A nervous Ephram feels the pressure of performing his first piano recital in Everwood; Dr. Brown and Dr. Abbott attempt to diagnose a man (guest star Dan Merket) with a mysterious sleeping disorder that leaves welts on his body; and Amy pretends to want to spend time with her grandmother, Edna, in order to secretly see Colin while she's grounded. Meanwhile, the town is buzzing with rumors of UFOs and aliens after locals observe something strange in the sky.

Dr. Brown faces one of the toughest moral decisions of his career when a distraught pregnant teenager (guest star Kate Mara) and her father (guest star Kevin Tighe) come to him for guidance about terminating her pregnancy. Meanwhile, Ephram is humiliated in front of the entire school when his date for the Spring Formal ditches him at the dance to make-out with her boyfriend. Lastly, Amy and Colin (Mike Erwin) have a huge fight when she chooses to console Ephram against Colin's wishes.