John Dorian, "J.D." to friends, is a boyishly handsome, self-deprecatingly funny, likeable guy who would be confident if he only realized his assets. Four years of medical school have prepared J.D. for his first day as an intern at Sacred Heart Hospital - but he has his doubts. As J.D. is thrown into the chaotic world of hospital life, we not only get to see the quirky characters that he encounters, but also hear the humorous commentary of thoughts streaming through J.D.'s head. By J.D.'s side is his best friend since college, the handsome and confident Chris Turk. As a new surgical intern, Turk struts around with a gregarious and cocky demeanor that hides a terror that he only admits to J.D. Both guys initially have the hots for their attractive fellow intern, Elliot Reid, but J.D. quickly finds out her beauty is only surpassed by her hyper-competitive attitude. Guiding the interns' education are those with more medical experience. Dr. Robert "Bob" Kelso, Chief of Medicine, wants the interns to think they can count on him. On the other side of the personality spectrum is Dr. Percival "Perry" Cox, a steamroller of a man short on patience. Watching over the interns with a caustically teasing but caring demeanor, is nurse Carla Espinosa, a woman who is motherly and sexy at the same time - which appeals mightily to Turk.
J.D. begins to feel distant from Turk, when he leaves him abandoned every time that he tries to talk to him. Elliot fights with Kelso for calling her "sweetheart," and she seeks Dr. Cox's advice. J.D.'s relationship with Elliot goes in a time race, when he has 48 hours to kiss her before he is put into her "Friend Zone."
The three interns are each assigned patients with various illnesses. Statistically speaking, one of the three is going to die. J.D.'s patient is 86 year old Mrs. Tanner, who is in renal failure. 20 year old David Morrison is Turk's hernia patient and Elliot's patient Mrs. Guerrero only speaks Spanish and might have lupus.
J.D. points out what seems to be a technical mistake to Dr. Kelso, but it was really an attempt of Dr. Cox to save a woman without insurance using a dead guy's insurance. Dr. Kelso and Dr. Cox show J.D. their different ways of looking at medicine. Meanwhile, the Janitor intimidates J.D., Elliot discovers the healing powers of her boobs and Turk gives Carla a pen he thought he took from the Lost and Found box.
Dr. Cox is still facing the threat of suspension, and coincidentally, J.D. is assigned to a special patient: Jordan Sullivan, an important board member. She is very demanding and J.D. ends up sleeping with her after he confronts her. Only he didn't know that she is Dr. Cox's ex-wife, and now the only one who can save J.D.'s mentor from being fired by the evil Dr. Kelso. Meanwhile, Elliot is assigned to take care of a shrink whose jaw has been wired shut, and for whom she ends up becoming a patient. Carla's mom makes a scandal after Turk spends the night at Carla's, and when she breaks her leg, Carla blames Turk for it.
J.D. has finally earned the spot as brightest student, but he's got competition: Nick Murdoch, who seems to be nicer, friendlier and has a better butt than him. But even J.D. can't hate the guy, for he is so nice. But he is surprised when he finds Nick sitting in a corner crying because he can't take the pressure of medical internship. Meanwhile, Turk is having problems at the operation table and doesn't tell Carla, who keeps bothering Dr. Cox about it. And Dr. Cox gives Turk a very unique suggestion on how to calm down before surgery.
J.D. and Turk become heroes after saving a cameraman's life on TV, while heading to a strip club. But Turk quickly becomes the target of a new publicity campaign led by Dr. Kelso, exploiting the hospital's diversity. Meanwhile, J.D. worries about his evaluation. Elliot is going out with Carla, but in the last minute she blows her off and later Elliot runs into her in a bar.
J.D. gets to see the hospital through the eyes of a patient when he's admitted for appendicitis. Elliot examines him and he tells everyone how cold and rough she is, which drives her crazy. J.D. doesn't want Turk to operate on him, which hurts Turk's feelings. Meanwhile, Dr. Cox is trying to show off to his mentor, Dr. Benson, the ex-chief of medicine, who is also a patient at the hospital. The only thing in his way is Dr. Kelso, who almost dismissed Dr. Benson prematurely.
