I ran the McNamara/Troy plastic surgery clinic in Miami with my best friend, Christian Troy. I am nearing middle age and trying to come to terms with the choices I have made in my life; I went into plastic surgery to help repair the bodies of the deformed and the mutilated, but became sidetracked in performing vanity procedures. When the show begins, I am considering going into pro bono work.
Julia and I have had many ups and downs in our marriage, but our relationship was slowly falling apart. At one point, I had an affair with one of my patients - Megan O'Hara, a breast cancer survivor who is separated from her husband. The affair continued until I confessed it to my http:/son Matt and tried to break it off, but I felt obliged to Megan when her cancer returns. She decides she would rather commit suicide than go through chemotherapy, and asks me to help her go peacefully. Julia accompanies me to Megan's funeral where she realizes why I am so upset about her death.
Julia and I worked hard to try to salvage our marriage. At the end of the first season, Julia learns that Matt is, in fact, Christian's biological son (the result of a one-night stand just prior to our wedding). Though I eventually forgive Christian, I find it difficult to do so for Julia, and we separate.
Around this time, a masked serial killer begins terrorizing Miami, raping and mutilating fashion models. Referred to as "The Carver" by the media, he leaves deep cuts on both sides of his victims' mouths, resembling a smile. When McNamara/Troy begins performing pro bono surgery on his victims, the enraged killer targets me. I am eventually attacked by The Carver in my own home, but I am more fortunate than most of his victims; I receive only a single cut on my right cheek and am not raped. Quentin Costa, a surgeon from Atlanta, is called in to help Christian fix my face.
After Christian becomes a Carver victim himself, I find it difficult to continue working. To pick up the slack, I offer Quentin a limited partnership, which he accepts. Christian is initially against the partnership, but eventually agrees to work with Quentin.
During this time, my life becomes even more chaotic. Julia files divorce papers and begins her own spa, and Christian is arrested in connection with the Carver rapes (and one murder). The Carver attacks while Christian is in jail, and Christian is set free. The incident greatly hurts business at McNamara/Troy, and I begin to question the cosmetic surgery business again. After an incident in which the doctors attempted to perform plastic surgery on an elderly woman in unfit condition for such a procedure, I quit the practice and join the Witness Protection Program. I only performed one operation on a son and mother, who I then began having a relationship with. Finally choosing between leaving my old life behind and getting a new one completely, I return to the practice and ignite a bitter rivalry with Quentin, who has since begun dating my ex-wife.
The rivalry ends with Quentin buying out the remainder of his contract and going to work at Julia's spa. Julia eventually fires Quentin, and discovers soon after that she is pregnant. Christian and I initially assume the child is Quentin's. However, Quentin, not knowing that Julia is pregnant, admits to Christian that the two never had sex. The child is now assumed to be mine, the result of a night we spent together after our divorce.
My relationship with Matt could be salvageable, since Matt asked me to do pro bono work on Cherry Peck, a transgendered person he beat up. Shortly after doing so, The Carver launched two more attacks, this time on a sorority house, and on my rival, Quentin Costa. I agreed to fix Quentin after a heart-breaking speech, but Christian and I pay dearly for it, because The Carver sneaks up and drugs me, and then takes off the mask, revealing himself as none other than Quentin Costa. He then straps both Christian and I to the operating tables, plays mind games with us a bit, and then cuts off one of my fingers. Christian decides to sacrifice himself, or more specifically, his left hand to save me. Before that happens, Quentin is shot from behind by Kit McGraw, a police officer who had a brief relationship with Christian — and is also Quentin's sister, who had been helping him commit the murders.
A micro surgeon saves my finger. After giving up the property deed to the house to Julia, she decides to add my name to it, saying she'll only move back in if I’m still living there. I agree and we move in together again but our relationship is put to a strain after I discover that my son is going to be born handicapped with ectrodactyly, commonly known as lobster claw syndrome. Furthermore, I have sex with a potential nanny named Monica Wilder, but afterwards decided not to hire her after feeling guilty of cheating on Julia once again. Although I had no feelings for Monica and broke whatever we had off after she returned to me, she had no intentions of leaving me and will prove to be a threat Julia's and I.
Despite not hiring Monica, she continues to involve herself in my life by filling in as Connor’s nanny when my regular nanny is hospitalized with food poisoning. After repeatedly telling her to leave, Monica confronts me at work and asks me to look at a possible infection to her nipple stemming from continuously breastfeeding Connor. I contemplate killing Monica to prevent her from telling Julia of our affair, but am ultimately unable to and tell her to leave and that she should see a psychologist. Enraged, Monica tells me that she is going to tell the police that I raped her and thus destroy my marriage. I hurry after Monica, trying to talk some sense into her when she is killed in a freak accident when a bus hits her while crossing the road.
When it got closer to the day of Connor's hand surgery, I was met with several obstacles. For one thing, Julia became more hesitant in even having the surgery done and with Marlo's (Connor's nurse) encouragement; she refused to sign the consent forms. Additionally, I became more conscious of Connor's hands as a young boy makes fun of his condition, prompting me to insult the child's own physical appearance and punching the boy's father. Eventually, I settle everything with the father and realized that I was merely projecting my repressed anger from my own childhood, in which I eventually revealed to Julia that I was born with a cleft lip, which made me an object of ridicule (it should also be noted that my mother's decision to repair it secretly with my college fund ultimately led to my father leaving the family). After discovering this, Julia agrees to the surgery and I was now more at ease with Connor’s chance of living a normal life. However, Julia has recently decided to cancel the second surgery on Connor’s hand and take Annie and him with her to New York, leaving Sean behind.
I had some therapy sessions with Faith Wolper without Christian knowing with my life seeming to fall apart with losing my family. She tells me that Christian has had dreams about me. I tell Christian, and our relationship goes back to normal. I have sold my share of his partnership to Christian and Michelle needing to know if I can live without Christian. I move to Los Angeles and get a new job. However, Christian soon joins me and will be setting up our new practice in Hollywood.
