A gas tanker explodes on a Seattle highway, causing multiple injuries, including paramedic Matthew. Meredith and Jo help a frantic mother whose child is suffering from a mysterious illness. Owen bonds with a young boy whose parents are in critical condition. Meanwhile true colors are revealed when Alex is forced to work with Jo's boyfriend on an ailing patient.
The team find themselves working for the devil when Hollis Doyle's daughter is kidnapped and held for ransom. Meanwhile, David is still in danger and is forced to seek shelter at Pope & Associates; Olivia and Jake take their flirtatious relationship to the next level even as the President continues to rely on Jake for intel; in the White House, Cyrus will stop at nothing to get back into the President's good graces; and Mellie's claws come out when she tells Fitz he needs to make some changes.
Same-sex marriage divides the Supreme Court, Emily Bazelon explains Proposition 8 and the Defense of Marriage Act, and Robert Lustig warns against sugar.
Elena and Rebekah take off in search of Katherine and find themselves in a small town in Pennsylvania, where Elena has a surprising encounter with another old acquaintance -- Elijah. Stefan and Damon are both concerned about Elena’s state of mind and are determined to do what’s best for her, but she makes it clear that helping her will be difficult. Damon is not sure how to react when Stefan reveals his unexpected plan for the future. Meanwhile, in Mystic Falls, Klaus receives Caroline’s reluctant help and comes to a new understanding of Silas’ powers.