Chapter Summaries

After Mark Sloan joined the Medical Center, Dr. Montgomery struggled to focus amid her conflict with Dr. Shepherd. Adam pushed her to assert her authority and perform an urgent C-section for a woman whose labor was endangering both her and her baby, leaving Dr. Montgomery to take responsibility for the decision.

• Adam sent Sheldon detailed information about Pain-Immunity Syndrome, then attended Alice Grey's tutoring session with Cristina.
• Mark Sloan appeared at the Medical Center as a new doctor, prompting gossip, and Dr. Montgomery confronted him before they parted on bad terms.
• Dr. Montgomery was thrown out of a patient room by a pregnant woman who insisted on following her natural birth plan despite a dangerous labor.
• Adam reviewed the patient's chart and warned that the fetus was not descending and could suffer late decelerations, making an immediate C-section necessary.
• Adam challenged Dr. Montgomery to act as the attending physician, and she agreed that the patient should have a C-section immediately.

Adam and Dr. Montgomery tried to persuade Rebecca to accept their medical judgment, but she insisted on a natural birth. When shoulder dystocia trapped the baby during delivery, Rebecca consented to an emergency C-section, and Adam rushed to get the surgical tray.

• Rebecca rejected Adam and Dr. Montgomery’s advice, insisting she would follow her own plan for childbirth.
• In the cafeteria, Mark Sloan congratulated Meredith and dismissed Cristina’s questions about Mr. Sullivan.
• Adam’s pager summoned him to help Dr. Montgomery, and he arrived as Rebecca’s baby became stuck with shoulder dystocia.
• Dr. Montgomery and Adam tried the McRoberts and Woods screw maneuvers, but neither freed the baby.
• Dr. Montgomery proposed the Zavanelli maneuver followed by an emergency C-section, and Rebecca consented.
• Adam ran to get the C-section tray while Dr. Montgomery prepared to deliver the baby.

Adam and Dr. Montgomery rushed to save a mother and baby during an emergency C-section, while Mark felt humiliated after Dr. Montgomery rejected his help. After the surgery, Dr. Montgomery resolved to leave her romantic turmoil behind and refocus on her patients, then went to the morgue to reflect on how close the case had come to tragedy.

• Dr. Montgomery performed an emergency C-section under local anesthesia and delivered a large baby who was not breathing.
• Dr. Montgomery resuscitated the baby while Adam treated the mother, stabilized her arterial bleeding, and moved her to the Operating Room.
• Mark offered to help, but Dr. Montgomery said Adam was more familiar with the operation, leaving Mark feeling dismissed and resentful.
• Dr. Montgomery revived the baby and sent him to the Neonatology Intensive Care Unit, then rejected Mark and hurried to the Operating Room.
• Adam and Dr. Montgomery completed the mother's surgery, and Adam performed the final sutures without calling Mark.
• Dr. Montgomery thanked Adam, vowed to leave her romantic drama behind, and pressed the elevator button for the morgue so she could reflect.

Adam praised Cristina for openly mocking Mark Sloan before examining Beatrice and approving her discharge. Beatrice planned to travel with Mary and Emilia, and Adam discovered they lived in the same town as Monica Geller and Anna Taylor; after seeing them off, he encountered someone familiar at the hospital.

• Cristina mocked Mark Sloan for failing to save lives, and Adam praised her while Meredith objected.
• Adam examined Beatrice and cleared her for discharge two weeks after surgery.
• Beatrice, Mary, and Emilia planned to travel together and visit Missy at the Wharton School of Business.
• Adam learned that Beatrice and Emilia lived in the town where Monica Geller's family lived and Anna Taylor taught.
• Adam escorted the women from the hospital, returned inside, and spotted a familiar figure.

Adam saw Dr. Montgomery fall for Elliot Deakin, a widowed funeral home owner, and later watched Mark Sloan challenge him. Mark’s attempt to intimidate Elliot with a crushing handshake backfired, while Dr. Montgomery rushed to check Elliot’s hand.

