Season 4, the last in Miami for Christian and Sean (Julian McMahon and Dylan Walsh), opens with a celebration: their 5000th surgery together. Out of the operating room, Christian's shrink (Brooke Shields), who's obsessed with him, tells him that his fear of emotional intimacy stems from a desire to be more than a friend and colleague to Sean. This haunts Christian, and he soon becomes emotionally intimate with physician Michelle Landau (Sanaa Lathan), the trophy wife of old and ailing venture capitalist Burt Landau (Larry Hagman), who buys McNamara/Troy and installs her as Christian and Sean's boss. Meanwhile, Michelle is harassed (and blackmailed) by a former boss of her own, a mysterious woman named James (Jacqueline Bisset), who has ties to Sean and Christian's old enemy, drug kingpin Escobar Gallardo (Robert LaSardo). As for Sean, his newborn son Conor's hand deformity leads to a disagreement with Julia (Joely Richardson) over corrective surgery. Advising against it is Conor's short-statured "manny" (Peter Dinklage), with whom Julia has an affair. In other plotlines, Matt McNamara (John Hensley) takes up with newly minted Scientologist Kimber (Kelly Carlson), who's really out to get back at Christian. And Liz (Roma Maffia) returns to McNamara/Troy but runs afoul of Michelle. She also finds romance with fellow anesthesiologist Poppy (Alanis Morissette) and experiences a health emergency. Among the Season 4 patients are a phone-sex operator (Kathleen Turner) looking for a "voice-lift"; a well-to-do gay man (Richard Chamberlain) who wants facial surgery for his younger boyfriend; the wife of a soon-to-return Iraq vet (Melissa Gilbert) whose dog bit off one of her nipples; a Frenchwoman (Catherine Deneuve) who wants her late husband's ashes placed in her breast implants; and the vulgar and gregarious Dawn Budge (Rosie O'Donnell), a lottery winner who becomes a frequent McNamara/Troy customer.
by Paul Droesch synopsis