Tippy's wedding is drawing near and everything is ready, except for the wedding ring. Everyone looks everywhere for it, and it is finally found to be in a dog's stomach. They decide to keep it a secret from Tippy and her fiancee, Captain Doss, but it appears that the wedding will have to be called off because of Captain Doss' deployment to Germany.
When one of Clint's patients wakes up, he is upset to learn that his daughter doesn't know if she should hug him. Meanwhile, one of Dr. Crane's old girlfriends wants to work at the clinic in order to get some grants approved.
Dr. Derek gets devastating news that he has Glaucoma and may lose his eyesight. Meanwhile, Dr. Crane has a hard time thinking up sayings to put on the board in the waiting room, and he wonders how Tippy does it.
Marcia, with the help of Clint and Westbury, tries to teach African doctors how to properly operate on African children over the Internet. Meanwhile, Dr. Crane is starring in a play while Tippy is the understudy for the leading lady. But when the leading lady gets sick, and Tippy must fill in, things start to get a little complicated.
Clint helps an old security guard for the clinic get his job back after he was fired for allegedly letting press in to take pictures of a famous person found dead in the operating room. But Clint's task becomes a little easier when they discover that the picture the press supposedly took is fake.
When Nate and Major Doss start a family history business, everyone gets to learn a little something about where they came from.
When Nancy feels like her life is stuck in a rut, she rides with Clint on a trip with the New York Emergency Medical Services Team.
Panic ensues at the clinic when a plane that Nancy was supposed to be on going to New Zealand with friends crashes and everyone is killed, but they are relieved to find that Nancy missed the flight. Meanwhile, Raul has a difficult time writing a paper for school about whether or not under God should be in the pledge.
Things are changing for everyone in this series finale episode. Nancy is moving to a third-world country to help out with the crises there, but Clint struggles with the decision to ask Nancy to marry him or move back to Montana to help out his friends with a new clinic. Raul gets heart-breaking news that he has diabetes, and Tippy is overjoyed to find out that she is pregnant and promises to name the baby Clint if it's a boy, and Nancy if it's a girl.