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What Happens Next

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What Happens Next is the eighth episode of the fourth season and the 62nd overall episode of Private Practice.

Short SummaryEdit

Charlotte chooses to suffer in silence as she tries to deal with the emotional aftermath of the attack, as Addison struggles to keep the events of that night a secret, while Cooper and the doctors of Oceanside Wellness fight their own demons arising from the assault.

Full SummaryEdit

At St. Ambrose Hospital, Charlotte walks down the hallway with doctors and nurses staring at her. She's wearing sunglasses and her arm is in a plaster cast. As she opens the door to her office, she remembers the attack and walks away.

Addison is staring at Sam, who's lying next to her in bed. He notices this, and asks if she's ready to talk now. She says she can't, and even though Sam insists he can keep a secret, she decided to keep her promise to Charlotte. He proposes to play doctor and patient, so she can tell him and he can keep it secret because of the doctor-patient confidentiality. She kisses him and then walks out of the bed, and he sighs.

Violet meets Addison, Sam, Amelia and Sheldon in the kitchen at the practice and asks if they've talked to Charlotte. Addison left her a couple of messages, but she didn't call her back. They start discussing about what they should say to her. Sheldon says he sent her flowers, and Violet regrets she hadn't thought of that. A fatigued Cooper enters, and he tells them that Charlotte first went to the hospital but is now parking downstairs. He asks them not to act weirdly, and Addison jokes he's setting a great example. As they're talking about how she looks, Charlotte enters, creating an awkward silence. "Take a good look then get over it," she says. They stare at her while she takes yogurt out of the fridge, and she asks them to stay away from her if they're all going to act nervous and annoying around her. She walks away, and Cooper yells that they all acted weird even though he told them not to. He leaves too, and Addison says she thinks it's too early for her to be back. Violet says it's therapeutically good she faced everybody, stated her needs and told them off. Sheldon agrees it's good that she's trying to regain control of her life.

Cooper enters a trauma room at the hospital, where he tells the patient he was paged that everything is going to be fine. Pete drains the fluid from her abdomen. Elisa, the patient, thanks him and tells her dad she's okay, but he asks Cooper if she really is, thinking her cancer has come back. Cooper says they need a CT to confirm that. Elisa tells her Papi not to worry, but he does anyway. He says her body can't take any more chemo. Pete suggests to try different techniques, but Cooper tells Diego that Elisa's lymphome is curable, even after a relapse. Diego says he doesn't believe in Western medicine, which is why he's going to take his daughter to a shaman.

To be completed


  • Addison Montgomery
  • Pete Wilder
  • Cooper Freedman
  • Charlotte King
  • Sheldon Wallace
  • Amelia Shepherd
  • Sam Bennett
  • Violet Turner
  • Nick
  • Diego
  • Rachel
  • Joe Price
  • Elisa
  • Judge Hansen
  • Nurse (right)
  • Carlos (right)
  • Shaman (right)

Main CastEdit

Guest StarsEdit


Medical NotesEdit


  • Diagnosis:
    • Lymphoma
    • Tumor
  • Treatment:
    • Chemotherapy
    • Surgery

Elisa, 14, came into the ER with fluid build-up around her heart. Pete removed the fluid to relieve the pressure. Her father was afraid her cancer was back and Cooper said he believed the lymphoma tissue had invaded the pericardium. Her father said chemo was hard on the last two times and he had lost faith in western medicine. He wanted to take her to a shaman instead. During the ceremony with the shaman, Elisa had trouble breathing. Pete couldn't feel a pulse, so he and Cooper started CPR and called an ambulance. She was in hypotensive shock and was taken into surgery when she got to the hospital to put a hole into the sac around her heart to drain the fluid. Her father wanted to continue with the shaman, but Cooper said he would go to a judge and get him to order Elisa's chemo. Pete said he wouldn't help Elisa by tearing her family apart. Elisa talked to Pete after she woke up and he asked her if she believes that a shaman will heal her. She just said she didn't want chemo. She later admitted that she didn't believe the shaman would heal her, but she didn't want any more chemo because she'd watch her treatment bankrupt her family. The judge ordered the chemo.

Charlotte KingEdit

  • Diagnosis:
  • Treatment:
    • Bandage

Addison told Charlotte she needed another pelvic exam to check on healing and continued HIV meds. Charlotte insisted she could handle it all herself. Pete later examined Charlotte to check on her healing. He changed the bandage on her back. Addison admitted to Sam that she had collected a rape kit and called to turn it over to the police.


  • Diagnosis:
    • Diabetes
    • Breast cancer
    • Kidney problems
    • Metastatic tumor
  • Treatment:
    • Medication
    • Surgery
    • Hospice care

Rachel had diabetes and had also survived breast cancer. She was also being treated for kidney problems caused by that. Addison ran some tests which revealed high levels of testosterone, which she said could be caused by metastatic breast cancer. Addison said it could be the cause of her rages. Addison said the only way to confirm and treat would be to go in and look around. Rachel decided she wanted to do that and Addison would have to remove the tumor in stages. In surgery, Addison wasn't able to resect the whole tumor and had to tell Rachel that she'd die. She decided to enter hospice treatment so that her husband wouldn't have to deal with her continued rages.

Rachel and NickEdit

  • Diagnosis:
  • Treatment:
    • Marriage counseling

Rachel and Nick came to talk to Sheldon. Rachel had multiple health issues and she was worried the stress of it would make Nick resent her. Sheldon asked what he does to relieve the stress. They admitted that they fight and then Sheldon witnessed Rachel hitting Nick multiple times. Sheldon advised Nick to come forward about the abuse, but he said it doesn't happen often and he'd deny it if the police asked him about it.


Song Performer Scene
"Stumble on the Line" Andy Zipf
"The Moon is Down" Ben Cooper
"Watermark" Sleeping at Last

Notes and TriviaEdit

Private Practice 4x08 Promo00:31

Private Practice 4x08 Promo

  • This episode scored 8.21 million viewers.


Episode StillsEdit


(Charlotte walks into Amelia's office, crying. Amelia stands up from her chair, worried about Charlotte)
Amelia: Charlotte, what happened?
Charlotte: Would you go to a meeting with me?
Amelia: Right behind you.
(They leave the office.)

See AlsoEdit

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

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