• Adam introduced himself to Elliot Deakin at the Medical Center and learned Dr. Montgomery had met him in the morgue.
• Dr. Montgomery told Adam she believed she had fallen in love with Elliot at first sight and compared him favorably with Derek and Mark.
• A few days later, Mark confronted Elliot after seeing his strong connection with Dr. Montgomery.
• Mark tried to intimidate Elliot by squeezing his hand, but Elliot stayed calm and proved stronger.
• Dr. Montgomery ordered Mark to let go, then took Elliot’s hand and examined it, leaving Mark furious.

After Dr. Montgomery’s confrontation with Mark Sloan, Adam noticed a dangerous coldness in Mr. Deakin’s eyes while Meredith became ill and was diagnosed with appendicitis. Meredith chose Adam to perform her operation, leaving Cristina and George out of the running.

• Mark Sloan left the hospital after losing his confrontation with Mr. Deakin, who departed with Dr. Montgomery.
• Adam and Cristina found Meredith feverish and weak, and Cristina teased her about dating Finn while being intimate with Derek.
• Dr. Montgomery invited Adam to observe a rare case scheduled for the next day, and Meredith vomited on her foot as she passed.
• Adam examined Meredith and diagnosed appendicitis rather than pregnancy.
• Meredith insisted that Adam operate on her, rejecting Cristina and George as possible surgeons.

Adam treated Meredith for appendicitis, while her morphine-fueled confession pushed Dr. Shepherd to let her go. At Friends Bar, Ted worried that Anna was withdrawing from their relationship, and Adam began investigating whether Ted was the problem.

• Adam confirmed Meredith had appendicitis and removed her appendix after Cristina gave her morphine.
• While drugged, Meredith told Finn and Dr. Shepherd that she wanted them both and revealed her history with George; after she recovered, Dr. Shepherd wished her and Finn well, and Meredith broke up with Finn.
• Adam met Anna Taylor at Friends Bar, where Anna said her former piano teacher, Mr. Hutton, had died and learned that Emilia's mother had little time left.
• After Anna left, Lily wrongly accused Ted of planning to break up with her, but Adam helped clarify that Ted was worried about Anna's mood.
• Ted told Adam, Lily, and Marshall that Anna had seemed distracted for days and that he feared she wanted to break up with him.
• Adam teased Ted that the issue might be with him and asked whether he had truly been passionately affectionate during the first few weeks with Anna.

Adam advised Ted to have Anna examined after noticing she seemed unwell, but she never came to the hospital. Four days later, Adam learned Anna had died in a car accident, and he rushed to the funeral home to help Ted, who had become unresponsive.

• Ted dismissed Adam's suggestion that his and Anna's relationship problems might have a psychological cause, while Adam urged Anna to get a checkup.
• Ted promised to persuade Anna to visit the hospital, but she never came, and Adam assumed her poor complexion was probably nothing serious.
• Lily called Adam and told him Anna had died in a car accident the previous night.
• Ted saw Anna's body at the funeral home and stopped responding to his friends.
• Adam informed Leonard, left the hospital, and drove to the funeral home to see Ted.

Adam discovered that Anna was alive but had been injected with anesthetic, and he pursued funeral director Elliot Deakin after realizing he was a dangerous criminal. He left Ted, Lily, and Marshall at the funeral home and followed Deakin while Kate hurried to help.

• At the funeral home, Elliot Deakin spoke with Lily about Adam before secretly removing a wall of photographs showing apparently dead people with open, gleaming eyes.
• Adam arrived, examined Anna, and grew suspicious when Deakin hesitated to retrieve the death report.
• Adam called Kate and told Lily, Marshall, and Ted that Anna was alive and had been placed in suspended animation with anesthetic.
• Deakin drove away, and Adam told the others to wait while he went after him.
• Adam followed Deakin at a safe distance and urged Kate to hurry to their location.

Adam and Kate pursued Mr. Deakin into the woods, where Adam disabled his van and police arrested him. Photographs in the van suggested Deakin had killed more than a hundred people, and Adam suspected he had buried his victims alive.

