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.

On a church ski trip chaperoned by perpetual party pooper Dr. Abbott, Amy and Colin share their first kiss since the surgery. Ephram finds himself intrigued by Colin's younger sister, Laynie (guest star Nora Zehetner), who has recently returned home from boarding school. Also, Bright attempts to get to the next base with his girlfriend (guest star Devon Reilly). Meanwhile, Andy hesitantly agrees to attend a singles mixer with the recently divorced Reverend Keyes (guest star Tim Dekay).

Dr. Brown faces one of the toughest moral decisions of his career when a distraught pregnant teenager (guest star Kate Mara) and her father (guest star Kevin Tighe) come to him for guidance about terminating her pregnancy. Meanwhile, Ephram is humiliated in front of the entire school when his date for the Spring Formal ditches him at the dance to make-out with her boyfriend. Lastly, Amy and Colin (Mike Erwin) have a huge fight when she chooses to console Ephram against Colin's wishes.

Andy is concerned that Ephram needs more extracurricular activities to get into a top college, but Ephram is only focused on his Julliard audition, which has surprising results. Amy's lack of interest in college preparation alarms her mother more than her father. Bright's poor grades get him kicked off the football team, threatening the scholarship his father believes may be his only chance to get into a decent school. Meanwhile, Andy tries to help a cheerleader (guest-star Kristen Bell) with ruptured breast implants, who cares more about looking good than her own health.

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 a coal mine collapses, Dr. Brown, together with Edna, Linda and Harold Abbott, rush to the scene to assist their neighbors. One miner is Will Cleveland (guest star James Earl Jones), a jazz pianist who has recently become Ephram's mentor. The other is Abbott's next door neighbor (guest star Beau Bridges), whose outrageous building plans Harold has tried to thwart. The third one, Andy's patient Ellie Beels (guest star Kirsten Nelson), who has been trying to conceive a baby. All three doctors utilize their special skills under terrible conditions, but it is Andy who must confront his biggest fears in order to save lives.

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.

As Andy finally realizes that his feelings for Amanda (Anne Heche) are only growing stronger despite his best efforts to maintain a platonic friendship, Andy decides it's in both of their best interests if he refers her husband's case to Dr. Abbott from now on. Upon hearing news that Madison (Sarah Lancaster, who does not appear in the episode) and her band are performing in Everwood, Ephram seeks guidance from Bright, signalling a thaw in the boys' chilly relationship as of late with Ephram and Amy dating. Lastly, Amy's curiosity brings about Hannah's (Sarah Drew) family secret.

Jake's visiting accountant brother Brian (guest-star Tom Parker) from LA says he sees no future for Jake and Nina, prompting Jake to seek advice from Andy. Also, accepted at Princeton, Amy assumes that her father secretly sent in her application. Lastly, health issues create tension between Rose and Harold, but the tension turns to fear when Harold finds out that Rose has a 3-centimeter long tumor.

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's father, whom the Brown's haven't seen in 15 years, pays a visit to Everwood surprising Andy, Ephram and Delia. Ephram and Amy try to cheer Bright up and take him out to celebrate his 21st birthday. This ends badly when a drunk Bright falls through a window and ends up in hospital. Hannah rushes to Bright's side, leaving Nick behind on their date. Jake's big question last week, gets an answer from Nina as she has decided to move to LA. Andy is not happy about this. Edna and Irv decide to drive all over the country for their retirement.