Ex-Life is the sixteenth episode of the second season and the 25th overall episode of Private Practice.

Short SummaryEdit

Derek and Addison work on one of Derek's patients, as Derek feels guilty over what happened in surgery. Sam has an 'asthma' attack, but nobody believes him. At Oceanside Wellness, Cooper, Violet and Pete work on a mother with post-partum psychosis and Pete confronts Violet about her baby and Charlotte confronts Cooper over Violet's baby.

Full SummaryEdit

Back at Oceanside Wellness Group, the remaining team worry about Archer, Addison, Naomi, and Sam. However, the four of them are enjoying themselves over a successful surgery with Mark and Derek.

Derek returns to the hospital after Jen develops breathing problems, and the rest, believing it to be about Archer, run back to Archer's bedside, only to find Bailey. Instead of Archer having a problem, Sam does instead, having an asthma attack and collapsing. Addison wants Sam to be on the surgical floor so at least Naomi and herself can monitor him, but Bailey tells her to find the Chief, as asthma is not surgical. Addison implies to Naomi that Sam isn't actually over her, while Bailey spends the day finding out what caused the attack. Sam doesn't respond to the meds as well as Naomi would like, but eventually discovers Sam's allergic to the generic asthma pumps, so it was an allergic reaction, not a panic attack over Naomi.

Cooper tells Charlotte about Archer and Sam, while Cooper tries to explain about the arrangement with Violet, but Charlotte doesn't want to hear it.

The Chief wants to publish Archer's case and use Archer's name. However, Archer feels Derek screwed up, and Addison requests Derek to order another CT scan, but he refuses, saying her brother's an ass and his post-op neuro exam was fine - no CT needed. Addison shouts at Derek, claiming this is unlike him, when he admits about clipping an aneurysm during Jen's surgery, he's ordered tests and they've all come back fine. Addison tells him to check the baby, and she does, indicating Mirror Syndrome: the baby's anemic, and so is the mother due to the blood transfusion during surgery and its incompatibility with the child's own blood type, causing congestive heart failure in both of them.

Cooper sees Rachel, who accidentally let her daughter, Cindy, fall into the tub while she answered the phone. Cooper notices she may have post-partum depression, and asks Violet to consult. To buy some time, Violet asks Pete to do some acupuncture to get her to sleep for a while. Pete goes to Violet, suggesting to her that this is more than some sleep deprivation, when Violet tells him that she believes it post-partum psychosis, annoying Pete as he now sees that he's been used while Violet rings her husband and pre-admits Rachel into the hospital.

Since Derek refuses to do a repeat CT on Archer, Addison goes over his head to the Chief, and considering he wants the paper published, agrees to order the CT and asks Bailey to do it.


Alex talks to Addison about running away.

When the results come back, Alex asks Addison if she was happy running away, to which she replies she walked away and then ignores the rest of the question, asking to repeat the tests. Derek, still feeling guilty, shouts at Addison for not telling him the first set of test results.


Bailey argues with Naomi.

The test results come back, and Addison tells Derek she has to deliver the baby or they both will die. Jen refuses this, demanding to wait two more weeks. Derek undermines Addison by suggesting in-utero blood transfusion, and Jen immediately chooses that, but Addison is against it as the risks are far too high for her. Jen chooses the in-utero procedure, tying Addison's hands.


Addison and Derek argue in surgery.

During surgery, Jen begins to crash, and Addison scolds Derek, just like the "Hot Dog Thanksgiving" where Carolyn breaks her wrist, Addison's never cooked a turkey in her life and Derek invites 34 people to their house for thanksgiving, giving her Nancy salmonella and Derek then cooks hot dogs and saves the day - same principle here, Derek gives false hope, Addison has to do the work and then Derek looks like the hero afterwards, until Addison successfully completes the procedure.

