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Gone, Baby, Gone is the season five finale and the 98th overall episode of Private Practice.

Short Summary

When Amelia goes into labor, the Seaside doctors - even those she pushed away - come to her side as she faces the hardest decision of her life. Meanwhile, after Pete finds himself in life-changing trouble, he and Violet realize what they mean to one another, and Addison is faced with a choice.

Full Summary

Addison tells her therapist that she is done with therapy because she has everything she has ever wanted. She thinks that is the goal of therapy, and she has it all.

Addison is making out with Jake on his office couch. Sam sees them from the hallway. Jake goes to close the blinds. Addison says to be continued and walks out. Amelia enters the office and says she doesn't want to bother him. She says she's having a baby with no brain. She's fine and devastated, but okay. He knows it's traumatic, so it's normal to develop feelings of fear. She clarifies she's having the baby right now. She's in labor.

Amelia is in a hospital bed. She says she could have waited it out at home since she's barely dilated, but Jake disagrees. He paged the transplant surgeons. He's going to talk to them as soon as he leaves this room. She reminds him no drugs at all, not even sedatives. She wants to be taken off the OB floor right away, and she wants her baby's head wrapped right away. She doesn't want to see it. Jake can take the baby away before he cries. She then remembers that brainless babies don't cry. They squeak. Life will out.

Sheldon and Sam are talking about Pete, who's still convinced he did the right thing. Addison comes in and Sheldon tells her Amelia is in labor. She wants to go check, but Sam says Amelia made it clear she doesn't want Addison in there. Sheldon calms things before they get too heated. Charlotte comes in and tells them Cooper is with Violet, who's blaming everyone but Pete. Jake comes in and says no one gets to go near here unless they can be supportive of her plan to donate the baby's organs. Sam says it's murder. A declaration of brain death has to be made before taking the organs, which is impossible. Jake says medical ethicists are split on the matter. They can't wait until the baby dies because the organs aren't usable then anymore. Charlotte wants to go talk to the lawyers, because she, too, thinks this is killing a baby.

Pete is in prison.

In the courtroom, Pete undermines his lawyer by stating he only obeyed his patient's wishes. The judge says he doesn't look too sorry for killing a man. Pete says he is not sorry. The judge denies bail. Pete is taken out and exchanges quick looks with Violet and Cooper in the audience.

Amelia is walking around in her room. Sheldon comes in and says it was quite a bombshell to hear about the organ donation. Amelia says that's how she is. Sheldon wonders how she came to that decision. Amelia has a painful contraction. She squats to deal with the pain but refuses to let Sheldon touch her to comfort her. She asks what Sheldon wants once the contraction is over. Sheldon says sometimes people try to circumvent the grieving process by focusing on an external goal. He thinks concentrating on the profits of the donation is a good short-term coping mechanism. Amelia says she's having the baby, thus dealing with her loss. She's swimming in it. Sheldon wanted to make sure she thought this through. Amelia says he just didn't want to feel guilty, and throws him out.

Sam wonders how they can declare the baby braindead, as the baby will have a rudimentary brainstem. Addison says the baby will never gain consciousness. Jake refers to the baby as it. Sam says it's not an it, because the baby has a life. It's he. They have to kill him to kill the organs. Jake needs Sam's help to harvest the heart and the lungs. Sam angrily gets up and leaves. Addison wants to help, but doesn't know how. Amelia doesn't want them to call her family. Jake says Addison can get Sam to help them.

In prison, Violet is paying Pete a visit. He doesn't need anything. Prison humor doesn't work on Violet, who's freaking out. He tells Violet he loves her. She tells him Lucas is good, but he misses Pete. Violet told him Pete is out of town. She wonders if she should tell Lucas his father killed someone. Pete thinks he did the right thing, but he only did right by his patient. He did not do right by his family. She asks him to say whatever he has to say to get out of here.

Addison thinks Pete should appeal. Charlotte and Sam feel like Pete broke the law, so he put himself at risk. Sheldon comes in and says Amelia is in a very bad place. He was supportive. Charlotte says the hospital still hasn't signed off on the organ procurement. Jake tells Charlotte she has to fight here. Charlotte wonders who thinks this is a good idea. She, Sheldon, and Sam are against it, which means it's right down the middle. She hates her job.

