When Andy's relationship with Delia is threatened after he breaks his promise not to date Linda Abbott, he decides to take his daughter on a special bonding trip to regain her trust. Andy is also surprised by Ephram's emotional reaction to the relationship with Linda. Meanwhile, Andy finds himself in a tough spot when a woman patient wants to get pregnant through in-vitro fertilization with sperm from her first husband, who is now dead, but her second husband is having a real problem over the matter. The Abbott family is still in turmoil when Amy decides to live with Edna and Irv, rather than playing by her parents' rules.

After returning from New York feeling lost and confused and needing Amy for support, Ephram considers his options in the wake of Madison's (Sarah Lancaster, who does not appear in this episode) life-altering revelation. Ephram tries to find the baby by going to Child Services Office, but finds out that Madison signed the adoption papers with "father unknown" and terminating the parent-child relationship with "Unknown Birth Father" leaving Ephram completely crushed.

Amy tries to get Ephram another audition at Julliard after he missed his first appointment due to the emergency with Madison and the baby, but it doesn't go well. Meanwhile, a tired Andy is a little stunned upon learning the extent of Nina's feelings for Jake and with a little encouragement from her friend Bright, Hannah decides to go on a date with a smitten Topher (guest-star Lukas Behnken).

The fourth season begins with a nice wedding of an unexpected couple and kiss at the airport for couple Bright and Hannah in Everwood.

Nina finally chooses between the two men she loves - Andy and Jake while at Delia's behest. Amy develops a new friendship with college-age student Reid (guest-star Justin Bardoni) while waiting on her mother Rose at the hospital. Also, Amy and Rose find that Rose's cancer has driven them apart rather than brought them together. Bright flirts with a new girl who might become his roommate, but is more involved in knowing what girlfriend Hannah scribbled off the postcard that she sent to him. Lastly, Ephram makes an emotional return to Everwood just in time for an unexpected wedding.