J.D.'s and Turk's college buddy Spence (Ryan Reynolds) has come to visit. Since he’s living the easy life with his job as a financial advisor, he doesn’t really see what’s so great about being a doctor.

In their college days, Spence really stirred things up and things haven’t changed. While being introduced to Dr. Cox and Jordan, he congratulates them on their baby and then proceeds to blurt out the secret that J.D. had been hiding - that Cox is the father of the baby. Cox is in shock. He tells Jordan that he’ll be there for the baby, but he doesn’t think they’ll be together. Jordan decides that she is going to hound Cox until he gives in and takes her back.

Jordan tries to justify her lie by telling him that she didn’t want to manipulate him into being with her just because they had a baby together.

Spence gets J.D. and Turk into trouble again when they end up partying and drinking in a hot tub with their neighbors. The problem is that they are technically on call. Sure enough both J.D.’s and Turk’s pagers go off because there is a multiple casualty emergency at the hospital. They return to the hospital and incur the wrath of Dr. Cox because he smells beer on their breath.

After meeting back up with Spence, J.D. and Turk realize that they are really angry about their medical careers, which up to this point, haven’t been very rewarding.

Dr. Cox finally gives in to Jordan’s constant badgering and decides to be a family.

Meanwhile, Dr. Kelso makes a very hard assessment of Elliot’s abilities that really shakes her up. She turns to Dr. Cox for help, but he’s too busy with his own problems. She turns to Ted, the lawyer, as well, but he has nothing for her either. But he does tell Dr. Kelso that how he is treating her is wrong.

Later, Dr. Kelso resumes his attack on Elliot, but this time she has a defender. After Kelso makes one last caustic comment, Cox strolls over to him and punches him in the nose.