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You Break My Heart is the fifteenth episode of the fifth season and the 91st overall episode of Private Practice.

Short Summary[]

Cooper and Charlotte take Erica to Seattle Grace to meet with Derek, Lexie, and Amelia regarding a very risky surgery. Scott tells Violet that he would like to take their relationship to the next level and Addison finds herself caught in the middle of Sam and Jake's fight about a patient. Meanwhile, Sheldon warns Sam to be cautious as he deals with the return of his sister, Corinne.

Full Summary[]

Addison is talking to her therapist. She's saying that she kept waiting for life to get easier with lower stakes, less risk, more reward, until she realizes that it doesn't. Maybe the struggle, the climb, is just life.

At Seattle Grace Mercy West Hospital, Amelia and Derek Shepherd are in the skills lab, practicing for a surgery. They finish, and Lexie Grey announces they took 88 seconds to complete the procedure. Ecstatic, Amelia hugs her brother and goes to call Cooper.

Back in LA, Violet is in bed with Scott, who suggests that she bring Lucas to the fire station. She dismisses his suggestion, which leads him to say that he wants to be more in her life. Violet doesn't answer.

Sheldon is talking to Corinne Bennet, who says she's feeling good. This morning she woke up at 6, did a load of Sam's laundry, alphabetized his bookshelf, went for a run, and looked at the ocean. She wants her life to be like everyone else's. Sheldon says that's what they'll work toward. Sam, who's sitting in on the session, is questioning whether she'll get there, to which Sheldon replies that it's important to understand limitations. Corinne is insisting that she's herself again, and there's nothing that she can't do.

Derek is with Amelia, Cooper, Erica, Charlotte, and Lexie. Amelia explains that she and Derek will insert vascular balloons into Erica's brain in hope of preserving the healthy brain tissue and remove the tumor. The catch is that they only have 90 seconds to do it before Erica strokes out. Charlotte isn't sure they can do it. Lexie pipes up and says they've successfully done it twice in the practice suite. There's a silence as it sinks in that the surgery is incredibly risky. Also, they have to remove the tumor as soon as possible so it doesn't get any larger. Erica requests a day to talk to to her son Mason. The Shepherds agree and book the OR.

Sam enters the ER where Gloria, a patient of his, is on a stretcher. Her husband says they were watching TV when she suddenly couldn't catch her breath. A paramedic tells Sam that Gloria's 30 weeks pregnant. Sam is surprised, as she isn't supposed to be pregnant. He determines she is in congestive heart failure when Jake steps in and says that he's Gloria's IVF doctor. Sam says she shouldn't be pregnant because he gave her a donor heart.

At the practice, Sam and Jake are arguing about Gloria. Jake had no indications that she shouldn't be pregnant. The two men are still at it when Addison walks in to get a yogurt. Sam doesn't understand how Jake could miss the massive zipper scar down her chest, but Jake says he doesn't have patients unrobe completely, which Addison would know. They insist that she take a side. Addison concludes that what matter is keeping the patient alive and giving the baby a fighting chance. Sam wants to deliver the baby now, at thirty weeks, because Gloria might be going into organ rejection. Jake thinks they should wait so the baby is more likely to be healthy. Addison says Sam is right before leaving.

Violet enters the kitchen to grab something from the refrigerator. However, Pete is already at the fridge, blocking the door. Violet tries to reach around him, leading to an awkward moment between the two. After she leaves, Sheldon sarcastically says that that wasn't awkward at all.

Erica is sitting on a park bench, watching Charlotte and Cooper toss a football with Mason. She gets up and tells Mason to go long and tosses the ball to him. Seeing her son so happy prompts her to tell him that she's very sick, a fact she's hidden from him for several months. Mason asks her if she's going to die. She hugs him and says she hopes not. Mason asks with tears streaming down his face why she didn't tell him earlier before running away from his parents.

Sam enters Sheldon's office and accuses him of being too patronizing with Corinne earlier. Sheldon explains that her speech was pressurized, she was highly energized, and her thoughts were expansive. All are symptoms of hypomania, which could easier progress to full-blown mania. It's very clear to Sheldon that Corinne is sick. Sam doesn't believe Sheldon and says that he thinks Corinne is back. His sister is back.

Jake is with Gloria discussing a C-section. She refuses one against Dr. Bennett's professional recommendation.

Violet tells Addison she might have messed up her relationship with Scott. Addison responds by saying she slept with Sam, but is not going to get back with him. Violet is having fun with Scott, and Addison says there's nothing wrong with that if she's happy.

Sam and Corrine are walking on the pier discussing their mother. Their mother never talks about Corinne anymore because it's too hard to think about. Sam suggests they call her. Instead, Corinne drags Sam to the amusement park on the pier.

Amelia and Derek are in the practice suite again. Ninety-two seconds. Lexie points out that they did it under 90 seconds five times before that, which prompts the Shepherds the tell her that you don't practice it until you do it right, rather you practice until you can't do it wrong. They try again.