J.D. begins a new relationship with Carla. J.D. gains a new nickname - "Scooter" - and his relationship with Nurse Carla evolves as he begins to out-distance her medical knowledge, while Turk trembles, when he learns that his secret lunch spot was claimed years ago by the territorial Dr. Kelso. Elsewhere, Dr. Cox gives Elliot the evil eye when she won't discharge a troublesome patient.
A woman slips and falls on the wet floor of the hospital. Afraid that she might sue the hospital, Dr. Kelso asks J.D. to stand by her and be friendly, so she won't sue them. But J.D. is very busy with Dr. Cox's 24-hour marathon to keep his ICU patients alive. Elliot is desperate for some attention from Dr. Cox. Meanwhile, Turk snaps at Carla when she steals fries from his plate.
J.D. is frustrated when his budding romance with an ex-patient wilts as their dates are constantly interrupted by emergency calls, while the beastly Dr. Kelso becomes less fearsome to the wide-eyed interns, when Dr. Cox informs them how to avoid the blowhard's bite. In addition, a perplexed Carla and Turk deal with their first sexual intimacy complication.
When a rampaging Dr. Cox suddenly shows up at his door in a strange funk, J.D. sees a possibility of a breakthrough in their relationship - until he learns that Cox loses control in almost an annual rite. Meanwhile, Turk elects to partner with Elliot on a research project so that he can maneuver her back with his buddy J.D., and Carla struggles to fulfill a comatose patient's final request - playing heavy metal music in his room.
J.D., Elliot and Turk are receiving their first medical students, and now they finally get a chance to see what it feels like to be on the other side. Turk's student is a very attractive young woman, to whom Dr. Cox is immediately attracted. But he doesn't know his way around women and needs Turk to give him a little help. J.D. doesn't know how to handle his student and Elliot's turns out to the be son of an important CEO.
J.D. has a patient who's rude to him and the nurses and eventually dies from cancer. J.D. feels awful for not giving him his full attention and worries maybe he could have saved the guy if he was nicer to him. Meanwhile, Elliot is convinced that Dr. Kelso is the one singing a song called "Tuscaloosa Heart" on a tape given to her by a patient who claims he went to college with Bob. And Dr. Cox finds himself trapped in a love square: He's falling in love with Kristen Murphy, his intern, just as his ex-wife reappears demanding sex – and there's also his crush on Carla.
An assortment of moms and dads descend on their offspring at home and in the workplace. J.D.'s father is a gregarious yet lonely divorcee who's desperately trying to be just one of the guys. Elliot's folks, on the other hand, are a snooty couple whose pompous behavior dismays their daughter. Similarly rattled is Turk, unnerved by the bonding of his girlfriend, Carla, and his brassy mother. But the most vexatious parent by far is the janitor's dad.
Turk's competitiveness is starting to annoy J.D., especially when it crosses the line of personal jokes and comes to patient's matters. Meanwhile, Dr. Cox finally has a taste of good coffee, but thanks to his feud with Dr. Kelso, the only nurse who was able to make it gets fired. Elliot meets a very attractive patient, whom she instantly identifies, but has a really hard time getting him to ask her out.
Ben takes the news of his diagnosis pretty well - at least better than his sister Jordan and J.D. Remarkably, it is Dr. Cox who is the voice of reason and compassion, until his own fears get in the way. Meanwhile, Turk and Elliot have their own issues to deal with. Turk is upset because he wasn't chosen to assist on a difficult surgery and Elliot is criticized during rounds by Dr. Kelso for the 100th time.
It's J.D.'s last day as an intern, and soon he will become a resident. Carla and Turk are arguing about dating other people. Elliot finally rebels against being everyone's doormat, and J.D. is just trying to stay out of people's way. Jordan has returned to get a physical and a new patient, Mr. Bober, has been admitted, because he needs his gall bladder removed. He really needs the surgery, but doesn't have the insurance to pay for it. They enlist the help of Dr. Cox, Dr. Wen and Jordan.
Relationships between the staff of Sacred Heart Hospital have been shaken since Jordan's revelations. Turk is sleeping on J.D.'s bed, after Carla kicked him out of his own. Elliot is having a hard time facing J.D. every day at work. J.D. desperately tries to get Dr. Cox's attention back, unsuccessfully.