Addison finds Sam on his deck and tells him the procurement has to be flawless. If it were her, there's no one she'd rather have holding the scalpel than him. Sam says it's good it's not her then. Sam feels uncomfortable rushing the process of the baby dying. Addison knows she's asking him to do the hard thing, but sometimes they have to compromise for the people they love. Sam seems to remember she recently told him to walk away if he wasn't all in, so he wonders what to do. Addison thinks she owes him an explanation for what he saw this morning. His inability to answer was Addison's answer. Sam will recommend other excellent cardiothoracic surgeons, but he can't be a part of it other than that. 

Cooper and Mason come home. Mason is angry and ignores Charlotte before disappearing into his room. Cooper explains it was mother's day lunch at school. Charlotte would have gone, but none of them knew. Mason threw out the note the teacher gave him.

Jake visits Amelia, who's squatting. Jake asks if she understand that without any medical intervention, she could be in labor for another 20 hours. He kneels behind her to relieve the pain, but she crawls away and asks him not touch her, as she'll cry if he does. It's stupid and weak, but she can't help it. She wants to be strong without feeling too much. Amelia moans in pain. Jake says screw it and starts appying pressure as he tells Amelia to cry. He's got her.

Cooper and Charlotte are watching over Mason as he sleeps. Charlotte is genuinely shocked by how much she loves Mason. She wants to take his pain away, and it kills her that she can't. Cooper says she takes his pain away. They go back to bed and kiss.

Violet informs Cooper and Charlotte that Pete's lawyer is trying, but she's afraid Pete will destroy himself. He's so stubborn. Cooper think he'll come around. Violet says Pete's mother was in prison, and sometimes families create patterns. She wonders what to tell her son.

Addison snuggles up to Jake, but she's actually trying to read the chart. Addison wants to help, but Sam told her no. Jake says there are 9 cardiothoracic certified to do this, and now all them rejected him. Jake doesn't want to do this either, but he promised Amelia he would. Addison catches a peak of Amelia when Jake enters her room. She sits down and Charlotte comes over. Addison says Amelia doesn't want to see her. Charlotte says the Addison she knows, a pushy bitch, would work herself a way into that room anyway. Addison says she's dealt with worse cases, but every time she tries to go in, she can't get herself to do it. Charlotte admits she's been avoiding it, too. This morning, she looked at Mason and she realized he's changed her. They're mothers now. Addison realizes they both became mothers without giving birth, and now Amelia is giving birth while she doesn't get to be a mother.

Cooper is visiting Pete at jail. He says his son's mother died. She'd give and do everything to get to spend more moments with her son. Maybe she'd even apologize, even if she thinks she didn't do anything wrong. Cooper gets Pete because they're alike, but he has a wife who loves him and a son who needs him. Pete has a chance to be there for and with them. Cooper doesn't get he's throwing that chance away.

Charlotte finds Jake and asks how much time she has. She's decided to pull some favors to get him the surgeons she needs. She needs a cardiothoracic surgeon before she can declare a full transplant team, and the lawyers may still say no. But she's going to fight. They high-five.

Sam wants to explain to Amelia why he can't be part of the transplant team, but she knows. The baby will be alive, but won't have a life. Sam will talk about technicalities, but that's not why he won't do it. He won't do it because it's unimaginable. It's horrible. She's asking him to help dismantle her baby for parts. There's no piece of anyone's soul that can hold that and feel okay, but she's asking as the baby's mother. She did a little research. She lists babies that could use her baby's parts. Her baby could save all those babies and give all them real lives with chances. What she's asking from him is unimaginable, but it's all those babies's mothers can imagine. She wonders why he can't get there when she can.

The doctors gather in the kitchen in the morning, but nothing's changed. Amelia is still in labor and Pete is still in jail. Charlotte lets Cooper know that Amelia's at 6 centimeters. They leave to go to the hospital, except for Sam.

Charlotte says the lawyers haven't signed off, so Jake can't harvest the organs yet after delivery. Jake assures her he understands. Addison wants to go in with him, but Jake says no until Amelia allows her to come in.

Inside the room. Amelia is pain as Jake gets gowned and gloved.

