Casey tells Izzie what Nate did. Sam tries to figure out which colleges to apply to. Doug discovers a need to educate first responders about autism.

Sam loses his portfolio for his art school application and panics. Megan gets flirty with Doug, who makes a decision about Elsa. Julia calls Miles.

Paige invites Sam to redefine their romance, Casey struggles with complicated feelings, and Elsa attempts to find a new normal with Doug.