Strenuous events impact all the Camdens as Kevin and Lucy cope with an unexpected tragedy in their young lives. Matters worsen when Lucy convinces her father to let her deliver next Sunday's sermon while she is still in an emotionally unstable condition. Martin frustrates Sandy by suggesting that they get married and build a family for their infant son, then becomes angry when he realizes why Sandy is really holding back. Ruthie is studying in Scotland for the time being, and Annie can't shake the feeling that something is terribly wrong with Eric.

Tension mounts in Kevin and Lucy's marriage as they continue to grieve over losing their babies. A hurt Lucy even blames Kevin in public in front of everyone at the church for miscarrying their boys. Lucy begins to disconnect more from the family as she's spending more time at the movies everyday alone at the promenade. Although, Lucy finds some solace with theater usher, T-Bone, who she feels able to talk to about her feelings. Meanwhile, Annie consoles a distraught Kevin and tells him to talk to Lucy. When Kevin finds out what's been going on between Lucy and T-Bone he is less than thrilled. Meanwhile, Sam and David's second grade teacher, Ms. Margo flirts with Eric when dropping the boys off to school, which makes Eric very uncomfortable. Eric also finds out that Sam and David have been referring him as their "Grandpa" instead of their father to their teacher.

Mary has recently given birth to twin daughters, so Annie heads off to Buffalo to help her out. Eric is left to take care of things at home. A difficult issue with the boys' teacher prompts him to pull them out of school without consulting Annie, and an excruciating physical pain in his neck isn't helping matters. Kevin's brother arrives for a visit, but there's only one way they can convince a emotionally unstable Lucy to let him stay with them for a little while.

Eric continues to manage the household in Annie's absence. He begins home-schooling the twins and finds even more stress added to his life when their third grade teacher shows up at the house, eager to start a relationship with him. Meanwhile, Kevin and Lucy start noticing Eric's strange behavior, but their attempts to uncover the truth only make matters worse.

Eric makes yet another decision without consulting his wife, who finally comes home to some drastic changes in the house. Elsewhere, Sandy finds herself in a romantic triangle with Martin and a guy from school.

When the paramedics are called to the house, Annie realizes that Eric has been hiding his health issues from her, even though he insists he's fine. Meanwhile, Lucy contemplates having more children after visiting with Sandy, who has problems of her own when she must choose between the two guys in her life.

Ruthie is nervous when she finds out that Eric and Annie are heading to Scotland. She reveals a very unattractive side of herself when she openly admits that she's not about to sacrifice her own freedom and happiness to come home and be with her sick father. Kevin has a difficult time helping Lucy come to grips with Eric's illness; Sandy accepts Martin's marriage proposal just to get rid of her clingy boyfriend; and Kevin finds out a secret about Jane.

Ruthie is informed of her father's health prognosis when her parents show up in Scotland, but she shocks them by reacting with very little sympathy or understanding. Sandy calls off her marriage plans with Martin after his best friend questions why they are in such a rush. Back at home, Lucy steps up as a much-needed source of stability for her younger siblings, as well as T-Bone, who needs help making a dramatic decision.

Eric, Annie and Ruthie are on their way home from Scotland, but they are held for questioning at the airport after Ruthie makes an unusual comment. Elsewhere, as a favor to Martin, Mac seeks information about Sandy's feelings for Simon. Lucy does her best to stay strong for the whole family as the truth about her father's health condition comes out.

Eric takes a new approach to counseling members of the church. T-Bone stuns Ruthie by telling her what he really thinks of her selfish and obnoxious attitude, then ending their argument with a kiss.

Eric suddenly finds himself in heaven, quite literally, when he runs into several people who have gone before him, particularly Annie's late mother. Meanwhile, the family becomes nervous when Eric doesn't come home from work, and Annie tries to hold everyone together. Could he soon be headed to the pearly gates himself?

When Ruthie and T-Bone work on a school assignment about the genocide in Darfur, they get the whole Camden family, and the community involved in the cause.

Eric and Lucy tell everyone that they're going out of town on "offical church business," which isn't exactly true, while Annie and Kevin seek the truth about their spouses' little white lies. Meanwhile, Sandy takes over Lucy's teen class for the day, and Ruthie will do anything to prove that she is not a little girl anymore.

Ruthie insists that T-Bone get his driver's license so they can go away for privacy; unfortunately, T-Bone makes the mistake of asking Kevin to help him get ready for the test. Lou informs a stunned Eric that the church deacons feel he and Lucy are no longer appealing to the younger church members, so it is suggested that Sandy deliver the next sermon. Mac gets a job at the movie theater so he can afford an apartment with Jane and Margaret.

Sandy starts falling for a handsome doctor, and Martin may not be able to handle it. Elsewhere, T-Bone and Ruthie want to do something romantic for Valentine's Day, and they profess their love for each other in an unusual way. The Colonel and Ruth drop by unexpectedly, prompting Lucy and Kevin to leave town, and Eric fears that his parents know about his health problems.

Ruthie tries to hide her tattoo from her parents, not realizing that they already know something's up with her. Lucy knows about the tattoo, but she has a very specific reason for keeping it to herself. As it turns out, most of the Camdens have dirty little secrets that they'd rather not reveal...

When small things happen, some Camdens see them as signs. Lucy and Eric both cross paths with a black bird. They both come to the conclusion that this is a sign, and a bad one at that. Meanwhile, Ruthie gets a sign on her own. When she loses a diamond in the ring that T-Bone gave her as a promise to get engaged someday, she thinks that this is her sign that maybe being with T-Bone is not the best choice.

When Lucy gets an unexpected job offer in a small town known as Crossroads, she and Kevin take a trip out there to see if they might consider making the move. Back in Glenoak, Ruthie learns that removing her tattoo will not be an inexpensive procedure, and after getting no sympathy from her parents, she tries guilting T-Bone into paying the bill.

Ruthie gets a text message from what she thinks is T-Bone breaking up with her. But the truth behind the matter is a bit different. Meanwhile, Lucy and Kevin try to decide whether or not they will relocate to Crossroads.

With plans for another child, Lucy tells Kevin that it might not be a good idea to move so far away from the rest of the family. T-Bone confides to Eric that he's having second thoughts about breaking up with Ruthie, who is spending all of her free time lately with her former crush, Martin. Sandy's boyfriend surprises her with a marriage proposal, and T-Bone's estranged father shows up on the Camdens' doorstep.

Annie rushes her husband to the hospital when he wakes up with a certain hunch about his heart condition. The kids are a bundle of nerves--especially Lucy--since they don't know whether the news is good or bad. While sitting around in the waiting room, Ruthie and T-Bone decide to get back together, but an unexpected twist of events brings back unresolved issues with the guy who broke Ruthie's heart a year ago.

After 11 heavenly seasons in Glenoak, the longest-running family drama in television history bids us farewell as Eric and Annie decide to celebrate Eric's clean bill of health in a spontaneous way. Meanwhile, Kevin and Lucy make some final decisions about their future; Ruthie addresses Martin's proposition to her in the previous episode; and as the lives of the Camden family members start changing dramatically, their most recent live-in houseguests must determine where their own lives are headed.