J.D.'s brother is in town. Turk is thrown out of a patient's funeral for not knowing his name and feels even worse because earlier he made a bet with Dr. Cox over another patient's life.

J.D. bonds with a patient, who is waiting for a heart transplant and discusses with her their idea of what death must be like. Elliot puts her foot down and demands a feminine locker room from Dr. Kelso. Turk decides it's time to propose to Carla, but a kid swallows the engagement ring.

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.

J.D. is feeling left out of his friendship with Turk and gets hurt when Turk is scared of opening up to him.

Meanwhile, Carla is driven crazy over an unidentified urine sample, and Elliot tries to balance Sean and her career, so that one doesn't end up getting in the way of the other.

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.

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.

The big day for Turk and Carla has finally arrived, but a patient holds up Turk.

With Elliot still angry at him, J.D. attempts to reconcile her with Sean as a way to make everything right again in their friendship.

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. is thrown out of the apartment.

Turk and Carla continue to struggle to keep the romance alive.

Dr. Cox has reason to believe that the son of an old buddy is autistic.

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."

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. 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.