Sutton has been held hostage at the mental hospital where Annie Hobbs is being kept. Dr. Hughes calls Alec and tells him that she has the "Sutton Mercer" that he warned her about locked up. Alec then tells her to keep an eye on her because the real Sutton (actually Emma) was in a Phoenix hospital with him. After a series of misunderstandings, Dr. Hughes thinks that Sutton is actually Emma Becker pretending to be Sutton Mercer and doesn't catch on to the fact that they are twins. At the hospital, Madeline overhears Emma, Ethan, and Thayer talking about Sutton, which then leads to broken trust between Emma (as Sutton), Mads, and Char. Madeline suspects that Emma (as Sutton) has been keeping secrets from her and their friendship is strained when it matters the most. Ethan begins to show signs of jealousy when he sees Emma exchanging search information with Thayer. Emma, however, is not fully convinced that Ethan is completely over Sutton after what happened at the hospital. Alec is getting more and more suspicious of Emma (as Sutton) and tries to keep everyone away from Eduardo, who might know a secret of his or two. Meanwhile, Laurel convinces herself that Justin is "the one" and wants to take their relationship to the next step, asking her sister for advice (although unlike Sutton, Emma isn't experienced in that field at all). Thayer gets Char to talk to her new boyfriend, Derek (Alec's undercover accomplice), about why he's been exchanging multiple phone calls with Alec. Emma and Thayer hack into Ted's computer to find a password for the hospital doors after visitation hours to hopefully get more information from Eduardo. At the door, Emma runs into Ethan, who won't leave her alone, saying that he's only looking out for her. She also runs into Mads and Char, who demand to know why she's sneaking around, especially with Ethan, who they still think cheated on her with "Emma." Eduardo is in a critical state and the girls are forced out of the hospital. Alec had also paid him a visit, allowing him to keep seeing Mads as long as he doesn't say a word about the phone call he overheard. Back at Char's house, Emma (as Sutton) decides to come clean to Mads and Char (to Ethan and Thayer's concern) and tells them that she's been looking for her birth mother and that Alec has been keeping vital information about her. Mads is also shocked to find out that her father paid Eduardo to leave town, leading to his tragic accident, although their important conversation is cut short when Alec walks in to check up on his daughter. At the Dowinger clinic, Sutton gets a male nurse to let her out of her room for 15 minutes to meet Annie. Annie recognizes Sutton and Sutton is eager to ask her questions about their adoption, Ted & Alec, and why she's been in hiding. Annie reveals that either Ted or Alec told her that Emma had died that day in the Fillmore house fire and she had blamed herself all these years, driving her to insanity. When Sutton tells her that Emma was indeed alive and taking her place in Arizona, Annie goes crazy and calls security on a heartbroken Sutton. Ted and Kristin find Laurel in bed with Justin through a phone-tracking device. In the ending scene, Emma is getting dressed for bed when she finds Travis, her foster brother from Las Vegas, in her room and is shocked to find out that he knows about her being a twin.