In the waiting area, Sheldon and Cooper says they should inform Violet. Sheldon says women who used coke are prone to develop more complications. He did some research after Amelia told him about the pregnancy. Cooper says she did oxy, not coke. Maybe everything will turn out all right. Sheldon jokes sure, because oxy is like a prenatal vitamin. He laughs as Mason joins them. Mason doesn't mind being here.

Addison is pacing outside Amelia's room as she hears Amelia's screams.

Amelia says she doesn't want to do this anymore. She can't not push, because then it hurts too much. She shouldn't have to do this with a unicorn baby and Ryan should be here. Jake says she's almost there. Amelia says she has to push. She wants drugs. Addison comes in and tells her she can do this. Amelia says she doesn't want Addison here. Jake says she does. Addison starts comforting her. Amelia tells Addison her baby is going to die. Addison is so sorry. Amelia says she's calling him a unicorn baby. They need to control her labor. Addison tells her to wait and takes her hand. Jake signs that it's okay for Amelia to push now.

Violet is packing things when there's a knock on the door. She opens the door and sees Pete. He says he cooperated. He kisses Violet.

Jake tells Amelia she did a good job. Her baby is okay. They're going to take him away now. Amelia wants to see him. Addison hands her son. Amelia says he's beautiful. She takes off the baby's hat. The baby starts squeaking. Amelia tells her son it's okay.

Addison leaves the room and finds Sam outside. He's waiting for Charlotte. He's agreed to Amelia's request. Charlotte comes over. They didn't sign off, but she decides they're going to do it anyway. They all enter Amelia's room, where Amelia introduces them to her son. The baby goes into respiratory distress. Amelia is not ready to say goodbye. Jake says it's okay to change her mind. If not, they need to give him to the transplant team right now. Amelia tells her baby that his father, Ryan, is waiting for him. She kisses her baby goodbye, and hands him to Addison. While she takes him out, Jake comforts Amelia.

In the OR, they're removing the baby's abdominal organs one by one, while saying the destinations. Sam and Addison switch places and they start removing his thoracic organs. The monitor starts beeping, and Sam asks to turn it off. The heart is the last organ to leave. Jake and Addison leave to go tell Amelia, while Sam stays behind to close. He wipes blood off the baby's face and thanks him.

Jake and Addison are talking to Amelia.

Addison and Jake enter a lounge. Addison is about to break down. She wants to go hug her kid. Jake asks if she knew what Amelia meant when she called her son a unicorn baby. Addison explains she was obsessed with unicorns when she was 12 as they do great things. The organs are going all over the country to do great, magical things. Addison starts crying. Jake comforts her. They start kissing and take off their shirts.

Addison and Jake are getting dressed again. Jake asks if she wants to get something to eat. She is hungry, but she has to relieve her nanny. Jake suggests they can meet at her place. He'll bring Chinese food. She'd like that. They kiss before walking out.

Mason and Charlotte are watching the babies in the nursery. Mason knows what happened to Amelia's baby. Charlotte points to a baby that can live thanks to new lungs. She should have been dead, and she would have if she was born 10 years ago. Now she's alive. It's a miracle. Mason asks if his mother would still be alive if she got sick 10 years from now. Charlotte thinks he could be a great doctor. He seems happy to hear that. Charlotte says she's not good with nature or soccer the way his mother was, but she is a doctor. Charlotte asks if it's weird she took him to see sick babies. He says it's not. Mason says he doesn't know what to call her, because he already has a mom. Charlotte doesn't want to take her place, but she is happy to stand in for her whenever he'll let her. Mason then suggests he call her "mama", like she calls her mom. Charlotte gets emotional and agrees to that.

Amelia wakes up with Sheldon by her side. She drinks some water and he says he's been here all day. She's his best friend, which is sad because she's younger and she doesn't return his affection. She laughs. Sheldon says that happens. Amelia says she had a baby. For a few minutes, she was someone's mom. Sheldon says she still is. Her son is just not here anymore. Amelia says she missed Sheldon. They hold hands. Sheldon starts crying. Amelia says that happens.

Violet and Pete just had sex. She asks if he's okay. "What if I blew it?" he asks, thinking he may have to go to prison.

