara to welcome, however the fact that it was spawn of Matt and Kimber could go either way, considering at first Christian believes it to be his. Pairing a marriage to boot.
Old friend Merrill returns from prison with news from Escobar. Having became his own version of a female dog, Merrill needed reconstruction surgery in an area you wouldn’t be entirely surprised about. Escobar claiming that the Docs would in fact assist in fixing the terrible burns brought to his face; leaving a present in Sean’s house as incentive.
With Sean catching heat from a lot of aspects in life, a great moment between Dylan Walsh and Peter Dinklage in reference to the affair. Both such fantastic Actors.

Episode 11: Conor McNamara, 2026
Written by Ryan Murphy Directed by Craig Zisk
We get to catch a glimpse of the future from Conor’s perspective as he spoke with his therapist. An otherwise hilarious depiction of how mostly things hadn’t changed, but that at least the family was able to come back together as it had been only then, he had decided to go thru with the other surgery. Marlowe having remained a big part of his life, at one point how his mother intended on living with him overseas with her children.
Wanting everyone to come together as a means of introducing them to his Doctor; Matt! Perhaps one of the few, if not only times we feel a glimmer of hope for poor Matty, who performs the surgeries with his fathers,’ considering such to be a great honor.

Episode 12: Diana Lubey
Written by Sean Jablonski Directed by Charles Haid
The two are visited by Mrs. Lubey (Catherine Deneuve) whose request of having her husbands ashes put into her implants seemed rather sentimental. All the way up until recovery when the real widower walks in demanding what was rightfully hers. Turning out that Mrs. Lubey was actually the woman in which had had an affair with Mr. Madsen. Who knew deep down who his heart belonged to; Sean feeling a kinship as he felt reminded of Michelle. Removing the ashes a simple ploy as he kept the actual remains to give to Mrs. Lubey where he felt they were rightfully placed.
Christian taking the next step with his own Michelle and proposing with intent on selling what was once known to a brigade of woman as he reminisces while showing the place to a few potential buyers. Unknowing of the information being fed to his partner, who had recently started seeing Faith (Brooke Shields). Crossing too far into the dark side, maliciously plotting lies into Sean’s lap after hearing of Christian having a new lover.

Episode 13: Reefer
Written by Lyn Greene & Richard Levine Directed by Lyn Greene
With Christmas around the corner and Julia having went to New York, Sean puts too much emphasis into a Holiday he ends up spending without Julia as she gets stuck in New York. Having begun to drink after receiving an early present from former patient Ms. Lubey, it seemed the season for giving had not been completely forgotten. Doing a favor for Poppy that ultimately backfires as playing a mall Santa could have gone progressively better. Later in the night taking in a homeless man by the name of Reefer and letting him stay in one of the recovery bed until the following day. Who unfortunately meets James in the process, receiving a phone call in being behind in payment. Forced to take the first kidney able to get her hands upon.
While Christian and Michelle get a surprise from James’ son, who gets a hold of him to inform them of having lost his parents two weeks prior and in said will, giving full right up for Wilbur. Sharing the news with Michelle who says she had just wasted years of her life caring of another, though changing her mind once viewing Wilbur for herself and seeing that he was African American.

Episode 14: Willy Ward
Written by Jennifer Salt Directed by Michael M. Robin
We see the last from James, who had reached the outer limits, irate at how easily Michelle could leave her side; admittedly in love with her. Explaining how she had lost her son while on the waiting list for a kidney, as some sort of means to explain her recent set of endeavors. Her real boss coming into play to inform Michelle that he would be continuing on in James’ place. Her demise soon to occur.
With the return of Gina who had entered with claims of wanting to know Wilbur, almost demanding such after hearing of his new mommy to boot. Going so far as to steal him when given the chance; forced to return him after finding taking care of another to be well out of her comfort zone.

Episode 15: Gala Gallardo
Written by Ryan Murphy & Hank Chilton Directed by Ryan Murphy
As asked of in the previous episode, Christian and Michelle buy out Sean, who planned on moving to Los Angeles. The couple thinking that they might even change the name until Escobar is found in Conor’s nursery. Asking if they would meet with his wife Gala, who had recently been attacked as her breasts were mutilated and chopped off due to her husband’s criminals antics. With Michelle stepping in to arrange the surgery as a way of calling things even. Having a moment with Liz while in recovery, who couldn’t comprehend what she would be doing with a monster like Escobar. Pulling a gun on him later, though coaxed into handing it over to Mrs. Gallardo. Who in turn, does something she felt was long overdue, taking over for her husband’s business and leaving the three in a familiar situation involving those finicky alligators. Ending the season with Christian deciding to join his partner in L.A as they, amusingly so, close us out mouthing the words of a song as they go about their days. Clearly, itching for Glee around said time.

While certain progressions for each of the character seemed to catch my interest, this season surly lacked overall for myself. However, I believe such was caused with the amount of celebrities floating in and out that didn’t necessarily belong, and if anything just took too much away from the main group of characters. There were a lot of interesting patient stories that are undoubtedly kept best for ones own run-thru of the season. Otherwise the entry of Michelle and her development with James didn’t hold my attention. If anything I think they should have left on the note of the third season to a new city. The wrap up for this season was super cheesy at the end as well. I was not digging the sing along to close them out. However, the next season would be a first in the series in that the season would be split into two parts.