Christian and Kimber put the final touches on their wedding plans, but an unsigned prenuptial agreement casts a shadow of doubt across the occasion.

Its the Christmas season and McNamara/Troy get a couple of very merry patients. A man and woman who's profession is to be Santa Claus and Mrs. Claus. They decided that they wanted to give their characters a new thinner image for children to know. When Julia is help putting up Christmas decorations she collapses. Julia goes to Sean to get her blood checked to see if there is anything wrong. She thinks it has to do with the stress of firring Quentin and getting divorced. But Sean discovers later that day, that she is pregnant. While Matt and his girlfriend Ariel are at school they see that their is an African-American nativity scene. Ariel gets very angry and has Matt help her paint the scene white.

When Chrsitian receives a very mysterious package covered in blood, he figures out that his ex-fiancé is being held hostage from "The Carver." Kit comes back to investigate Quentin who is their number one prime suspect at the moment. A transgender woman comes to get work done for her mangled face, and wants her surgery free because Sean's son is the one who beat her up and made her face look worse. Seans asks Julia to move back into the house, but Julia declines his offer. When interrogating Quentin, Kit finds a very shocking fact about him.

After nine women are attacked by "The Carver," Kit knew that he was getting very desperate and they had no leads on who the carver could be. Sean and Christian thought it was still Quentin, however he was attacked the same night as the nine women. Matt decides to break up with Ariel, but finds out that she and her dad wanted to mess with him for being friends with a transvestite. In this very shocking and nail biting season finale we find out who "The Carver," really is.