Addison comes home and finds Sam on her couch with Henry. He sent her nanny home, because after this day, you want to see your kid. Addison reminds him Henry is not his kid. Sam says he has the energy to fight her. He's fighting for her right now. He should have said yes when she asked him if he was all in. He's in love with her and it's never too late for that. Addison says he didn't want to have a family when he had the chance. Sam doesn't want a baby, but he wants this baby and her. He wants them to be a family. He was afraid of that before as he couldn't imagine being a new father. It was unimaginable, but he can imagine it now. So, he's all in. He's fighting for her. He kneels in front of her and says he loves. "Will you marry me?" he asks. They smile at each other.

Jake is driving to Addison's house, with Chinese food and flowers on the passenger's seat.

Addison is speechless on her therapist's couch. She just smiles at him.

Cast

Main Cast

Guest Stars

Co-Starring

Uncredited

Medical Notes

Addison Forbes Montgomery

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

Addison told her therapist she was ready to be done with therapy. She's grateful, but she has everything she ever wanted.

Amelia Shepherd

  • Diagnosis:
    • Pregnancy
  • Treatment:
    • Vaginal delivery

Amelia went into labor. Because of the baby's condition, Jake admitted her to the hospital to monitor her labor. She said no to any sedatives or drugs. After several hours of labor, she delivered her baby.

Baby Shepherd

  • Diagnosis:
    • Anencephaly
    • Respiratory distress
  • Treatment:
    • Organ harvest

Amelia's baby was born and she held him for a while. But when he went into respiratory distress, she handed him over so his organs could be harvested for transplant.

Music

Song Performer Scene
"Roll Baby Roll" Duquette Johnston
  • Addison decides she's done with therapy because she has everything she wants.
  • Addison and Jake make out on a couch and they see Sam approaching.
"Vines" Lost in the Trees
  • Addison tells Sam that him not answering is her answer.
  • Mason comes home and goes right to his room. There was a mother's day lunch at school.
  • His teacher said she sent home an invitation with a note, but he threw it out.
  • Amelia's squatting by the bedside.
  • Jake tries to help Amelia with her labor. She says she'll cry if he does and she wants to be strong.
  • He steps in and tells her to go ahead and cry.
"We're Not the Same" Peasant
  • Cooper tells Pete not to throw his family away.
  • Charlotte agrees to help Jake get doctors together and fight the lawyers.
  • Sam wants to explain to Amelia why he can't be part of her transplant team.
"A New You" Release the Sunbird
  • Mason says he doesn't mind waiting.
  • Jake coaches Amelia through her labor. She wants to push.
  • Addison comes in and starts to soothe Amelia.
  • Amelia says her baby is a unicorn baby.
  • Violet finds Pete at the door. He cooperated and made bail.
"Be the Song" Foy Vance
  • Amelia asks to see her baby.
  • Addison brings him over and Amelia pulls his cap off to look at him.
  • She says he's the most beautiful baby she's ever seen.
  • He starts squeaking and she soothes him.
  • Addison leaves the room to find Sam.
  • Charlotte says the lawyers said no, but they're doing it anyway.
  • The baby starts to struggle to breathe.
  • Amelia says she's not ready, so Jake tells her she can change her mind and hold him until he dies.
  • Amelia hands him over and Jake holds her.
  • They retrieve his organs. Sam stops his heart and removes it.
  • Sam wipes the baby's cheek and thanks him.
  • Addison and Jake talk to Amelia.
  • Addison struggles not to cry as she leaves the room. She wants to go home and hug Henry.
  • Addison and Jake start to kiss and undress.
"Lost in the Light" Bahamas
  • Mason asks if he can call Charlotte Mama and she says he can.
  • Amelia wakes up and Sheldon says she's his best friend.
  • Sheldon tells her she's still a mom even though he's gone.
  • Amelia tells him she missed him and it's okay to cry.
  • Violet and Pete lie in bed together. He worries about going back to prison.
"Montreal" Bahamas
  • Sam tells Addison he doesn't want a baby. He wants Henry and Addison.
  • He tells her he's all in and going to fight for her.
  • He tells her he loves her and asks her to marry him.
  • Jake drives with flowers and Chinese food.
  • Amelia sits on her therapist's couch in silence.

Notes and Trivia

Gallery

Episode Stills

Quotes

Mason: (To Charlotte) I don't know what to call you...How about mama? I already have a mom, but how about I call you mama, like you call your mom?

See Also

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

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