After the procedure, as Derek and Addison scrub out, Derek admits his mother did hate Addison, until Richard interrupts with the CT. Archer's seen the scan and see two persistent cysts. Derek didn't get them all, and he's going to die, so Archer breaks down, admitting to things he should have admitted to, such as sleeping with Mark's girlfriend, wrecking Sam's car, until Derek barges in, telling Archer he's wrong and that it is common for post-op neurosurgery patients to have a fluid build up.


Bailey and Sam.

Rachel wakes up, running to Cindy who's crying as she wants a bottle. Violet refuses to let Cooper or Dell give Cindy back to Rachel, when Rachel then admits she tried to drown Cindy. Violet begins to panic about her child: What if her baby doesn't sleep?

At St. Ambrose, Violet talks to Rachel's husband, until Rachel wakes up and wants to see her baby. Violet, again, refuses to let her see Cindy. Pete disagrees, and Cooper tries to get Violet see Pete's perspective. Violet comes round, letting Rachel see Cindy with her husband.


Jen cannot speak.

Pete confronts Violet about her baby, and telling her she is selfish for cutting him out of the baby's life.

Sam confides in Miranda that he thought he'd still be with Naomi, spurring Miranda to try and save her marriage, unlike Sam and Naomi.

Addison apologizes to Derek for second guessing Derek, and tells Jen and Rob the good news, the procedure worked and that both mother and son are OK, until Jen's speech becomes jumbled.


  • Addison Montgomery
  • Pete Wilder
  • Naomi Bennett
  • Cooper Freedman
  • Charlotte King
  • Dell Parker
  • Sam Bennett
  • Violet Turner
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Mark Sloan
  • Derek Shepherd
  • Jen Harmon
  • Rob Harmon
  • Rachel
  • Joe
  • Archer Montgomery
  • Andrew

Main CastEdit

Special Guest StarsEdit

Guest StarsEdit


Medical NotesEdit

Archer MontgomeryEdit

  • Diagnosis:
  • Treatment:

Archer woke up after his surgery and had trouble speaking. He also had blurry vision and his hand was shaking. He believe Derek had missed something. Richard then had Bailey run the CT that Derek refused to run. The CT showed persistent cysts and Archer believed he was going to die. However, when Derek came in to see him, he told him they were just filled with fluid, which was common, and they'd be relieved quickly.

Sam BennettEdit

  • Diagnosis:
    • Asthma attack
    • Bronchospasms
    • Allergic reaction
  • Treatment:
    • Steroids
    • Bronchodilator

Sam had trouble breathing. He used his inhaler, but it didn't help and he collapsed. He was admitted to the hospital for treatment. Because of the timing of his asthma attack, Mark believed it was related to Naomi being with Archer. They later found out that when Bailey had refilled his inhaler, she had substituted the generic, which used a corn-based propellent, which he is allergic to.

Jen HarmonEdit

  • Diagnosis:
    • Pregnancy
    • Mirror syndrome
    • Congestive heart failure
    • Hemolysis
    • Fetal anemia
    • Aphasia
  • Treatment:
    • Bronchodilator
    • Intrauterine transfusion

Jen was having trouble breathing. Alex tried using the bronchodilator, but it didn't help. Derek ran further tests to find the cause. He then consulted with Addison, who said the baby might be the problem. Jen was mirroring her baby's anemia, which caused congestive heart failure. Addison said the situation was dire and ideally, she'd do an intrauterine blood transfusion, but given the situation, she suggested delivering the baby. Jen said they could wait two more weeks to deliver him, but Addison said they didn't have time to wait. Derek mentioned the in-utero option and over Addison's objections, Jen decided on that. Derek pushed Addison to do it because he believed Jen's condition was all his fault. Addison ultimately agreed. The transfusion was successful and Jen was stable after surgery, but then she presented with aphasia.


  • Diagnosis:
  • Treatment:

Cynthia's mother brought her into the practice after she slipped and was submerged in a bath. Cooper examined her and said she was completely fine.