Cooper is panicking about Erica's surgery. He feels like he is trapped in the middle of a horror show. Charlotte tells him he didn't screw up and assures him that no matter what happens, it's going to be okay.

Erica is about to go into surgery and lets Mason know she will always love him, where ever she is, even if he's mad at her. Cooper takes Mason out of the room. Erica, now in tears, knows that the likelihood she won't survive the surgery is high, so she requests that Charlotte teaches Mason how to drive a stick, not to push him on his grades, and to talk about her. Charlotte acknowledges the requests.

Violet is shocked that they're doing the surgery today and asks Cooper to update her afterwards. She bumps into Pete, who asks if he can come over tonight to see Lucas. She agrees.

Addison enters Jake's office and apologizes to him for defending Sam. Jake brushes it off and says Gloria has earned the right to put her baby's life before her own, even if she did lie to her doctors. He then dismisses Addison and she leaves.

Derek and Amelia are scrubbing for Erica's surgery. She nervously points out there's no margin for error, to which he replies that there's no margin for self-doubt. She knows that. For inspiration, he tells her about the time she set off firecrackers until she wasn't afraid of the noise anymore. She stands and fights, and that's stronger than any karmic payback.

Corinne is cooking and she accidentally reveals to Sam that she's been in LA for five years. Sam is furious, as he and his mother thought she was dead. Life was so much easier when they thought she was dead.

In Sheldon's office, Corinne tells him that she dreamed that the piece of roof above her head would fall and crack her head open. She doesn't know what's real. Sheldon says all of it is real, but that she is bipolar. She says she used to be popular. In her junior year in high school, everyone wanted to be her. Why her? Why did this happen to her? Sheldon says she needs to let him help her to make her life better.

In the OR, the timer is set for 90 seconds. Amelia and Derek look at each other, and begin the surgery. The timer is ticking down.

Cooper and Mason are sitting anxiously in the waiting room.

Forty seconds are gone.

Charlotte is sitting in a bathroom stall crying and worrying.

"Done!" Amelia and Derek finish with 5 seconds on the clock left, Lexie informs them excitedly. Blood pressure suddenly spikes, and Derek determines that Erica's thrown a clot. She's stroking out.

In the waiting room, Charlotte shows Mason his mother's brain scans and explains that they need to cut into her head to remove the tumor. He asks what could go wrong. Charlotte says there are risks in every surgery, and that his mother could die. Mason thanks her for finally telling him the whole truth. Cooper watches, heartbroken.

Lexie says that Erica's pressure has gone up to a dangerously high level. Amelia takes the shunt out to clear the clot. She reinserts the shunt, and the blood pressure goes down. That scared the crap out of the Shepherd siblings.

Corinne walks into her brother's office and tells him that he's the one who's selfish. He doesn't think about her, she is the one living with the disorder. When he was in med school, she did her first stint in jail. It's her life. He may hate her, but she hates herself even more.

Jake runs into Gloria's room. She can't breath again. Sam doesn't understand why this is happening, as she's a year and a half post-transplant and everything was fine before. Gloria reveals that she stopped taking the immunosuppressant drugs after she got pregnant because they could harm the baby. As soon as the words are out of her mouth, her water breaks and she is rushed to the OR.

As Addison begins the c-section, Gloria's pressure drops. The surgeons are forced to do a thoracotomy. Addison takes the baby out as Sam cracks Gloria's chest open. She goes into ventricular fibrillation.

Erica wakes up to see Derek leaning over her. He and Amelia tell her that they got the whole tumor and she lived. With difficulty, Erica waves to Mason, who is looking through the window.

Derek says if Amelia ever considers doing drugs again, she should remember this moment and he'll fly down to LA and knock some sense into her. They hug.

Gloria's husband is holding their newborn daughter. He tells Gloria that they should've talked about girl's names. Now it's too late, as she's lying on a stretcher, dead.

Violet and Pete are at her house. Violet says her life is so bizarre, and that she doesn't know who she is. Pete doesn't either.

Cooper, who is sitting with Charlotte, screams that he loves medicine. Charlotte says she loves Mason, and she loves Cooper. They kiss in the Seattle twilight.

Violet is at Scott's doorstep. She tells him she doesn't want a relationship with him, so it's either mind-numbing sex or nothing. He takes the sex.

Jake enters Addison's office and asks if he is reading too much into her - the grocery store, Fiji, Palm Springs. Is there something emotional between the two of them? Or is it just physical? Addison says it's not just physical and Jake leaves.

Sam tells Corinne that he thought she left because of him. But she didn't leave because of him. She left because she was sick. It's not his fault she's sick. They hug.

Addison tells her therapist that you'd think that'd be a depressing thought, that life doesn't get easier, it just changes. But it's not. Life is complex, so she can stop waiting and she can just live.

