Ephram gets the wrong idea when Madison tells him her roommate is going to be out of town, but the misunderstanding leads to an intimate moment for the couple. In other matters of the heart, Amy decides she's ready to have sex with Tommy (guest star Paul Wasilewski), so she works up the courage to ask Dr. Brown to write her a prescription for birth control pills, and Andy makes the important decision to talk to Ephram and Delia about Linda spending the night at their house.

At her father's suggestion, a heartbroken Amy is determined to make the most of her senior year in the wake of Ephram returning from New York and telling her that piano has to be his number one priority. Andy contemplates telling Ephram about Madison's (Sarah Lancaster, who does not appear in the episode) pregnancy. Meanwhile, Rose naively agrees to help Bright find his true calling after she discovers that he hasn't enrolled for college classes and is in fact leading a life of total leisure.

Also, Dr. Jake Hartman (Scott Wolf) creates a marketing blitz for his new practice that threatens to push Dr. Abbott over the edge. Lastly, Nina takes in her friends' teenage daughter, Hannah (Sarah Drew, "Radio"), and asks Ephram to take her under his wing.

On the morning of his Julliard audition in New York, Ephram makes plans to meet up with Madison (guest star Sarah Lancaster) for coffee where he finds out that she was pregnant with his child. This devastating revelation causes Ephram to make decisions that will alter the course of his life. Amy tries to figure out what this will do to her and Emphram's relationship. Meanwhile, Dr. Abbott counsels a man (guest star Chris Penn) whose son may die as a result of a hunting accident.

Ephram prepares to leave for Europe as he feels that he has nothing left for him in Everwood. However, he's caught off-guard and questions his plans when Andy reveals the secret that Amy has been keeping from Ephram. Meanwhile, Nina and Jake contemplate going into business together, but the stress on their relationship proves a big obstacle to overcome. Meanwhile, Bright finally confesses he has feelings for Hannah.

Andy learns that Ephram has no intention of moving back home, while Bright invites Ephram to move in with him and Reid (Justin Baldoni). Meanwhile, Hannah (Sarah Drew) begins to worry about the long term possibilities for her relationship with Bright after he shares his "three dates and out" policy; Harold suspects Andy is up to something after he frequently goes missing from the office.

Nina and Jake have the grand opening for their new restaurant, Sam's. Nina is having a hard time convincing Everwood patrons on her new restaurant politics as "Mama Joys" is officially gone. But Nina gets some help when a couple of celebrities walk in and like her new establishment. Lastly, Ephram and Amy finally confront the unspoken fate of their relationship.

Bright takes Ephram to one of the college keggers to help cheer him up for some reason, but Ephram ignores the girls who are flirting with him and the party as he's playing video games. Also, lonely Edna suffers a panic attack and is rushed to the hospital. Lastly, Delia grows more rebellious against her father. Harold and Rose consider adopting a child from Africa, but the process of it is a lot harder than they expected.

An eighteen-year-old girl wants Andy to check her for the breast cancer gene, as it runs in her family. The girl and her older sister (who already had cancer and a double mastectomy) go see Andy for the results. Bright and Hannah are out on a date when something happens to both of them, and they call Harold. Kyle doesn't want lessons from Ephram anymore, again.

After their house has been sold, Nina and Sam temporarily move in with the Browns. Wanting to take care of an unresolved issue in his life before he can propose to Nina, Andy takes a mysterious trip. Bright learns that Hannah has received a scholarship to Notre Dame and is devastated at the thought that she may accept it. Edna upsets Harold and Rose when she reveals her plans to leave Everwood. Delia is thrilled with Andy’s belated Bat Mitzvah gift.