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.

Renewed sex with J.D. calms Elliot, who's facing personal and professional dilemmas: She's broke, and patients are bailing out on her.

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.

Elliot is torn between moving too quickly and ruining her new relationship with Jake.

Dr. Cox teaches Turk about having a healthy ego and Dr. Kelso and the Janitor fight over who gets to use the motorized cart.

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.

A new patient at the hospital wakes up and sees everything happening around her as a musical.

Carla can't decide whether or not to return to work and Elliot must find a way to tell J.D. he can't move into her new house with her.

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.

As his increasing workload from being Chief of Medicine begins to take a toll, the unimaginable happens when Dr. Cox reaches out to Dr. Kelso for friendship.