J.D., Elliot and Turk find themselves alone in the hospital night shift and face responsibilities without supervision for the first time. Luckily, they have Carla there to support and guide them through the night. Meanwhile, Dr. Cox doesn't know what to do, when he realizes that he has feelings for his ex-wife Jordan and is asked (forced actually) to introduce Dr. Kelso at a social event, where he will be receiving an award from the medical board.
When Dr. Kelso challenges the residents by offering a trip to a medical conference in Reno as a reward to the individual, who presents the most interesting case study, J.D. refuses to play along, earning him the respect of Dr. Cox. In the meantime, Turk misses his opportunity to ask for a new laser on the one day of the year, that Dr. Kelso grants favors, so he is forced to find another way to come up with the goods.
Elliot sleeps with a handsome doctor she hardly knew and soon becomes the hospital tramp. Turk suffers from his back after operating with Dr. Amato, a very short surgeon. J.D. finds out that wearing a white coat doesn't make him a better doctor, but is upset by having Dr. Cox throw in his face that he made another mistake. And Dr. Kelso is just dying for an opportunity to lash out his anger on Dr. Cox.
All of the male doctors are euphoric due to the visit of Julie Keaton, the pharmaceutical sales rep, except for Dr. Cox, who still believes in treating patients for their best health, instead of trying to get some attention from the hot Ms. Keaton. Meanwhile, J.D. and Elliot argue over a risky decision regarding one of Elliot's patients. Turk tries to talk Carla into entering a practitioner nurse course, so she won't be so underestimated by the doctor's staff.
When an expectant Jordan shows up unexpectedly, Cox is forced to choose between her and his new love, Julie. Meanwhile, J.D. and Turk take advantage of the hospital's supply closet for sleep, when they take on extra shifts at a free clinic to supplement their income. Carla encourages Elliot to stand up to her father, when he pressures her to pick a specialty more "suitable for a woman."
Ever since her father cut her off financially, Elliot's been feeling the weight of the world on her back. While having to find a new affordable place to live, she also has to face the threat of being sued by a patient whom she told he had only eight months to live. Carla and Jordan hit a sore spot when Carla gives her opinion on Jordan and Perry's relationship. Meanwhile, J.D. has a fight with Dr. Cox and the two dispute over who gets to give the better treatment to two patients with the same prognosis.
Elliot still doesn't have a place to live. J.D. think he's lost his mojo when he can't even kiss the giftshop girl while they go out on a date. Turk and Carla are having romance problems, because she feels he's not being as generous to her as she is to him. And Dr. Cox freaks out when he lets Jordan move in to his place due to her pregnancy.
Turk is still waiting for Carla to answer his proposal and asks his brother to stay over a few days to help him deal with it. Dr. Townshend, an old friend of Dr. Kelso and one of the nicest doctors around befriends J.D. Elliot accidentally finds out the sex of Jordan's baby, becoming the object of Dr. Cox's anxiety.
Elliot meets a nice guy at the bar, but freaks out when she finds out he's a male nurse at Sacred Heart. Turk keeps asking Carla to marry him, but she still won't give an answer. Dr. Cox feels the pressure he puts on himself everyday: His psychiatrist, his subordination to Dr. Kelso and his paternal feelings for J.D.
J.D. and Turk think they've got bad karma after hitting a car and causing an accident, while playing golf on the hospital roof. Dr. Cox bends over backwards to give Jordan as much comfort as possible on her labor day, and she confesses to J.D. that Dr. Cox is the real father. Elliot seeks advice from Carla on how to tell Paul that she's crazy, because they're getting more intimate and she can't hide it anymore. But Carla is feeling too crazy herself with the upcoming wedding.
J.D. flirts with the wife of a patient who's been in a coma for the past two years, whom they all call T.C.W. (Tasty Coma Wife). He feels guilty for doing that, even though she wants to go ahead with it. Meanwhile, he can't stand listening to any more relationship problems, as everybody dumps their issues on his ears: Elliot, sabotaging her relationship with Paul over beef jerky, Carla, finding out her engagement ring passed through a patient's digestive system and Dr. Cox's unsucessful attempts to get some attention from Jordan, who can only think about her baby right now.
