Jordan's brother and sister return, but Dr. Cox learns that his brother-in-law Ben hasn't visited a doctor about his cancer in the two years he has been gone traveling the world.

J.D. mistakes an elderly woman's happiness as her wish to stop treatment for a fatal illness.

Turk and Elliot struggle to find the cause of a patient's body pain and Carla tries to organize the annual group photo.

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. and Kim start contemplating about their future and their baby's future. Meanwhile, Turk rushes Carla to the hospital after she goes into labor. And Jordan accuses Dr. Cox of not being a more defensive father towards Jack.

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.

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.

The Janitor and Lady invite the Sacred Heart staff to their fake wedding in the Bahamas hoping to score some loot but their scheme is about to backfire...

J.D. is planning on leaving Sacred Heart but before he goes there are a few things that he wants to do including; getting a hug from Dr. Cox, and learning the Janitor's real name. Elliot is ready for the next step in her and J.D.'s relationship and she begins moving her furniture into J.D.'s apartment.