For a split second, Treat's happy, like he can see the future laid out all perfectly before him. Of course, when Ephram reminds him, "I've got to go meet Madison," he realizes Fate may not have much more family harmony in store for him after all, and says, "I know."
Irv voices over the last lines of his newly written book, saying he thinks of the doctor in the mountain town, helping so many others despite his grief, looking ahead to new memories and new mistakes. "I think of him, and remember there's always a reason to try again. I think of him, and I can hope to hope."
And on that note, we fade out to hiatus on Treat, looking not so very hopeful at all.