Turk takes J.D. up to surgery, and right from the start J.D. steps all over Turk when trying not to be the geek among the surgeons. Paul hears Elliot say "I love U2" while she was rearranging her CDs and thinks she said "I love you too." Dr. Cox decides to get even with Dr. Kelso by telling everyone he's dead, revealing what people really think of him.
Jamie's (T.C.W.) husband died, and J.D. struggles with the ethical issues involved in starting a relationship with her. Dr. Cox babysits his son, whom Jordan still hasn't chosen a name for, and is disturbed that he feels nothing for the baby. Turk is haunted by erotic dreams about Elliot, which gets him into hot water with Carla.
J.D. and Turk's college buddy, Spence, drops by for a visit, and accidentally tells Dr. Cox a secret. Too much partying with successful Spence causes Turk and J.D. to show up late and drunk for work, which Dr. Kelso fully reprehends them for. Elliot's feeling low since she can't measure up to Dr. Kelso's standards, and the Janitor starts another feud – this time over paychecks – with J.D.
A run-in with her old flame Sean and an accident in her new car lead Elliot to the realization that nothing good has happened to her in the three years that she has been at Sacred Heart. This realization drives her to take drastic measures, including a complete makeover, both inside and out, in an attempt to change her luck. Meanwhile, J.D. gets stuck with a patient, whose diagnosis he can't quite pin down, and when Dr. Cox denies him any assistance, he looks to Carla and Turk to help him out. While Dr. Cox is busy not helping J.D., he takes the time to make amends with Dr. Kelso.
Finding difficulties training his interns, J.D. asks to Elliot for some help. She tells J.D. about Sean, who gave Elliot great tips based on his dolphin training that fit perfectly for her interns. Dr. Cox finds the ideal pediatrician for his son: Dr. Norris, who acts and looks just like him. However, Dr. Cox is quick to find a problem with him once Jack develops a cough that scares both him and Jordan.
Sean is a bit surprised and disturbed to learn about Elliot and J.D.'s history together, but it turns out his anger is really a cover up for his upcoming six month long trip and he doesn't want Elliot to explode. Dr. Cox. is forced to swallow his pride and actually ask for help when he decides to throw his hat in the ring for the Residency Director position at the hospital. Carla picks up an extra shift as a surgical nurse, which allows her to spend the day working alongside with Turk, to his great annoyance.
Dan decides to stay with J.D. for a while after their mom's new fiancé kicks him out, but after spending some quality time with him at the hospital, Dan isn't sure if he likes the cynical person his little brother has become. Elliot tries to deal with her own problems of a long distance relationship and decides to try moonlighting as a pet examiner with Carla to save up money.
A chance meeting in the elevator sparks a new friendship between J.D. and the mysterious Danni whose ongoing dialogue about her ex forces J.D. to talk about his feelings for Elliot. Carla's brother Marco comes to visit, but he still hasn't forgiven Turk for mistaking him for a valet at their mother's funeral. Unfortunately, Turk can't even apologize because Marco can't speak anything but Spanish. At the hospital, Dr. Cox relishes his new job promotion but is surprised when J.D. doesn't follow his lead in contradicting Dr. Kelso's orders.
As J.D.'s relationship with Danni progresses, he and Dr. Cox are forced to spend more time together outside of the hospital, to Perry's great chagrin. Meanwhile, as they each deal with problems in their own relationships, Carla and Elliot work to find their own balance between their personal and professional relationships. Dr. Kelso accidentally punctures his eardrums giving the hospital staff an opportunity to tell him how they truly feel about him.
Elliot is feeling uncomfortable using clinical terms for her patient's private parts – a result of a repressed childhood and an accidental orgasm she inflicted on a patient during a pelvic exam - so Carla tries to teach her how to say "vagina" and "penis" without blushing. Meanwhile, Dr. Cox crashes at J.D. and Turk's after taking bad advice from J.D. Carla suggests no more sex until the wedding and Turk only comes to terms with it after learning the real meaning of romance from a patient with prostate cancer. Ultimately Carla backs down on her own idea when she has a stressful day at work finally letting people make fun of her.
Carla and Elliot try to help a patient, Maggie, lose her virginity as she prepares to die. Walking in on her sister and Dr. Cox prompts Danni to move in with J.D. Dr. Cox attempts to convince Turk to do a kidney transplant for a patient he has "moved up" the list. But a personal grudge seems to stand in the way and may decide whether the patient lives or dies.
