Dr. Brown and Dr. Abbott must put their striking differences aside to educate the town of Everwood after several of their teenaged patients are diagnosed with a sexually transmitted disease. To make sensitive matters worse, Dr. Abbott has reason to suspect that his son, Bright, may have been intimate with one of the patients. Meanwhile, Ephram pushes his romantic feelings aside to comfort Amy who is distraught over not being able to go to the Fall Dance with her boyfriend who remains in a coma.

After a lost deer makes the Brown's backyard its new home, Andy insists on accompanying Ephram who decides to help the animal find its way home to the wilderness, where the journey includes a long hike through the mountains. Meanwhile, Ephram finally admits to Amy that he never asked his father to consider operating on her boyfriend, Colin, who is in a coma. Lastly, Delia questions the existence of God after a classmate tells hear that he doesn't believe in higher beings.

Andy meets with Colin's parents to discuss a potential course of treatment for the comatose teen. Amy is heartbroken and Ephram is furious when Andy decides against performing a risky operation on Amy's comatose boyfriend. Meanwhile, Delia is forbidden from playing with her only friend, Magilla (guest star Bret Loehr), after his parents discover them playing dress up. Dr. Trott, a traveling psychologist (guest star Jane Krakowski) sets up shop and stirs up the emotions of several townspeople who seek her guidance, much to the chagrin of a distrustful Dr. Abbott.

As his wedding anniversary draws near, Andy loses all hope and questions whether he will ever feel his life is worth living again. Meanwhile, Ephram and Amy share their first kiss while on a field trip; and Dr. Abbott has a panic attack when his wife Rose(Merrilyn Gann) proposes they take salsa dancing lessons. Andy also helps a couple whose marriage problems are caused by hives.

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.

Dr. Brown courts Linda Abbott despite Edna's and Harold's insistence that he's wasting his time, but Andy persists, forcing Linda to tell him that she is H.I.V. positive. Bright tells Ephram he can win Madison's affections by ignoring her, but the plan goes awry when she breaks up with her boyfriend. Amy meets a flirtatious and attractive town bad-boy, Tommy Callahan (guest star Paul Wasilewski), whose compassion for her problems touches her heart for the first time since Colin's death.

Amy confides to Bright that she may have developed feelings for Ephram and sees him in a new light, but Bright begs her to have mercy on poor Ephram, who is still nursing a broken heart from his recent break-up with Madison. Meanwhile, Linda reveals her HIV status to Delia after the girl confronts her about all the pills she's been taking. While Delia takes the news better than expected, the rest of the town goes ballistic after Linda's secret unintentionally becomes public knowledge. Dr. Abbott faces a potential malpractice suit, and Andy is forced to come clean with Ephram, who doesn't take the news very well.

Ephram and Amy decide to go to prom together as friends, but Amy can't get up the nerve to tell Ephram that she has feelings for him after they run into his ex-girlfriend Madison and Amy realizes that he's still nursing a broken heart. Meanwhile, Linda decides it may be time to leave Everwood behind, and Andy's mentor, Dr. Donald Douglas (guest star Philip Baker Hall), asks him to perform risky brain surgery on a patient who turns out to be Dr. Douglas himself.

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.

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.

Ephram regrets promising Nina that he would watch over Hannah at school, especially when her constant presence interferes with his time alone with Amy. Amy befriends Hannah out of a sense of charity, but soon finds Hannah so refreshing that a real friendship develops. Meanwhile, Andy tries to ignore the tension between Dr. Abbott and Edna, but his attitude forces Edna to quit and go to work for Dr. Hartman. Andy treats a 13-year-old patient (guest-star Carter Jenkins) whose mysterious injuries cause Andy to suspect the boy's mother (guest-star Elizabeth Mitchell) of abuse.

Andy finds himself at a loss over what to do when Delia naively stumbles upon Nina's vibrator and starts asking questions. Meanwhile, Ephram attempts to write Amy a love letter to show her the extent of his feelings. Amy makes it her mission to make new best friend Hannah (Sarah Drew) popular. Meanwhile, Harold and Rose question Bright's euphoria over being selected "employee of the month" and decide it's time for some parental intervention.

Dr. Abbott becomes worried that his son Bright is settling too little in life when taking a job at a restaurant. Lastly, Andy treats a patient who needs a transplant, but won't tell his wife.

