Matt and Sarah begin their student rotation in the ER, but get off to a bad start by arriving late and angering Dr. Norton, the attending ER physician. Matt and Sarah's relationship is tested when Matt quickly demonstrates an aptitude for the work, but Sarah accuses him of trying to make himself look better than the other students, especially her. However, Matt ends up looking foolish when he can't figure out how to turn off the ringer on his cell phone and he gets stuck fielding calls from his family. Matt's day ends tragically, leaving him to question his destiny.

Simon's ex-girlfriend, Georgia (guest-star Rheagan Wallace) tells Simon she's supposedly pregnant and Simon doesn't know how to tell his parents---but Georgia is not being completely honest. Eric, Annie and the twins are on a road trip from Ginger's house back to Glen Oak and reminisce on old times. Meanwhile, Matt rushes Lucy to the hospital when she collapses at the grocery store. They can't track down Kevin as he is working on a drug bust. Lastly, a lonely Ruthie is having a miserable time in Puerto Rico with Mary, Carlos and baby Charles and calls home for comfort.