Elliot finds herself perplexed over a simple procedure that leaves her questioning her career path. She goes to seek Dr. Kevin Casey's advice but becomes frustrated when she learns that the epiphany toilet, which the Janitor secretly installed on the roof, is getting more attention than she is. Meanwhile, Turk asks J.D. to be his best man at his wedding, which sends J.D. into sheer bliss momentarily until he hears a phone message that makes him question his friendship with Turk.
Jordan's friends Allison and Maddie come to town to provide moral support for Jordan after her brother's death – however, their constant presence does not provide any relief to Dr. Cox. Meanwhile, Turk tries to impress the new female surgeon, Dr. Miller, but his first encounter serves only to leave him baffled by the opposite sex yet again. Attempting to reinforce the policy on sexual harassment at Sacred Heart, Carla is forced to teach a course where Dr. Kelso is the number-one student.
J.D. must keep a secret when Carla's "what-if" guy asks her out on a date. Meanwhile, on the other side of the argument, Carla hounds Turk for checking out other women. Elliot is also on the spot as Dr. Cox and Dr. Kelso both advise her not to give her patient drugs as they suspect he is an addict faking pain.
Elliot asks Sean to move in with her, which only adds to J.D.'s problems. Turk is unsure why Dr. Miller's attitude towards him has changed, until he finds out that Carla un-invited her from their wedding. Dr. Kelso outrages Dr. Cox when he announces that Sacred Heart will begin doing full body scans, starting with an ever present hypochondriac patient, who wants any freebies he can get.
Dr. Clock tries to reconcile J.D. and Eliot, while waiting to see which one Dr. Cox will give the Chief Resident position to. Molly and Carla are experiencing some subtle conflict and Elliot and J.D. begin to come together after long bouts of conflict of their own. Meanwhile, Dr. Cox, Turk and the Janitor are forced to work together to help a patient.
Dr. Cox is having issues with Jordan, since Ted revealed that they are still technically married due to some filing problems. J.D. has problems of his own as he can't shake off the tag of Co-Chief Resident the Janitor assigned to him, while Elliot keeps the Chief Resident tag. Elsewhere, Turk begins to doubt his abilities after letting a patient die and isn't helped, when he finds out J.D. has no confidence in him either. Dr. Cox and Molly spar about her involvement in his patients.
J.D. is shocked to hear Dr. Cox tell his interns that eventually, they will screw up and kill a patient. J.D. fears his first time killing someone will soon be upon him. Elliot is upset with Molly, after she disagrees about a patient's promise to attend drug rehab. Carla loses Rowdy and she and the Janitor go looking for him.
Elliot becomes unsure, if she wants Molly as her mentor, when she finds out that Molly doesn't have a perfect home life. J.D. is tested in leadership skills when Dr. Cox yells at him in front of his interns. Carla and Turk try to come to an agreement when Turk continuously wakes Carla up every night.
When Dan resurfaces, J.D. is shocked to learn his father has passed away. The reactions from his co-workers help J.D. a little, but the one person, Dr. Cox, who he wanted to be there for him is too busy with J.D.'s patients. Meanwhile, Dan sits drunk in the bath tub the whole day and Turk finds out he has Type II Diabetes.
With the case against Turk on his mind, J.D. attempts to end it with Neena, but she won't take "no" for an answer and keeps him wrapped around her finger. Carla tries her own way of persuading Mr. Corman to drop the lawsuit. Elliot sets out to prove she isn't the doctor she was four years ago and doesn't need to rely on anyone anymore.
When J.D. has to address a bunch of pre-med students about what it's like to be a doctor, he strays off the beaten path and chooses to discuss his best moments as a doctor instead. When he challenges the rest of the staff to do so, they all remember their best memories in the medical field. Meanwhile, Elliot is forced to face her fear of children, when she must befriend a ten year old boy, whose father is being treated in the I.C.U.
J.D. has a crush on a girl, who he met at a club, and he's torn about telling her, that her boyfriend has gonorrhea. Elliot decides to take a stand against Dr. Kelso with one of her patients. And Dr. Cox is blackmailed by the Janitor for a basketball game's score, after he spoils the end of "The Sixth Sense."
