This is the second hour of a 2-hour season finale. A two episode entries have been created. The 10pm EST marker will mark to beginning of the second episode. A couple undergoes surgery. Derek and Meredith clinical trial has another patient. Izzie helps Alex. McSteamy hooks up with someone.

When an attractive woman, Katy, comes to the office to solicit her purses, all of the male staffers vie for her affection. Pam struggles with whether or not to be jealous of Katy's attention.

Ben confronts Jack, claiming that Naomi is not who she seems. Meanwhile, Sawyer and Juliet try to come up with a plan to rescue the hostages at the beach. Inside the Looking Glass, Charlie and Desmond struggle to find a way to shut off the blocking signal.

Tony and Carmela quarrel over the prospect of sending A.J. to military school after he is expelled. Ralphie is forced to make a decision about Jackie, while Meadow reflects upon her life as a Soprano. Writer: Lawrence Konner, David Chase Director: John Patterson Guest star: Denise Borino (Ginny Sacrimoni), Vincent Curatola (John "Johnny Sack" Sacrimoni), Frank Pando (Agent Grasso), Frances Esemplare (Nucci Gualtieri), Matt Servitto (Agent Harris), Frank Pellegrino (Frank Cubitoso), Dan Grimaldi (Patsy Parisi), Joseph R. Gannascoli (Vito Spatafore), Maureen Van Zandt (Gabriella Dante), Lola Glaudini (Agent Deborah Cicerone), Jason Cerbone (Jackie Aprile, Jr.), ...

Monk undergoes hypnotic therapy as treatment for his OCD. After a session, he adopts a more childlike personality. Meanwhile a soon-to-be divorced woman disappears and a murder occurs.

Monk is summoned to jury duty against his wishes and must solve two crimes: he has to convince the jury the defendant is not guilty, and solve the mystery of a corpse outside the jury room's window.