8 This Is Us Finale Tissue Moments Ranked: Randall and Kevin's Big Fight -- Plus, Big Baby News!

After a wild and sometimes meandering season on "This Is Us," everything -- well almost everything_ -- came full circle in a very dense and very dramatic finale that packed so much action around hospitals and babies across the decades, we're still processing it all.

There were trips to the hospital in the past, including a very welcome return visit with Dr. K, for the Big Three's first birthday, as well as in the present, as baby Jack celebrated his own first birthday. Then, in the far-flung future, adult Jack and his lady love Lucy also made their way to the hospital for the birth of their daughter.

But that wasn't the only big baby reveal, or surprise, on the night, as we finally got some more answers in the middle future (the one where Rebecca appears to be dying) to fill in more of the gaps about Kevin's life and family.

And in the midst of all that, in one of the most complicated and layered emotional sequences we've seen yet, Randall and Kevin finally came to blows.

Oh, it wasn't the fists kind, though that might have been better in the long run. These were the kinds of blows that land with the words you can never take back and they were brutal flying both ways. And all because Randall thought Rebecca had finally decided to invest in her future only to have her echo those same words to Kevin later.

The biggest issue, other than the very problematic way Randall emotionally manipulated his mother into agreeing to that nine month clinical trial in St. Louis, is the fact that both of them opted to lie about it to the family. Rebecca was clearly protecting Randall, but he should never have gone along with it. That he did just shows he knows he crossed a line. He may have no regrets about it, but it was still wrong.

It's not necessarily wrong that he convinced her to do the trial, as he was within his right to fight for that. It's just the way he did it was low-down and dirty. And then to lie about it to his siblings' faces. It's no wonder Kevin was at his wit's end by the time their fight reached its concluding blows.

Of course, he was also reeling from a revelation that came down in the middle of the fight from an entirely different source.

On a related note, the episode tried to follow the framing of the season premiere, by introducing us to a few new faces we could follow. There was a beautiful art curator who'd hooked up with a famous movie star as well as a father-and-daughter duo trying to tame a wild horse.

The daughter's words of wisdom rang in the father's ears and from his to his patient's as she grappled with a surprise pregnancy and what to do about it. Yup, that third pregnancy. We weren't sure how the man and his daughter were going to fit the overall narrative, but in a way they're acting as the modern-day equivalent of Dr. K, with sage advice just when its needed.

"You haven't even given him a chance to be himself yet." Those words spoke to the wild horse that just wanted to run free, but also to the father, who doesn't even know he's going to be one yet.

As we do every week, we're going to single out the show's most powerful moments, scoring them by how many tissues we tore through just to watch them. Believe us, these are happy tears of anguish.

Oh Nicky, how we missed you. We got a couple of fun scenes with Uncle Nicky, as well as a reprise of his appearance in the future at Rebecca's bedside. And it's great to see that he seems to still be doing well, attending meetings, razzing Kevin for his cologne ad (and rightfully so) and maintaining human connections. It was also nice to see Cassidy again, albeit briefly, as she arrived to go with Nicky to that meeting. These two represent Kevin's continued growth as a human being; he was a positive and lasting influence in both of their lives.

1 tissue (for personal, long-lasting growth)

This is going to have to be unpacked in the next season, but Beth has made it very clear that she does not approve of how her husband manipulated Rebecca into agreeing to do the trial. But she also chose to not have his back, or deal with the fallout, when Kevin figured it out. She has not outright come to shouting with him over it, and even said he usually knows what he's doing, but she's still allowed her take on it. And her decision to clear the house out so Kevin and Randall could hash this out was indicative that she felt he'd made this bed and he needed to lie in it himself.

1 tissue (we are Team Beth forever)

A genuinely heartbreaking moment, and yet one that rang very true, as Rebecca opted to lie to her children and perhaps even her whole family about why she suddenly reversed course and decided to do the trial instead. Even though she clearly doesn't seem thrilled about bowing to Randall's manipulation, she still opted to protect him from the potential wrath of his siblings, and especially Kevin. But this lie hangs heavy, as both Beth and Randall know she's doing it. We don't yet know what Rebecca told Miguel about her decision, but this is a moment that felt like a mother protecting her children, even from one another and even as it pains her.

1 tissue (a mother's love is multi-faceted and endless)

A powerful mini-flashback served an important role of reminding us just how invested and committed Toby is in Kate and Jack's story. It was key because the couple's storyline this week needed us fully back on the side of them being madly in love, on the same page and Toby being the super-dad and super-husband he's been pretty much since he appeared. He may have faltered this season a bit struggling with Jack's blindness, but he was there from the moment of birth in full support mode for both his bride and his baby. Toby's allowed to be human, just as Kate's father Jack has been revealed to be less than perfect, and it doesn't make him less wonderful overall.

2 tissues (unconditional love even at the most challenging moments)

Struggling with the one-year anniversary of the loss of their third triplet, young Jack and Rebecca went back to see Dr. K for some more advice. And while he'd already used his great lemons speech, he did a pretty good job of reminding the young couple that you can't try and keep joy and tragedy separate, because life is full of ups and downs and all of it matters. He shared how he sang "Blue Skies" to the baby he and his wife lost and then again to the daughter they kept and even at her wedding. It was the right message at the right time to help them process their loss and embrace every experience.

