In hopes of raising his little sister Delia's spirits, Ephram does his best to recreate his mother's Thanksgiving traditions as the Brown family spends their first holiday without her. Meanwhile, in order to save a patient's life, Dr. Brown must find the man's missing brother, who is believed to live in the woods; and curmudgeonly Dr. Abbott attempts to befriend the entire town when he has a health scare and questions whether anyone would attend his funeral.

Andy's well-intentioned plan to give Ephram more free time by hiring college student Madison Kellner (guest star Sarah Lancaster) as a caretaker for Delia ends up making things worse when Madison treats Ephram like a child, as well and embarrasses him in front of Amy. Meanwhile, Andy's concern for Colin's alcoholic father (guest star Michael Flynn) blinds him to Nina's struggles with her divorce proceedings. Dr. Abbot continues to clash with his sister, Dr. Linda Abbott, when she tries to take over his office and the difference in their personalities and medical philosophies becomes alarmingly clear.

When Phil the mechanic (guest star J.K. Simmons) correctly ""diagnoses"" meningitis rather than flu in Andy's young patient, the town begins to believe he is a seer. Ephram confronts Madison about his feelings for her. Amy agrees to see Linda Abbott for help, but out of desperation, steals her pad to forge a prescription for anti depressants, forcing Harold to heed Phil's warning about his daughter's condition. Meanwhile, Edna learns the disturbing truth about why her daughter does not want to pursue a relationship with Dr. Brown.

When Amy accompanies Ephram to his Julliard audition in Boulder, a romantic moment leads her to confess her newfound feelings for him. Meanwhile, Andy struggles to convince his mentor Dr. Douglas (guest-star Philip Baker Hall) that he needs even riskier brain surgery than originally thought and that Andy is the man to do it. Dr. Abbott faces losing his medical practice after it appears no company will insure him. Lastly, Bright decides not to attend his graduation ceremony, much to the disappointment of his family.

Ephram is on cloud nine after being accepted into Julliard's summer program, but his emotions are sent into a tailspin when Amy shares her feelings for him and asks that he stay in Everwood for the summer. Meanwhile, Dr. Abbott's family thinks he's gone off the deep end when he decides to open a bagel shop in response to losing his malpractice insurance, and Andy learns a shocking revelation about his family.

Ephram and Amy are reunited after a long summer spent apart while Ephram attended Julliard's summer program in New York, but Amy's euphoria is quickly replaced with paranoia after she notices Ephram acting distant. Meanwhile, Andy is plagued by guilt over whether he made the right decision concerning Madison's pregnancy, and Dr. Abbott befriends the town's newest citizen, Jake Hartman, who turns out to be a doctor from California looking to open a new practice in Everwood.

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.

With Ephram (Gregory Smith, who does not appear in the episode) gone and no longer feeling any significant ties to Everwood, Andy consults with Delia and contemplates accepting a prestigious position with a Chicago hospital. Uncharacteristically upset over this bit of news, Harold takes it upon himself to give Andy a reason to stay. Meanwhile, Jake moves in with Nina, causing Andy to question whether he should rock the boat by telling her how he really feels, and Bright finally admits his feelings to Hannah.

Andy is harassing Ephram for being in community college and Kyle is in the room. Amy bonds with a cool teacher at Colorado A&M. She goes to a meeting about a search for the new Provost with a few other women invited by her cool new teacher.

Ephram reveals information about his dad to Nina that surprises her and adds a new twist to her inner Andy-or-Jake struggle; Andy finds more of a connection with his dad (guest star Charles Durning), who's still in town; Amy and Ephram recall a moment from their past that helps Amy realize that Ephram is always there for her. Lastly, Hannah and Bright come together as friends, realizing that there's still a close bond between them.