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Marco helps Turk write his own wedding vows; J.D. resigns himself to a relationship with Elliot despite not loving her; when Jordan insists she and Cox stop fighting, he antagonizes the Janitor. Moved by Turk's vows, J.D. admits to Elliot he doesn't love her.
J.D. attempts to make Elliot jealous by getting back with Danni (Tara Reid); Dr. Cox realizes he has a crush on Dr. Miller; Turk and Carla encourage the Janitor to take a promotion to security guard; Sean confronts J.D. about what happened with Elliot.
A butterfly, symbolizing the butterfly effect, prompts the question on what could have happened different as Turk looks for his lucky do-rag for surgery and Elliot tries to find a lost stuffed animal for a child needing a bone marrow transplant.
Jordan's siblings, Danni (Tara Reid) and Ben (Brendan Fraser) come to visit for Jack's first birthday; Carla agrees to take Turk's last name only if he has his mole removed; Dr. Cox is angry to find out Ben has not been to a doctor for a followup since his remission.
Elliot admits she has a problem with the clinical terms for genitalia after accidentally giving a patient an orgasm, and Carla attempts to help her get over her fear of dirty words; Cox is moved by the relationship of his prostate cancer patient (Barry Bostwick) and his wife;
Marco (Freddy Rodriguez), Carla's brother comes to visit and pisses of Turk; Dr. Cox and Kelso disagree on patient care and J.D. ends up taking Kelso's advice; J.D. is interested in Danni (Tara Reid) until he finds out she's Jordan's sister.