http://tvtropes.org/pmwiki/pmwiki.php/Recap/OneTreeHillS4E21AllOfASuddenIMissEveryone
"All of a Sudden I Miss Everyone" is the twenty-first episode and Season Finale of Season 4 of One Tree Hill. The episode premiered on June 13, 2007 and was both written and directed by Mark Schwahn.
The Tree Hill High School graduates share their bittersweet final moments together. Haley goes into labor as Karen is rushed into surgery, and Dan faces the consequences of his actions. Peyton and Lucas struggle with whats next after graduation, and Brooke and Mouth have surprising reunions with faces from their past. Lucas and Nathan reflect on the journey that took them from strangers to brothers.
- Artistic License Medicine: Whilst some surgical suites did include observation rooms, they were used for educational purposes; as such, Lucas would not be allowed to observe Karen's surgery.
- Auto Erotica:
- Peyton lies about her car breaking down in the spot where she and Lucas first spoke in order to get him alone. The scene cuts away as they have some intimate time in the back seat.
- Chase and Brooke have sex in the backseat of a car.
- Book Ends: The Pilot builds up to a one on one game of basketball between Lucas & Nathan; The characters' time in high school ends in the same way, albeit with them playing as brothers rather hated rivals.
- The Bus Came Back: Rachel has returned to Tree Hill, after leaving with Mouth on prom night.
- Breaking the Fellowship: The bulk of the episode is based around the kids attending the last party of high school, as the school year ticks over at midnight and theyre officially no longer high school students and about to go their separate ways due to college and job opportunities.
- Call-Back:
- Peytons car once again breaks down at the spot where she & Lucas first spoke; or rather, this time she claims thats the case, and just wants to get her boyfriend alone.
- Keiths spirit appears to the comatose Karen, and he offers her the choice to stay with him or go back with their daughter; Keith presented Lucas with a similar choice in "Songs to Love and Die By".
- The Cameo: Craig Sheffer returns as Keith Scott, visiting Karen as she flatlines in surgery.
- Clean, Pretty Childbirth: Haley giving birth to James. Not only is James clearly clean when he's born, but Haley's level of exhaustion looks more like she had just been for a run than give birth.
- Contrived Coincidence: Seconds after seeing Nathan & Haley off to the hospital, Lucas receives a phone call telling him that Karen is being rushed into surgery. On top of that, Karen & Haley wind up passing each other in the hallway as theyre rushed to their respective wards.
- Dead Person Conversation: Karen has one with Keith after flatlining in surgery.
- Dénouement Episode: With graduation occurring at the end of the previous episode, the only plot threads that need resolving are Dan being exposed as Keiths killer, Haley giving birth and Karens medical issues; by the end of the first act, Dans turned himself in, Haleys given birth to her son, and Karen is in recovery. The rest of episode is largely about the gangs last party as high school students and everyone saying goodbye.
- Driven to Suicide: Dan tries to hang himself with his bed sheets after Karen makes it clear that he will never be anything more to her than the monster who killed Lilys father.
- End of an Age: The gang have graduated from Tree Hill High, and are about to go off into the world. Appropriately, the party they attend is taking place on the day that the computer systems are updated and the graduating seniors are officially no longer high school students.
- Girlfriend in Canada: After Skills gives Junk and Fergie grief for remaining single throughout high school, Junk protests that his girlfriend lives in Canada.
- Helicopter Parents: Nathan and Haley, on their first night away from James. At one point they rush home from the party to check on their son because Deb stopped answering their phone calls, only to find out she unplugged the landline and turned off her cell phone because of the sheer volume of calls from her son and daughter-in-law.
- Internal Reveal: Dan walks into Tree Hills police station, and confesses to Keiths murder at the front desk.
- Meaningful Name: Nathan and Haley name their son James Lucas Scott - his first being taken from either his mothers maiden name or his maternal Grandfather's first name, whilst his second given name clearly comes from his paternal uncle and godfather.
- Spontaneous Choreography: Brooke, Bevin, Peyton, Haley, Rachel and Shelley break into a routine to "Wannabe" by the Spice Girls.
- Sure, Let's Go with That: Lucas reaction when he finds Skills singing along to the Spice Girls and he defends his singing along because the songs catchy.
- Talking to the Dead: Karen takes the newborn Lily to her fathers grave and introduces them to one another.
- Time-Shifted Actor: A 4 year old Lily appears in Karens dream as she flatlines.
- Wild Teen Party: The gang attends their final party as high school students.