In the aftermath of their near-indiscretion, Elliot realizes she doesn't want to be with Keith, and J.D. resolves to stop sabotaging himself.

Meanwhile, Dr. Cox and Turk find a patient they both like who is in danger of being discharged.

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.

J.D.'s teenage burn patient gives him a hard decision to make when he wants to go to his high school graduation. Turk doesn't want Carla to find out that he secretly learned Spanish. And to address Dr. Kelso's weight gain, Dr. Cox makes a game out of stealing his breakfast.

Dr. Kelso's beautiful but unethical replacement, Dr. Maddox, shakes things up at Sacred Heart, while J.D. struggles to manage a new crop of incompetent interns and Carla helps Elliott put her ego in check.