Of all the reasons I can only hate watch this so (and it's not for lacking of trying to like it. Hell, given the cast and Kamins as the show runner, I should LOVE it), this episode illustrated the main one: despite its blatant emotional manipulation, Parenthood has never -- ever -- made me cry.
I may be in the minority here (or maybe not), but sad scenes like Kristina at her dying friend's bedside, or Amber and Ryan, never develop organically; rather, they're announced in all CAPS, italicized, bolded and in quotes, like "laugh" and "applause" signs for live television audiences.
Part of it is likely the large cast; with so many characters, there's not enough time to let the emotions unfold. I've always suspected that the other side of this is the suits at NBC, because given the shows Jason Katmins has done in the past -- Friday Night Lights -- hard to believe he's forgotten how to write with subtlety and nuance.