Cindy Plumb is the first episode of season 4
Sean and Christian may be celebrating a milestone surgery, but it looks like the future of McNamara/Troy is in jeopardy. Julia tells Sean some devastating news about the baby. Christian decides to redecorate his apartment after a disturbing appointment with his psychiatrist.
We begin with Christian and Sean performing double face lift on an elderly couple. Christian has finished, and Sean calls him over to remind him that this is their 5,000th surgery by presenting him with a special scalpel. To celebrate, they go to a bar, where two attractive women approach them. They are Riley White and her mother Jill. While Sean opts to go home to Julia, Christian takes the two home. Cut to a montage of Sean trying to have sex with Julia, who is six months pregnant, while at the same time, Christian is with Jill and Riley.
The next day, Burt Landau appears in the office with his wife Michelle (who is about 30 years younger than him)for testicle implants. Burt had testicular cancer, but he is unhappy with the size of his new ones. He would like to get bigger ones. Kiwi size, to be exact. Julia is visting with her doctor, who tells her that her baby boy has a problem. She does not say what is is, but Julia knew there was a possibility of it.
Christian is with a therapist (played by the lovely Brooke Shields). Before you know it, they are talking about how he only has sex with women doggy style, so he can't look at them. Christian gets defensive, and the therapist brings up the possibility that he is in love with Sean.
Meanwhile, Sean is consulting with Cindy Plumb, a phone sex "artist" who is in her mid-50's. Cindy's husband left her because she couldn't satisfy him sexually, so she got into the phone sex business to get over it. Since Cindy's voice is changing (due to alcohol, smoking, and her age), her regular clients have stopped calling. She asks Sean to lift her voice an octave, to which he sympathetically accepts.
Julia meets with a woman with ectrodactyly, the problem that her baby boy will have. After a talk with her, she knows for sure that she wants to keep her baby.
After the appointment with his therapist, Christian decides to redecorate his apartment.
Meanwhile, Christian can't seem to get over the flirtation between him and Michelle. They are even flirting during her husband's surgery, after which Michelle offers to buy the business, which Christian accepts, but Sean shoots down. To add to Sean's bad mood, Julia tells him about the baby. He is so upset, he goes to Christian's house drunk. Christian tells him to go home. He leaves to talk to Julia.
In the end, a patient waits outside a door marked "Faith Wolper, PhD". Inside, the room is a mess, and Faith and Christian are having sex doggy style. Later, while Sean and Christian are signing the papers, Christian continues to stare at Michelle. The episode ends with Christian in the same bar. A beautiful woman approaches him, but he turns her down.