• Mr. Deakin fled toward the outskirts, but Kate pursued him by police helicopter while Adam followed by car.
• After Mr. Deakin ignored police warnings and drove into the woods, Adam rammed his van, causing it to overturn against a tree.
• Kate and other officers arrested Mr. Deakin after he emerged with his hands raised, and police found a satchel filled with photographs of apparent victims.
• Mr. Deakin claimed he had killed people he considered walking dead, including Anna, and said he had given her a chance to redeem herself.
• Adam suspected Mr. Deakin had buried his victims alive and told Kate to inspect the most recent victim's coffin to confirm it.

Adam and Kate captured Mr. Deakin and headed to the Medical Center to check on the surviving victim. Adam arranged to keep Monica from hearing about the case while pregnant, then asked Kate to investigate possible accomplices among the emergency personnel and doctors who had certified the victims dead.

• Adam and Kate learned that Anna had not yet woken but was expected to recover, then Adam told Chandler that Mr. Deakin had been caught.
• Adam warned Chandler to keep the news from pregnant Monica and laid out plans to shield her from reports about Mr. Deakin’s crimes.
• Adam reassured Chandler that Monica’s grandmother had died naturally at the Medical Center, not as one of Mr. Deakin’s victims.
• Adam told Kate to investigate the paramedics and attending doctors involved in the cases because repeated false death declarations might point to accomplices or financial interests.

Anna woke in the medical center after Adam explained that an embalmer had drugged her into suspended animation, and she revealed that her piano teacher, Mr. Hutton, might also have been alive when he was buried. She reconciled with Ted but admitted she had suffered recurring nosebleeds, taken painkillers, and experienced frightening hallucinations, leaving Adam concerned that something else was wrong.

• Anna described waking in the morgue and recalled that the embalmer claimed she was dead.
• Adam explained that chloral hydrate had left Anna in suspended animation, and she remembered the embalmer calling his later injection a muscle relaxant.
• Anna recalled seeing Mr. Hutton's mouth move at his funeral, and Adam suspected he was another victim of the funeral home.
• Anna explained that she had distanced herself from Ted because she feared getting hurt, and she decided she wanted to love him.
• Adam asked about Anna's earlier hallucinations, and she disclosed recurring nosebleeds, heavy painkiller use, and a vision of the school hallway lights going out as doors refused to open.

Adam discovered that Anna had primary brain cancer after she survived Mr. Deakin’s attempt to bury her alive. Ted resolved to marry Anna immediately and stay by her side, while Adam agreed to help arrange the wedding.

• Dr. Montgomery learned that Mr. Deakin had murdered many women and fled in shock.
• Adam and Dr. Shepherd found a malignant brain tumor in Anna, and Adam told Ted she might have only a few years to live.
• Ted decided to propose to Anna that night and give her as much happiness and love as he could.
• Adam offered to arrange a quick wedding in New York if Anna accepted Ted’s proposal.
• Adam reflected that Ted would have to prove his love through sincere, lasting actions.

After Elliot Deakin confessed to burying people alive, Kate told Adam that one of the paramedics had helped him for years. Adam worked with Kate and the police to investigate the case and protect his loved ones, and the paramedic was killed by victims’ families after the news leaked.

• Kate told Adam that the town’s residents had learned their relatives were buried alive, and that officers had helped get Elliot Deakin out of the station before the grieving families could kill him.
• Kate said Elliot had confessed to his crimes, beginning with his mother, and explained that he had continued killing for more than twenty years after returning from military service.
• Kate revealed that a paramedic had been Elliot’s follower and apprentice, prompting Adam to warn her to investigate every detail and ask Ada to minimize his own public connection to the case.
• Adam analyzed Kate’s case files through the wedding and over the following week, helping the police investigate Elliot’s connections and protect his family and friends.
• The paramedic apprentice was exposed when news of his role leaked, and enraged families shot him dead.

Adam visited Anna Mosby in the hospital and learned that Sheldon was too frightened by the news from Hell Town to attend Beatrice's funeral. Missy stayed with Sheldon to comfort him, while the Coopers prepared to take Beatrice's body to Texas.

• Adam examined Anna and said she could attend Marshall and Lily's wedding briefly, with him monitoring her condition.
• Adam told Missy he would not travel to Texas for Beatrice's funeral and warned her against visiting dangerous places.
• Missy said Sheldon had learned about Hell Town, wet himself from fear, and refused to leave the apartment or attend the funeral.
• Adam realized Mrs. Cooper had sent Missy to comfort Sheldon, who remained terrified despite her efforts.
• Missy reflected that Emilia had a more supportive place in the Cooper family than she had growing up.

