Erica Noughton.Sean turns 40, and has begun to experience spasms in his hand which affect his surgical skills. Gina (guest star Jessalyn Gilsig) tries to keep baby Wilber away from Christian, who later discovers that Wilber's nanny (guest star Portia Dawson) has been drugging him to keep him asleep. Julia's mother, Erica, comes to Miami wanting a face lift just before she starts promoting her new book. Erica and Christian have a history: they slept together at Sean and Julia's wedding. A middle-aged woman (guest star Romy Rosemont) and her gay best friend (guest star Chris Diamantopoulos) come to McNamara/Troy, the woman seeking corrective surgery after being shot in the face nine months ago. But their friendship harbors a dark secret...