Andy puts his foot in his mouth by picking a fight with Everwood's patron saint, Amanda Hayes (Anne Heche), who, unbeknownst to Andy, has been caring for her profoundly disabled husband (guest-star Jason Beghe) for the past five years. Meanwhile, Jake surprises Nina by asking her out on a date; Ephram and Bright realize their friendship may have grown too far apart to salvage; and neurotic-as-ever Dr. Abbott struggles to come up with a medical invention after learning that Dr. Brown and Dr. Hartman have successful inventions of their own.

Ephram seeks guidance from his and piano mentor, Will Cleveland (guest-star James Earl Jones) when he's struggling to select the music program for his Julliard audition tape. Things don't go well for Ephram as he faces losing one of the most important relationships in his life after he accidentally hurts Will's feelings. Meanwhile, Bright takes a job working at the restaurant, "The Firehouse" where he meets waitress Serena. Things go bad though when they get caught by their boss in the most compromising position in the closet.

Lastly, Andy and Amanda experience a miraculous breakthrough in their music therapy with Amanda's husband (guest-star Jason Beghe), but Andy quickly questions the results.

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.

Nina finds Andy and Amanda (Anne Heche) together causing her to question Andy and her friendship with him. Meanwhile, Ephram and Amy convince a reluctant Hannah to ditch school for the day and take Bright along for the ride as the recover from sending out college applications. Lastly, Harold and Edna are forced to work together despite their hostility toward each other when a medical emergency comes up at his office with the water pipes bursting.

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.

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.

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.

Ephram is back in town and is giving piano lessons at ECC now. Ephram begins his piano tutor session with a 13 year-old Kyle Hunter who has a major attitude. He doesn't want to play the "classical crap" though. He wants to go to Julliard, which Ephram finds funny but isn't as amused when he insults him a lot on his Julliard past. Nevertheless, once Kyle starts playing he is extremely good and Ephram is intrigued.

Hannah's mother (guest star Jayne Brook, "Chicago Hope") pays an unexpected visit to Everwood to tell Hannah that her father has passed away. Elsewhere in Everwood, Ephram stifles his feelings for Amy while forced to watch her relationship with Reid (guest star Justin Baldoni) grow more serious; Andy advises a patient (guest star Keith David, "Crash") who desperately needs a kidney transplant, but refuses to accept one from his daughter (guest star Gina Ravera). Lastly, Bright is at a loss at how best to help Hannah through this difficult time.

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.

Andy consults Josh Stein, who's studying to become a rabbi. Josh also helps Delia with her Bat Mitzvah. Ephram supports Kyle, as his father comes to town. Amy's professor talks to Harold about a medical procedure. Andy is trying to go on a date with someone he met over the internet, but he has to postpone multiple times.

Andy and Jake are having a little get-together before work when a car crashes into a lamppost in front of them. Both doctors immediately detect the person in the car had been drinking. Harold meets a member of Rose's cancer support group. Jake checks up on the drunk guy in the hospital and ends up having a good talk with him. Reid has a discussion with his academic counsellor. Amy takes Hannah out to a restaurant where she meets with her college friends.

Ephram discovers that Bright cheated on Hannah and confronts him about it. Irv takes Edna along on his book tour, where they meet his daughter Cassie. Reid is faced with expulsion from medical school for cheating on an exam. Harold confesses to Andy that he neglected to report Rose's cancer on the adoption application. Ephram tells Amy what happened with Bright, prompting her to confront him and force him to admit the truth to Hannah.

Just out of the hospital and wanting to start his life over, Reid asks Amy out on a date. Amy talks a very reluctant Hannah into a double date with Amy's friend Nick, leaving Bright to deal with his pain and jealousy. Delia panics when her Bat Mitzvah falls on the same day as the birthday party of the most popular girl at school. Nina tries to deal with her confusing emotions over Andy and realizes she will have to make a decision when Jake asks her to move to Los Angeles with him. Harold points out to Rose that they were so caught up in the adoption procedure they've been taking each other for granted.

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.

While packing up her house and preparing to leave Everwood with Jake, Nina tells Hannah that she knows Andy bought an engagement ring for her. Hannah convinces Nina to sneak into the house while the Browns are out to get a look at the ring. Later, Jake finds out about the ring and confronts Andy once again about his feelings for Nina. At Delia’s Bat Mitzvah, Amy watches Ephram with his new girlfriend Stephanie, and realizes her feelings for Ephram are still strong. When one of Harold’s patients leaves her baby on the Abbott’s doorstep, Harold wrestles with the right course of action while Rose immediately becomes attached to the little girl.