With her impending death, 500-year-old Katherine reminisces about her life and the night she gave birth in 1490. Stefan informs Elena, Caroline and Bonnie that Katherine doesn't have long to live. Damon, Matt and Jeremy talk about Katherine's infamous moments. Stefan and Elena are forced to help Nadia save her mother. Caroline indulges in some scandalous behavior. Katherine and Elena share a moment of bonding.moreless
After making a decision that infuriates Klaus, Elijah presents Rebekah with challenge that could change her life. Caroline is upset to discover that Elena has ruined her plans for the perfect Senior Prom, so she turns to Klaus for help. Determined to get through to Elena, Damon and Stefan both attend the prom, but they quickly lose control of the evening. When Elena suddenly behaves in a violent and unexpected way, Matt seeks Rebekah's help. Finally, Bonnie uncovers some terrifying news, and Klaus receives a message that could change everything.moreless
Elena and Rebekah take off to track down Katherine and end up in a small town in Pennsylvania, where Elena has an unexpected run-in with Elijah. Stefan and Damon worry about Elena and try help her, but her behavior makes it clear that she doesn't want their help. Damon doesn't know how to react when Stefan reveals a startling new plan. Back in Mystic Falls, Caroline reluctantly agrees to help Klaus, who now recognizes Silas' powers.moreless
Elena, Bonnie and Damon head to Whitmore College. Bonnie visits with Professor Shane who took over the classes her grandmother used to teach while Damon teaches Elena how to choose a victim. Stefan questions Klaus about Connor but he insists that Stefan get Rebekah to forgive him before he gives any answers. Klaus tells how in the 12th century he encountered a powerful group of vampire hunters and how Rebekah learned their secrets after she fell in love with one.moreless
While Charlie is still in his coma, the doctors try one last ditch attempt to wake him. A female jockey has a tough surgery performed on her by Joel.
A sick airline passenger is taken to the hospital. As Alex performs emergency surgery on the passenger, she believes the patient may be infected with a deadly and contagious virus.
Fear and doubt strike Joel in the OR, so Kinney takes him on a therapeutic trip to where she is originally from, then they try to rescue a woman who's pinned under a truck. Elsewhere, Charlie connects with a deceased therapist; and Alex cares for a fitness buff with a rare condition.moreless
Charlie is removed from the ventilator. It is discovered that a patient who arrives for a routine follow-up could hold the key to understanding Charlie's condition.
Dawn and Alex bicker over who will make decisions for Charlie. Charlie meets with a prisoner that has died in the spirit world.
Alex is performing a routine surgery when it takes a turn for the worse after the patient falls into a coma. Charlie connects with the patient and Alex gets personal with a case.moreless
When a hypnotist is called into the hospital to help with a patient who can't remember his identity, the man uses his psychic ability to connect Charlie and Alex.
A double hand reattachment gives Alex a chance to prove that she is still capable of being chief surgical resident. Maggie thinks a homeless man received the wrong diagnosis.
An exhausted Alex treats a hockey player while working the nightshift in the ER.Charlie must fight hard for his life when he comes down with pneumonia.
Alex must treat a patient who already has had multiple surgeries.
Alex treats a boy with mysterious symptoms and Joel and Maggie must help a patient despite his religious beliefs.
When Charlie Harris, Hope Zion Hospital's chief of surgery, falls into a coma, he ends up wandering the hospital in spirit form.
Jeremy makes an important decision that will change everything as he tries to protect Elena. Facing the harsh reality of her present situation, Elena longs for simpler times when her parents, Grayson and Miranda, and Aunt Jenna were still alive and her only concern was her relationship with Matt. Damon and Stefan leave Mystic Falls together on a mission, but soon part ways when Elena needs help from one of them. Caroline and Tyler face a life-changing decision, and Bonnie makes a secret deal that has tragic consequences.moreless
Elena, already upset after learning of Damon's latest indiscretion, is frustrated when none of her friends agree with her on how to handle the Original family's power struggle. Bonnie and Abby, still entangled in the destiny of the Bennett witches, participate in a ritual to appease the spirits of nature. Elijah presents Damon and Stefan with a dangerous ultimatum that puts Elena's life in danger, forcing Damon and Stefan to seek help from Alaric and Meredith with a plan that leads them to a terrifying option.moreless
Damon and Stefan accompany Elena to a formal ball being hosted at Klaus's newly renovated mansion. Meanwhile, Caroline and Matt also receive invitations. While at the party, Elena discovers a plan that could lead to numerous deaths, and she must choose whom to trust with the information. Klaus shows a different side of himself to Caroline. As the evening ends in violence, it's Damon who must find a way to cope.moreless
Sheriff Forbes delivers some unsettling news to Alaric and Elena about the murder weapon used in a recent killing. In Damon and Stefan's ongoing mission to kill Klaus, Stefan turns to Bonnie and Abby for help, and Damon seeks out to an old acquaintance to help him put together an elaborate plan. With a plan of his own, Klaus hosts an unusual dinner party, where he reveals another story from his family's violent history, but a surprise visitor brings the party to an abrupt end. Meanwhile, Caroline's heart is broken when she is unable to prevent a tragedy.moreless
Bonnie believes her dreams she's been having about Klaus's coffins will help her figure out how he can be killed. The recurring dreams also lead Bonnie to a reunion with her mother, Abby, whom Bonnie hasn't seen for 15 years. When they visit Abby's farmhouse, Bonnie and Elena meet Jamie, a young man Abby took in years earlier. Though Bonnie's sudden appearance catches Abby off-guard, she does her best to explain the past. Tyler turns to an unexpected ally as he works to regain his free will. Damon is intrigued by Dr. Fell, and Klaus and Stefan continue their violent negotiations over control of the coffins containing Klaus's family members.moreless
Elena and Bonnie help Alaric in his effort to decipher the meaning behind his recent discovery. Elena and Rebekah find themselves in a mean-girl power struggle until Rebekah finally reveals some of her family's ancient secrets and her violent past with Klaus and Elijah. Still trying to make a breakthrough with Stefan, Damon tries a reckless new approach, and they're both surprised by an unlikely ally.moreless