Dr. Kelso's nose is still bruised from Dr. Cox punching him a week ago, but no one will be a witness to the incident so Kelso can't punish him. But he can send him to the local prison to do physicals on the inmates. J.D. can't figure out what is wrong with his patient Mrs. Farr, so he goes to Dr. Cox for advice. Cox meanwhile, informs J.D. that he no longer will be available for consults now that he has new residents and interns to supervise.

With the help of Turk, Carla and Elliot, J.D. tries every procedure in the book to try and figure out Mrs. Farr's diagnosis. But, with a little help from Dr. Cox, they determine that she has Familial Mediterranean Fever, a very obscure condition.

While J.D. and Turk are entering their third-year residencies relatively confident, Elliot is still as insecure and down in the dumps as ever. She bought a new car to lift her spirits, but two seconds after she was handed the keys, the another car drove by too close and ripped off the door. Later, at the smoothie shop, Elliot sees Sean (Scott Foley) sitting at a table. She's surprised and happy to see him, thinking that maybe her bad luck is finally changing. Her hopes are dashed when a woman comes over to Sean and kisses him. It's his girlfriend.

After getting that shock, she decides once and for all to make drastic changes in her life. She cuts her hair, changes her wardrobe and adopts a much tougher attitude. Even J.D. likes her new look. And just as her new good luck would have it, she runs into Sean again.