2 tissues (Dr. K is the best)

Madison has slowly become one of our favorite characters, expanding from comic relief into a genuine and well-rounded person. Finding out she was pregnant with Kevin's kids -- yes, kids as in twins -- was the week's biggest shocker, and yet we're okay with it. When she talked to that doctor (with the horse) about how she had yet to tell him about it, her reason was that she believes Kevin deserves the type of "great love stories" that define his family. We even got glimpses of both Sophie and Cassidy in this hour to show the kinds of women he's shared real connections with.

Kevin and Madison barely know one another, having shared one night together. But Madison's prior health issues with bulimia make her even having a baby somewhat miraculous, so she was determined to have the baby. And she put absolutely no pressure on Kevin to be involved in any way. But, of course, he was having none of that telling her, "I'm all in."

Now, there's a lot -- a lot -- to unpack with Kevin right now considering this is the even that happened in the very middle of his blowout fight with Randall, but we also know that he means it. It's also telling that he told her that maybe the love of his life would be his child, indicating that this more evolved version of Kevin isn't going to try and shoehorn Madison into this romanticized role of his dream wife. They barely know one another. When he says he's in, he means as a father. The timing is terrible, but he's wanted children for a while now, and maybe he's reconciled the fact he can do it without being married.

And yet, we know he's not single in the future. Could Madison become the woman of his dreams? Honestly, we kind of hope that's what happens. Sophie and Cassidy both have lives and husbands -- even if Sophie doesn't seem particularly happy -- and Madison is good people. The two will likely grow closer throughout the pregnancy, so an organic love story could happen as they get to know one another. Or it will be his "great love story" and turn out to be Sophie, after all. We'll just have to wait and see.

3 tissues (for the maturity showed by both)

Like we said before, reconnecting us with Toby as a great husband and father was key to setting up his revelation that he so loves the dynamic of the Big Three that he wants to have another child for Jack to grow up with. And this was where the other mysterious new figure came in, as art curator Hailey who slept with a movie star has no connection to Kevin at all, but rather is Jack's adopted sister.

What a beautiful way to reveal that the adoption is going to happen, that Kate and Toby are making their dreams come true, building their family and persevering through any and all adversity. Randall and Rebecca are very much relationship goals in many ways, but Randall is too controlling and manipulative right now for us to fully be on his team. Kate and Toby have been open, honest and vulnerable with one another in a way that Randall refuses to do still, so they're our new couple goals on this show for now.

3 tissues (we are in love with their love)

Siblings fight and sometimes it can get ugly, but we never expected the depths to which both Kevin and Randall would go in this fight. Despite Kevin being there for Randall during panic attacks over the years, he was mostly pretty awful to his brother. And Randall's resentment that Kevin left the family to pursue his Hollywood dreams has apparently never gone away. Not to mention his resentment that Kevin was hanging out with Sophie the night Jack died.

Apparently Kevin believes he would have run in to save Jack had he been there. But he wasn't. And that's where resentment resides for both men, in how they each perceived that the other failed Jack on the night he died. Honestly, this is something so far beyond either of their responsibilities as children and yet they're taking out this perceived responsibility on one another.

Randall's low blow was telling Kevin that Jack died ashamed of him, while Kevin countered that the worst day of his life was when their parents brought Randall home. Both cut to the core of some of the other's internal issues of self-worth. It was ugly on both of their parts.

Can we also add, as an aside, that this scene was just beautifully shot and directed, with one continuous shot following Kevin as he reeled from one blow to the next, and even lingering on his face in a moment we really thought would go to commercial but didn't. Instead, they let us sit in Kevin's silent discomfort with him until those final verbal blows. It was truly masterful.

Randall appears to be struggling to justify his actions in manipulating Rebecca, but rather than own that it was a dirty tactic but he's not ashamed of it, it would appear he is ashamed of it. But rather than process that internally, he's lashing out at Kevin, for whom he has so much resentment throughout his life.

Kevin, on the other hand, is reeling not only from what Madison just dropped on his lap, but also with never being taken seriously in the family, even as he's been cleaning up his act and actually offering sound suggestions and really being there and listening to Rebecca. Randall doesn't see Kevin's growth because he's too wrapped up in his fear of losing his mother and has too much built-up bitterness toward his brother.

And Kevin can't see Randall's fear and pain about Rebecca because he's so wrapped up in feeling like he's finally someone to be taken seriously and yet Randall -- who he's looked up to as someone who got it together and got the perfect family -- refuses to truly see him as he is now. The past is haunting both men and they don't know how to deal with it so they attack.

There's a long journey ahead for them, and while they appear at least cordial in the Rebecca's bedside future, we don't know if they are friendly again or if they've allowed this bitterness to drive a wedge between them that tears this family apart for years. But those answers won't be coming anytime soon as that's all she wrote for this season.

Thankfully, "This Is Us" will be back in the fall to make us try even more tears. Hopefully, we'll be able to stock up on tissues before then.

Got a story or a tip for us? Email TooFab editors at tips@toofab.com.