Clock tries to reconcile JD and Eliott, while waiting to see which one Dr Cox will be giving the Chief Resident position to. Meanwhile, Dr Cox, Turk and Janitor are forced to work together to help a patient.
Turk gets cold feet as the wedding invitations go out, and foxy Dr Miller is still causing havoc amongst the male members of staff.
The surreal medical comedy soars to new levels of bizarreness as the flight of a butterfly seems to influence the fate of JD's patients.
JD questions the bond he has with his interns when Dr Kelso tells him that inevitably he will begin treating them badly, as it has been throughout history at the hospital. The Janitor further complicates matters by telling JD that his interns only laugh at his jokes to suck up to him. Meanwhile, Carla visits Elliot at her new job and inadvertently creates an awkward new nickname for her friend.
JD becomes annoyed that his new girlfriend Julie doesn't laugh, but rather tells him when things are funny. Afraid that he is going to screw up yet another relationship, Elliot encourages JD to start saying his feelings out loud.