J.D. tries to impress Kylie by paying a hobo in the hospital to fake a heart attack, when everything becomes boring due to a quarantine that he caused. Turk learns, that Carla dated Cox and gets mad at her for not telling him. The Janitor makes a bet with Dr. Kelso, who is starving, that will make him pay $700, unless the Janitor is able to get a "face cake," in order to satisfy him, from Laverne. Also, Danni Sullivan returns to annoy everyone, causing a constant fight between Ted and Doug.
When J.D. meets a former writer from his all time favorite TV show "Cheers," he begins to picture his life at the hospital as a bland, multiple camera sitcom, where everything is perfect and wraps up nicely. Back in reality, Cox is relunctant to fire an amiable cafeteria worker, while Turk and Carla struggle to keep their promise of constant romantic affection afloat.
With their residencies over, there are big changes at Sacred Heart. J.D. moves out to live on his own, while Turk and Carla consider a family change, creating another rift in their long friendship. Jordan is hired to handle some paperwork for Kelso, which annoys Cox. Elliot has a job interview at a different hospital thanks to her boyfriend Jake.
J.D. wants to show Dr. Cox and Dr. Kelso how to treat interns, but instead he finds out that they laugh at his bad jokes out of fear and respect. Everyone at the hospital is avoiding Jordan to get rid of her except for Turk. An aborted attempt to bond with her results in Jordan being conned by Sam, the drug addict. Elsewhere, Elliot's fellowship goes sour and she finds herself confiding in loose-lipped Carla.
While planning his birthday, J.D. finds a list of things he wanted to accomplish, before he turned 30. He enters a triathlon to begin. Meanwhile, Elliot discovers a side of her boyfriend Jake, that freaks her out. And Turk is working hard to impress his bosses and takes on a patient, who wants to be hypnotized during surgery in effort to be promoted.
J.D. is asked to introduce Dr. Kelso at an awards dinner, so he wants to find out something good about him. Dr. Kelso and Dr. Cox each have a patient, whom they feel deserves the benefit of a new experimental treatment, but there is only one open slot. Elsewhere, Carla and Turk try to help Elliot get her old job at Sacred Heart back. And the Janitor taunts J.D. with the made up game of "Jiggly Ball."
In a "Wizard of Oz" homage, J.D. is trying to go home, Turk searches for a heart donor and Carla worries, that she doesn't have the courage to become a parent. Meanwhile, Elliot doesn't believe, that she has the brains to lead a question and answer session. Also, the Janitor is painting color coded lines throughout the hospital for easier navigation.
J.D., Turk, Elliot and Carla are interrogated about the mysterious death of a patient. Dr. Kelso learns, that J.D. and Turk were away tracking down a patient, Elliot was traumatized over finding out that her make-out buddy was married and Carla was busy recruiting hospital personnel for a group lottery purchase.
J.D. is annoyed that Julie doesn't laugh, so Elliot encourages him to tell her his feelings, as Turk tries to use psychology to fix the issue. Meanwhile, Carla is upset when the Janitor refers to a new nurse as a "hot young Carla," which intensifies her growing concern that she is too old to conceive.
J.D. is still dealing with his recent breakup and trying not to kill intern Keith, who has become annoyingly perfect. To make matters worse, a favorite patient is in a serious coma and each of the staff finds their own way to deal with it. Dr. Cox and the Janitor bond over drinks at the bar and Carla makes it her mission to make the hospital's gym female friendly. Meanwhile Turk suggests, that J.D. and Elliot find themselves 'booty calls'.
Dr. Kelso is outraged, when he discovers, that a bird has been living in Sacred Heart. He orders the Janitor to dispose of it immediately. However, the Janitor likes the bird so much, he secretly keeps it as a pet. Meanwhile, J.D., annoyed with Keith, tries to get his intern fired, but things don't turn out as intended.
J.D. and Dr. Cox go through the five stages of grief with their favorite patient, who is declining in health. Carla forces Turk to go on a string of double dates, including Elliot and her booty call Keith. Elsewhere, Dr. Kelso hits Ted with his car, thus Ted finally has the upper hand with a potential lawsuit.
