We don't really see what Izzy is up to until mid-episode when she puts Moody in his place for thinking Pearl should be with him. Their conversation also helps Izzy unveil a major revelation: Lexie got an abortion (Moody says it was Pearl, but Izzy uses common sense to deduce that it was her sister). She demands Lexie to tell Elena the truth, but Lexie rebuffs her.
Izzy goes to Mia's apartment where she finds Bebe hysterically crying after losing May Ling. She embraces Bebe alongside Mia and is worried about Bebe's ability to move forward. But Mia, citing the healing effects of fires and turmoil, assures Izzy that Bebe will be OK.
Later, back at her house, Izzy sees Mia and Pearl, who are putting their apartment key in the Richardsons' mailbox before driving away in a packed car (this, of course, takes place after Elena kicks them out). Completely distraught, Izzy takes Mia's fire analogy to heart and begins pouring gasoline on her bedroom belongings. Lexie, Trip, and Moody try to stop her but are stunned when she tells them that Elena forced out Mia and Pearl.
Izzy and Elena then get into a screaming match and Izzy reveals she had a girlfriend named April for a year. This is the first time she's openly addressed her sexuality in front of her family. She also says Mia was the only person who truly cared about her and wishes Mia was her mother. That's when Elena delivers the final blow, yelling that she never wanted to have Izzy. The youngest Richardson child leaves the house — before Lexie, Trip, and Moody set it ablaze — and catches a bus heading to an undisclosed destination. While she's riding toward her unknown future, Izzy dreams of hitching a ride with Mia and Pearl.