After Anne leaves, Allie is torn, claiming to want "a happy ending without hurting anyone." Not wanting to lose her again, Noah asks Allie to stay with him. Though she wants to stay with Noah, Allie is not sure she can. Allie gives Noah the sketch she drew earlier in the morning, a sketch composed of Noah's face and the current state of his house. They embrace and kiss and admit their love for one another. Noah watches Allie drive off, believing that she is driving out of his life forever. And as she exits, he likens Allie to her mother — remarking that both women make decisions and then never look back.
The significance of this title is both metaphorical and symbolic — in their lives and in their relationship. They truly are at a vital intersection where important decisions need to be made. Noah recognizes that they are adults and can't live their lives for others; Allie is torn between the life she was making and the life she wants to have with Noah. She does love both men in her life, just differently.
Not revealing the subject of the sketch that Allie was working on for two hours in the morning until after Allie collects her belongings suggests finality in their relationship. The sketch — a current likeness of Noah and the current state of his remodeled house — captures the reunion and simultaneously serves as a goodbye gift, something by which Noah can remember her and the past 48 hours.