J.D. is sick of perfect intern Keith and he's not the only one. Elliot's relationship with Keith is revealed, so the other interns think that he is getting special attention. In the meantime Dr. Cox boasts about being named "The Best Doctor in the City" by a local magazine, thus Dr. Kelso assigns him to the most difficult patient in the hospital to deflate his ego. Also, Turk and Carla continue to struggle in their quest for conception.
J.D. urges Cox and his fellow doctors to do special, unconventional things for their patients, but J.D. himself is not sure he can shave his head for a woman undergoing chemotherapy, after meeting a woman who loves his hair. Meanwhile,Turk and Carla attempt to eliminate all the stress in their lives, to better their chances of conceiving. Also, Elliot can't stop giving her new boyfriend Keith stupid gifts.
Turk finds out, that Carla is pregnant, before she does, so J.D. convinces Turk to tell the entire hospital staff to surprise Carla with the news. But Carla wants to personally share her baby news with everybody, so Turk and J.D. have to quickly contain the hospital gossip. Meanwhile, when Elliot puts Dr. Cox into an embarrassing situation, he decides to get even with Elliot through Keith and Carla.
When J.D. rearranges his schedule to allow himself more time to spend with Turk, Turk secretly resents hanging out with J.D. in that time because it interferes with his own "Turk Time." Meanwhile, Dr. Cox and Jordan go on a double date with Elliot and Keith, and Carla covers for Kelso at work, as he grieves for his dead dog. Later, a patient almost dies, after giving up part of his liver for his brother, and the hospital staff learns about making sacrifices for the people they really care about.
J.D.'s brother Dan returns for a surprise visit and Elliot learns that J.D. has been telling Dan that she still likes him. A patient with weight-related problems needs an MRI, but he's too big for the machine. Carla and Turk freak out when they begin to discuss baby names. Meanwhile, Dr. Kelso assigns Dr. Cox to assist Ted with malpractice claim paperwork after Dr. Cox insults Dr. Kelso's son.
J.D. asks Dr. Cox out for lunch, but runs into annoying former patient Jill Tracy, who unexpectedly teaches him something about responsibility. Elliot and Carla discover that Todd has been lying about all his hospital "conquests" and suspect that he's been less than truthful about other issues. Turk warns them not to meddle in his affairs.
Dr. Cox starts drinking after his decisions result in the death of three of his patients. The staff tries to cover for him at the hospital, while everyone tries to convince him how inspiring he is for them. Turk starts his new rotation with orthopedic surgery, but isn't so fond of his attending doctor's touchy-feely methods. Thus, J.D. and the Janitor attempt to help Turk find ways to bond with his new supervisor.
J.D. feels that the same things happen over and over again at the hospital. Dr. Cox returns to work, but Elliot believes that he has lost his usual confidence. Elliot calls Dr. Cox on his behavior. Carla gets fed up with Turk, because he still can do a lot of stuff, but she can't since she is now pregnant.
J.D. challenges an urologist's assessment on a consult for a patient in need of a risky surgical procedure. He also starts to fall for her. Meanwhile, Elliot considers breaking up with Keith, but Carla is showing extreme hormonal changes due to her pregnancy and tries to interfere. The Janitor and Dr. Kelso are having a little tiff of their own about fear.
J.D. addresses the news that he is going to be a father and Dr. Cox is worried about how his anger is going to impact his offspring. Meanwhile, Carla and Turk prepare for the impending arrival of their new baby. Elliot feels left out because she is childless, while the Janitor wonders if he has wasted his life.
Elliot begins enjoying luxuries since she has extra money with her new private practice gig. But eventually, J.D. becomes jealous of her and that forbids him the use of these privileges. Dr. Cox and the Janitor become roommates in one of the hospital suites, while Turk tries to convince Carla that she has postpartum depression and that she needs help.
A Croatian Doctor comes to Sacred Heart, only to find out that he has to redo his Internship there. J.D. shows symptoms of 'Vasovagal Syncope', a condition that causes fainting and blackouts. Turk and Elliot argue over whose turn it is to take care of him, whilst Carla tries out her new excuse "I have a baby" and the Janitor takes a vacation.
J.D. develops a crush on a new physical therapist but due to his latest misfortunes, he finds it difficult to ask her out. Elliot asks Keith to move in with her, but is not willing to budge on her home rules. Turk breaks his arm and is sent back to residency by Dr. Kelso. Thanks to Dr. Cox, he realizes that he doesn't know as much about medicine as he thought.