Adam welcomed Heather and Tatiana to Boston ahead of Lily’s wedding, where Tatiana reunited with Nurse Carol and showed how well she was doing. As the group left to prepare for the wedding, Carol cried with happiness and lingering sadness over not having adopted Tatiana.

• Adam met Heather, Tatiana, Juno, and Karen outside the medical center.
• Tatiana happily reunited with Nurse Carol, who asked about her life to make sure she was being cared for.
• Adam greeted Juno and reflected on how she had helped Kate investigate Elliot Deakin and plan precautions.
• Tatiana told Adam she wanted to dance with him at the wedding, and he promised to dance with her before Heather.
• Adam and the others left for the wedding, and Carol wept as she watched Tatiana go.

Adam and Juno helped resolve a last-minute wedding problem when a heavily pregnant harpist had to leave, and Adam arranged for another musician. At Lily and Marshall's wedding, Adam stopped Lily's ex-boyfriend Scooter from interrupting the ceremony and had him removed.

• Adam and Juno urged the heavily pregnant harpist to go to the hospital, and Adam paid her for the performance she could not finish.
• Juno told Adam that Lily had wanted a guitarist, so Adam called his assistant Ada to find a replacement while Karen offered to play.
• Adam followed Scooter into the bride's dressing room after seeing him sneak in.
• Scooter declared that he still loved Lily and challenged her to say she wanted to marry Marshall, but he kept twisting his neck and crossing his eyes to avoid her gaze.
• Adam held Scooter still so Lily could tell him she wanted to marry Marshall, then carried him out and told a waiter to keep him from returning.

At Marshall and Lily’s wedding, Adam helped them recover from a string of mishaps, including Marshall’s half-shaved head and Lily’s missing custom underwear. He then treated Gretchen Hans’s burn and persuaded her to leave for care, insisting the wedding would go smoothly without her.

• Adam found Marshall with half his head shaved after Marshall grabbed clippers in a panic, then helped him cover it with a hat.
• Juno told Adam that Lily’s veil was dirty and her custom wedding underwear had gone missing, so Adam wrote the design on a replacement pair.
• Adam checked the crowded wedding hall and saw Barney using the bride as an excuse to collect women’s phone numbers.
• Gretchen Hans burned her hand when a cup shattered, and Adam treated the injury.
• Adam urged Gretchen to leave for immediate care so she would not risk her bar exam, and she agreed.

At Marshall and Lily’s wedding venue, Adam realized Gretchen had injured herself to avoid the bar exam and escape watching Marshall marry Lily, so he encouraged her to seek another path and stop hurting herself. He sent Gretchen away with Scooter for medical treatment, leaving the wedding protected from Scooter’s attempts to get inside.

• Adam escorted Gretchen from the hotel and questioned her about her repeated bar exam failures and injured hand.
• Gretchen admitted she had injured herself to escape the wedding and revealed her feelings for Marshall.
• Adam urged Gretchen not to give up on herself or hurt anyone, and she thanked him for his support.
• Adam asked Scooter to take Gretchen to the Medical Center, and the two left together in a taxi.
• Adam paid the waiter to keep watching the hotel and stop Scooter from returning.

At Lily and Marshall’s wedding banquet, Adam danced with Tatiana and Heather and discussed finding Tatiana a friend. He proposed introducing her to Megan, and Heather agreed to wait for Adam to arrange it before telling Tatiana.

• Lily and Marshall entered the wedding banquet as newlyweds, and Adam explained to Tatiana why Lily had kept her surname.
• Adam danced with Tatiana, who then led him to Heather so they could dance together.
• Heather told Adam that her mother was doing better and that she missed him; they agreed she could visit him two days a week.
• Adam suggested that Tatiana befriend Megan, explaining that the girls shared difficult circumstances and could spend time together safely.
• Heather welcomed the idea but worried about Megan’s parents accepting it, and Adam promised to persuade them and asked her not to tell Tatiana yet.