ABC’s Private Practice ends its fourth season with some big changes, as the episode title, “…To Change the Things I Can,” implies. Violet (Amy Brenneman) has her medical license suspended, and the investigation into her extends to the entire practice. Only Sam (Taye Diggs) appears ready to fight to preserve Oceanside Wellness. Many characters ponder leaving the practice behind altogether. Violet decides she should go on a book tour, despite her husband, Pete’s (Tim Daly), objections. Naomi (Audra McDonald) ponders a proposal from Fife (Michael Patrick Thornton). Addison (Kate Walsh) considers taking a trip with a handsome stranger (Benjamin Bratt, Law & Order, The Cleaner) she just met, whose name she doesn’t even know. Meanwhile, Amelia (Caterina Scorsone) slides back into alcoholism, Charlotte (KaDee Strickland) struggles to counsel a rape survivor, and Cooper (Paul Adelstein) talks down a father (Joshua Malina, The West Wing) who wants to euthanize his daughter.
The ending of this episode is a cop out. Addison decides not to run away, and instead, proposes dissolving the practice, only to immediately restart it again under a different name. Will that really throw the medical investigators off? If the same group of doctors stick together, it doesn’t seem reasonable to assume changing the name of their organization will do anything substantial to get them out of trouble. Because of this, the whole thing feels forced upon any examination at all, and it becomes a hollow story with little suspense. At first, it looks to be an exciting challenge, but it peters out by the end of the hour. Hopefully, it will be revisited next season in more depth, and not just wasted.
Why is the board even investigating them in the first place? Perhaps doctor / patient confidentiality is a tad confusing, but a when a group of doctors work together, they are not allowed to consult with one another? Sometimes the characters do slide into gossip, but trading opinions also occasionally leads to unexpected help. Keeping the information within such a community seems like it is only beneficial to the patient. No doctor is telling non-medical professionals anything about their cases. It is purely a professional arrangement. Don’t any real life practices operate this way? If not, why not?
That being said, the doctors on Private Practice have been pulled in a variety of directions, and a crisis like this may be just what they need to renew their commitment as a group. While only Sam initially steps up to fight, the possible dissolution weighs on all of the characters, and many take the problem into account as they decide what to do next. It is unfortunate that more screen time is not given to this plot, instead the hour is split between a variety of smaller problems. This could easily be a couple of episodes all on its own.
Poor Amelia has little plot in Private Practice. Her current story arc, where she resorts back to alcoholism, feels contrived just to give her something to do. With no romantic entanglements and few medical cases that tie her to the other doctors, it is always a stretch to include her in episodes. The solution? Give her a dumb arc where she revisits past mistakes, and has learned absolutely nothing. While relapse is a part of many addicts’ lives, Amelia doesn’t seem the type to actually do it, until she does. With luck, the writers will come up with something for her soon that doesn’t involve her addiction.
Pete has a problem with Violet leaving because of past issues. Violet has shown a tendency to run away when things get tough. In Violet’s mind, this is a totally different situation. Her medical career is stalled by her suspension, so she is pouring her energy into another job, that of selling and promoting her book. From her point of view, the decision is understandably not about running away, but keeping busy in a way that satisfies her professionally. But Pete’s opinion is also easy to see, because of Violet’s history. The couple needs a serious discussion with open minds. Neither of them seem willing to look at the other side, and that might end them.
What happens to Pete at the end of “…To Change the Things I Can?” He collapses on the floor in front of his young son. Pete is showing signs of illness throughout the episode, so it isn’t a total shock. But is the kid old enough to know how to dial 9-1-1? And what exactly is wrong with Pete? While this is a season finale, and so some months may pass before the season premiere, it is likely Violet will give up her book tour and come home to care for her family, even if that isn’t shown in an episode.
Who is Addison’s new friend? Reports are that Benjamin Bratt is joining Private Practice full time next season. It is quite likely he is a doctor, though obviously not one that has worked at St. Ambrose, or Addison would know him before now. If he is not a doctor, it will be hard to serve his character in story from week to week, unless much more screen time is devoted to Addison’s after house person life, which is not what Private Practice needs. Bratt’s character is apparently here to start a love triangle with Addison and Sam. If he wants kids at all, he’ll definitely win Addison over.
It is a total mistake for Addison to fall back into Pete’s bed. He probably does it because her strength in taking charge of the problem with the practice makes her attractive all over again. But they have an insurmountable disagreement that they cannot get over. There is a good, solid reason they end their relationship, and it isn’t going away. As such, it is purely a mistake on both of their parts to risk reopening wounds by renewing a sexual relationship. It is just forced drama to create conflict when Bratt returns next season.
Naomi’s departure is a little anti-climatic. The production team has been willing to work with McDonald this year as she frequently commutes back home to her family in New York City. It is no surprise that she is leaving the cast, at least as a main character. She has been absent for many episodes this season. At least she is given a happy ending, and in NYC, no less. That will make it easy to film any stories the writers may come up with for Naomi in New York on location, instead of making her fly back to Los Angeles. Hopefully, that means her story isn’t over, since the Private Practice developments somewhat mirror real life.
It is sweet that Betsey (Hailey Sole) is brought back one more time. It is very sad that Betsey has had to go through so much, but the last time she came into the lives of the doctors, it felt certain that Naomi would have adopted her had she been in town and aware of the situation. Thus it is with poetic justice that Betsey returns back to them at a time when Naomi is there, so the caring mother can end any custody issues. It is too bad Betsey must suffer, but it concludes the story the way it should have ended in the first place, and so fixes a past mistake.
Cooper only ever wants to help people. He is perhaps the most compassionate doctor on the show. In “…To Change the Things I Can,” he faces a very tough decision. Should he help a father end his daughter’s life, when she doesn’t have much of a life left? This is a moral quandary, similar to other episodes of the series, but different because a child is involved. There is no right or wrong answer when it comes to end of the life decisions, which are usually left up to the family. This one is a little confusing because the option is not given to end the child’s life, though she is a vegetable. But Cooper handles the father with grace and care, in a way few people could.
Charlotte has come full circle with the admission of a patient who has been abused and raped, but will not allow a rape test. It is no surprise that Charlotte relives old feelings, having only recently begun to recover herself from a similar ordeal. Charlotte is a very dynamic character, who has experienced a lot of growth over the course of the series. It is a logical step for her to have to face those demons again, and thankfully she comes through with flying colors. Charlotte is able to offer comfort and connect with the patient without totally tossing aside her personality, which prevents too much bonding. Kudos to a nice capper on a very good story arc.
Private Practice will return for a fifth season next fall on ABC.