  • Diagnosis:
    • Sleep deprivation
    • Post-partum psychosis
  • Treatment:
    • Acupuncture
    • Anti-psychotics
    • Benzos

Rachel brought her daughter into the practice to be examined by Cooper. He realized she was exhausted and he took her daughter for a moment so she could rest. When he came back with Violet to talk to her, Rachel was gone. They found her in an OB exam room. Violet stayed and talked to Rachel while Cooper took the baby. Because she was still breastfeeding, Violet took Rachel to Pete to get acupuncture to help her sleep. Pete later came to Violet, saying it was worse than sleep deprivation. She said she suspected postpartum psychosis and her husband was going to pre-admit to the hospital to admit her to the psychiatric ward. Rachel then had an episode at the practice in which she admitted that she'd started to drown Cynthia on purpose. Violet started her on anti-psychotics and benzos. When Rachel wanted to see Cynthia, they debated over whether or not to allow it. They ultimately allowed her to see the baby with supervision and Rachel apologized to her daughter.


Song Performer Scene
"(There's) Always Something There to Remind Me" Naked Eyes
  • Addison, Naomi, Sam, and Mark celebrate at the bar.
  • Derek leaves to go back to the hospital. He says it's not about Archer, but they don't believe him.
"Big Bird In a Small Cage" Patrick Watson
  • Pete and Violet talk about Rachel. Pete's upset that Violet didn't mention her suspicions.
  • Rachel comes out of the room hallucinating that she hears Cynthia crying.
  • Alex asks Addison if she's happy and asks for advice about Izzie.
  • Rachel tries to take Cynthia and says she didn't mean to hurt her.
  • Rachel confesses to holding Cynthia under the water in the bath.
"Lullaby" Rosi Golan
  • Addison and Derek operate on Jen. She has trouble breathing.
  • Violet doesn't want Rachel to see Cynthia, but Cooper and Pete say she should get to see her supervised.
  • Pete gets upset and leaves.
  • Addison and Derek argue while they operate. Their surgery is successful.
  • Richard visits Archer and shows him his scans. Archer sees persistent cysts and thinks he's going to die.
"Worried" Tyler Ramsey
  • Charlotte talks to Cooper about Violet.
  • Rachel and her husband sleep while Cynthia sleeps in a bassinet by the bed.
  • Violet and Pete talk about her pregnancy.
  • Bailey and Sam watch Archer and Naomi.
  • Addison apologizes to Derek and examines Jen. Everything looks okay, until Jen develops aphasia.

Notes and TriviaEdit

  • This episode scored 14.10 million viewers.
  • This is the second part of the Grey's Anatomy-Private Practice crossover.
  • This episode continues directly from the Grey's Anatomy episode Before and After.
  • This episode has 5 credited special guest stars, which is the highest number of special guest stars of all episodes of both Grey's Anatomy and Private Practice.
  • The episode was also written by 4 credited writers, also the highest number for any episode of both shows to date.


Episode StillsEdit

Behind the ScenesEdit


  • Sam: HA!
  • Naomi: Excuse me?
  • Sam: I said ha! Ha because I was right. Ha because it was an allergic reaction, so HA to Mark and Addison and you if you believed them. It wasn't a panic attack, it was an asthma attack. I am not pathetic, I am a man. I am a man with asthma, so HA! Gimme some Dr. Bailey!

  • Addison: This is the hot dog thanksgiving all over again...
  • Derek: What?
  • Addison: Oh you know what, your mother breaks her wrist so the day before thanksgiving you invite 34 people over to our house, without even asking me, knowing I've never cooked a turkey in my life. Your sister gets salmonella, and your mother who never liked me, accuses me of trying to kill everyone, and you, ha ha, make hot dogs and you're the hero.
  • Derek: Addison.
  • Addison: No, it's the exact same thing Derek, you make a cavalier statement and then I gotta do all the work and no matter how it turns out you're the hero and I'm incompetent.
  • Alex: Her respirations are stabilizing.
  • Addison: How's her pulse ox?
  • Derek: 92, her lungs are clearing. You did it.
  • Addison: I did it, I did it.
  • Derek: Who's the hero now?
  • Addison: Shut up.

See AlsoEdit

A complete overview of this episode's crew can be found here.

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