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As the Sacred Heart residents find their jobs monotonous, an old college buddy of J.D. and Turk's, Spence (Ryan Reynolds) comes to visit and spices things up.
J.D.'s relationship with Jamie (Amy Smart) starts to decline when he realizes she's a drama queen. Carla's mother dies.
J.D. attends the funeral of Jamie's (Amy Stuart) husband and they end up having sex in the coat room! Turk has a sex dream about Elliot.
J.D. does a temporary surgical elective, and his friendship with Turk is compromised as his competitive side takes over. Janitor gets a new power saw.
Dr. Cox competes with baby Jack for Jordan's attention. J.D. goes on a date with Jamie Moyer (Amy Smart), aka Tasty Coma Wife (TCW).
J.D. likes his patient's private practice doctor, Dr. Peter Fisher (Jay Mohr), but is shocked to find out he's the reason Jordan and Cox got divorced. Janitor tries to flirt with Elliot. Carla begins to doubt her sexiness.
When J.D. and Turk's golfing from the roof ends up sending someone to the hospital, they try to hide things by the Janitor knows. Jordan gives birth and reveals that Cox is the father to J.D.
The episode is told from Cox's viewpoint as he discusses the hospital and Jordan in his therapy sessions with Dr. Gross (Eric Bogosian). Elliot meets Paul Flowers (Rick Schroder), who she likes until she finds out he's a nurse.
Turk's brother, Kevin (D.L. Hughley) comes to visit with important news. Dr. Townshend (Dick van Dyke) runs into trouble with Kelso when J.D. screws up an out-dated procedure under Townshend's supervision.
Kelso is trying to consider ways to make a bigger office, but Elliot demands single sex locker rooms. Turk proposes to Carla, but not in the way he planned.
J.D.'s feelings for Elliot continue to grow even after they stop being sex buddies. J.D. tries to see Lisa (Sarah Lancaster) again.
Trying to avoid their last disastrous relationship, J.D. and Elliot try and be "sex buddies." Turk tries to help Elliot with her workload.
Both Turk / Carla and Cox / Jordan have problems as their hospital consumes their lives. J.D., meanwhile, feels the hospital is also killing his mojo.
Elliot is forced to move out and deal with a malpractice suit. J.D. shows up Cox and an unofficial competition is born.
Dr. Cox and Julie (Heather Locklear) hook up, but Cox's happiness is cut short by the arrival of a pregnant Jordan. J.D. and Turk have financial problems and steal from the hospital.
An attractive pharmaceutical rep, Julie Keaton (Heather Locklear), arrives at Sacred Heart and tension mounts between her and Cox.
J.D.'s older brother, Dan (Tom Cavanagh) comes by to visit but J.D. is embarrassed by him. Turk learns a lesson when he bets on a patient's life with Cox.
J.D. gets an ego boost when he dons a white doctor's coat. Elliot is nervous about her reputation when she sleeps with another Sacred Heart doctor.
J.D. and Carla's friendship deteriorates when he reveals some of her secrets. The surgical residents compete for a trip to Mexico with Kelso.
Dr. Kelso starts a competition among the residents for an all expenses paid trip to Reno for whoever can bring him the most interesting case study.
The residents spend a night on call with no attendings there to help them. Cox struggles with his feelings towards Jordan.
After Jordan reveals she slept with J.D., he fears the worst form Cox. Elliot, embarrassed by Jordan revealing Elliot's lingering feelings toward J.D., does her best to avoid him.