Cast[]

Main Cast[]

Special Guest Stars[]

Guest Stars[]

Co-Starring[]

Uncredited[]

Medical Notes[]

Addison Forbes Montgomery[]

  • Diagnosis:
  • Doctors:
    • Therapist
  • Treatment:
    • Talk therapy

Addison spoke to her therapist about waiting for life to get easier and then thinking maybe it doesn't. Maybe that's just life. She says you'd think it was a depressing though, but it's a relief to her. She can stop waiting for it to get better and just live.

Erica Warner[]

  • Diagnosis:
    • Gliosarcoma
    • Stroke
  • Treatment:
    • Clot evacuation
    • Tumor resection

Amelia and Derek had perfected their surgical technique and were ready to bring Erica to Seattle for the surgery. They took her into surgery and they did the procedure in 85 seconds, but then she had a stroke. They were able to remove the clot and continue removing the tumor. They finished the surgery and Erica was awake and stable afterward.

Corinne Bennett[]

  • Diagnosis:
    • Bipolar disorder
  • Treatment:
    • Talk therapy

Corinne told Sheldon how she felt normal now that the med fog had lifted. She'd been up since six and had spent the morning doing many things in a manic state. Sheldon diagnosed Corinne with bipolar disorder.

Gloria Murphy[]

  • Diagnosis:
    • Congestive heart failure
    • Pregnancy
  • Treatment:
    • Vaginal delivery
    • Surgery

Gloria was brought to the ER after having trouble breathing. Sam ordered tests and Gloria's husband told her she was 30 weeks pregnant. Sam was shocked because he'd told them that it was dangerous for her to become pregnant because she'd had a heart transplant. Jake then came in and was the one who'd gotten her pregnant. She had lied to him about her cardiac history. Sam wanted to deliver immediately because he suspected Gloria was in rejection, but Jake wanted to wait to give the baby a better chance. Addison said Sam was right and they should deliver right away. Jake relayed the news to Gloria, but they refused to go through with it. When she had trouble breathing again, Sam went to take her for a biopsy, but she refused because of the risks to her baby. Sam wanted to figure out why she was getting worse. She admitted that she'd stopped taking her anti-rejection drugs. Her water then broke, so they took her to labor and delivery. After the baby was born, Sam cracked her chest, but despite his best efforts, Gloria died in the OR.

Music[]

Song Performer Scene
"Our Hearts" Firehorse
  • Addison tells her therapist she keeps waiting for life to get easier, but now thinks it never will.
  • Derek and Amelia practice their surgery. They do it in 88 seconds. Amelia can call Cooper now.
  • Violet and Scott are in bed. He says he's ready for their relationship to be more.
"All Waters" Perfume Genius
  • Sheldon talks to Corinne.
  • Derek and Amelia start working on Erica.
  • Cooper and Mason wait in the waiting room.
  • Charlotte cries in the bathroom.
  • Derek and Amelia finish in 85 seconds.
  • Erica starts having a stroke.
  • Charlotte shows Mason his mom's MRI and talks to him about the surgery.
"Rivers and Homes" J. Viewz
  • Gloria tells the doctors she stopped taking her immunosuppressants when she got pregnant.
  • Her water breaks and labor starts.
  • Addison asks Gloria to slow her delivery. Gloria struggles.
  • As they prepare to operate, Gloria's child is born.
  • Erica starts waking up and Derek tells her they got the whole tumor.
  • Erica waves at Mason through the glass.
"One Sunday Morning (Song for Jane Smiley's Boyfriend)" Wilco
  • Derek and Amelia hug outside Erica's room.
  • Brad holds his daughter and thinks about a name for her because Gloria died.
  • Pete and Violet watch Lucas play and talk about their separate lives.
  • Cooper and Charlotte celebrate Erica surviving and Charlotte talks about how much she loves Mason.
  • Violet tells Scott she doesn't want they relationship to become more and he accepts that.
  • Jake asks Addison if there's more to their relationship than physical.
  • Sam talks to Corinne about her being gone.
  • Addison says there's relief in acceptance.

Notes and Trivia[]

  • This episode scored 7.08 million viewers.[1]
  • This episode is the second part of a Grey's Anatomy-Private Practice Crossover that began with the Grey's Anatomy episode Have You Seen Me Lately?.
  • This episode is the last one to feature characters of Private Practice at Seattle Grace Mercy West Hospital until Addison's return in Hotter Than Hell, almost 10 years later.
  • It is also the last time characters of Grey's Anatomy appear in Private Practice.
    • It is also the last episode in which former spouses Addison and Derek appear in together, though they share no scenes.
  • This episode is Griffin Gluck's favorite because of the football scenes.[source?]
  • This is the only episode of Private Practice to feature Lexie Grey and BokHee.

Gallery[]

Episode Stills[]

Behind the Scenes[]

Quotes[]

Addison: I was thinking I would keep waiting for life to get easier. You know, lower stakes, less risk, easier. And I was thinking, maybe it doesn't. Maybe the struggle, the climb, one obstacle after another... maybe that's just life.

Erica: You get to be mad. You get to have all of your feelings as long as you know, you have to know, that I love you.

Cooper: I love medicine!

See Also[]

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


References[]

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