The former Big Apple neurosurgeon, Dr.Andrew Brown, puts on his scrubs for the first time since he relocated his family to Colorado to operate on Amy's comatose boyfriend, Colin (Mike Erwin), with the help of his friend and surgery partner from New York, Dr. Brian Holderman (guest star Lamont Thompson). Adding to his performance anxiety is the identity of the patient---Colin Hart, the boy who was dating Amy before she stole Ephram's heart.

It also doesn't help that the tricky procedure he plans to perform has never been attempted before. Amy leans on Ephram for support as she awaits the outcome. Meanwhile, an emotional Bright breaks down and admits what actually happened the day of the car accident as Colin's former life in Everwood is also revisited as flashbacks reveal some startling secrets about the teen's last days before the accident that put him in the hospital.

Although conflicted by his feelings for Amy, Ephram finds himself serving as confidante and friend to Amy's boyfriend, Colin, who continues to feel like a fish-out-of-water as he attempts to reclaim his life before the accident. Meanwhile, Andy hopes to convince Ephram to resume the piano lessons he abandoned after his mother's death; Nina's absentee husband (guest star Dylan Walsh) comes home for a visit, which proves to be far from happily ever after; and in a bittersweet turn of events, Amy and Colin are nominated for Homecoming King and Queen.

When Andy invites Linda Abbott over for dinner to discuss a patient, Delia lashes out through foul language, but it is an enlightened Ephram who figures out the cause of his sister's bad behavior, thanks to insight provided by Madison (Sarah Lancaster). Amy's depression deepens, but when her therapist recommends medication, Dr. Abbott refuses to write a prescription to help his daughter cope with Colin's death.

Ephram gets the wrong idea when Madison tells him her roommate is going to be out of town, but the misunderstanding leads to an intimate moment for the couple. In other matters of the heart, Amy decides she's ready to have sex with Tommy (guest star Paul Wasilewski), so she works up the courage to ask Dr. Brown to write her a prescription for birth control pills, and Andy makes the important decision to talk to Ephram and Delia about Linda spending the night at their house.