Laverne and Dr. Cox engage in a philosophical debate. Carla finds a hot nanny for Isabella, and Turk struggles to find a way not to leer at her. Elliot smuggles a patient's dog into the hospital to cheer her up and ends up in hot water with Dr. Kelso. A tragic twist awaits at the end, challenging everyone to decide if they think everything happens for a reason.
Laverne is brain-dead, and her family decides to take her off life support. One by one, the staff say their goodbyes, except Carla, who stoutly refuses to accept what's happening. She consequently finds herself "haunted" by Laverne. Meanwhile, Jordan gives birth, but Dr. Cox doesn't want to tell anyone because he doesn't want his daughter's birthday to always be associated with Laverne's death.
In the wake of Laverne's funeral, the Sacred Heart Staff decide to implement lessons from her life to their actions. Carla is upset that everyone seems to act as if nothing has changed. Dr. Cox tries to take twenty minutes for himself every day, but has great difficulty doing that. Meanwhile, the Janitor helps J.D. and Turk treat a deaf patient. And Elliot learns that Keith wants more from their relationship.
The perspective shifts between Jordan, Ted, and Todd, as they go about their day. Jordan messes with Elliot and Keith's relationship and is disturbed when it doesn't give her any satisfaction. Ted tries to settle a pay dispute between the nurses and Dr. Kelso. Todd has found his calling in plastic surgery, but must convince Turk not to interfere with a sixteen-year-old girl getting breast implants.
When Keith leaves town for a few days, J.D. expects that he'll finally be able to spend some quality time with Elliot. But he doesn't anticipate Elliot's old college friend dropping by. J.D. switches between hitting on her and competing with her for Elliot's attention. Meanwhile, Turk and Dr. Cox volley a hypochondriac patient back and forth since there's nothing wrong with him.
J.D. tries to get together with Elliot's sorority sister Melody, but she just wants to make out with him without going further. Meanwhile, Keith re-proposes to Elliot after she gets to make everything perfect, while everyone has fantasies about being married to Elliot. Elliot and Carla are having problems figuring out what is wrong with two elderly patients, who show the same symptoms but have no obvious connection.
Kim goes into labor, and J.D. struggles to decide if he should tell her what he really thinks of their relationship. Turk, desperate to do something not baby-related, races to beat a video game before Carla discovers him. And Dr. Cox searches for someone he trusts enough to give his daughter a shot.
Turk tries to assure a worried Carla that their daughter will acknowledge her Latin heritage. Meanwhile the Janitor challenges J.D. to identify everyone in the hospital, when it is discovered that he uses nicknames, because he doesn't know the people's actual names. If J.D. can't name all of them, he must take up the mop for a day. Elsewhere, Dr. Cox realizes that he is lonely without his wife and children.
Though Elliot boasts that through private practice she gets to get to know her patients, nobody seems to care. Carla is amazed at how the Janitor was able to score such an attractive girlfriend. The doctors are improving their services to get a higher ranking on a website and although J.D. appears nonchalant initially, he is elated when he is ranked #1.
Elliot and J.D. discover a major change in their relationship, when they spend time together looking for a former patient. Dr. Cox contemplates his new job title, when Ted refuses to do the majority of his work, whilst Carla and Turk talk about the possibility of a second baby. Meanwhile, the Janitor claims Dr. Kelso's abandoned office for the brain trust.
After a hard day of work, Dr. Cox has the burden to tell his son Jack a good night story, so he disguises his hard day as a fairy tale about the little village Sacred Heartlia with Carla and Turk as the two-headed witch Turla, Elliot as the princess and J.D. as the village idiot. Other people featuring are the Janitor as the giant, Keith as the prince, Dr. Kelso as the dark lord Oslek, Ted as his hunchback and of course Dr. Cox as the brave knight.
J.D. intends to leave Sacred Heart to move closer to his son, while he and Elliot plan to take their relationship to the next level. He then goes around saying his farewells to everyone and gets upset when Dr. Cox won't say goodbye to him.
J.D. continues his last day at Sacred Heart, and tries to hold out hope for a great sendoff.