J.D. (Zach Braff) Turk (Donald Faison) and Eliot (Sarah Chalke) quickly become overwhelmed on their first night without the supervision of an attending physician when their newly established authority as residents turns out to be more work than they anticipated forcing them to rely on Carla (Judy Reyes) and even the janitor (Neil Flynn) for assistance. Meanwhile Dr. Cox (John C. McGinley) begrudgingly acquiesces to Dr. Kelso's (Ken Jenkins) request that he introduce him at an awards ceremony fueling Cox's resentment and resulting in a rather unusual presentation.
A seizure patient's heart attack prompts the team to consider a transplant.
Roger joins Don for an evening of dinner and drinking, during which Roger's behaviour leads to a rift in their friendship. Though Don accepts his apology, there are further consequences for Roger. Pete faces trouble at home as he continues to struggle with the demands of his new marriage.
Paul stands in the way of Susan receiving a kidney transplant; Tom passes up a lucrative job to continue working with Carlos; Andrew's alcohol consumption increases, worrying Bree.
Frankie and Mike attempt to have a romantic date night at home by renting a movie. But every time they turn it on, they end up falling asleep and try desperately to get through the film over a series of nights. Meanwhile, Axl teams up with Brick to invent the next big thing, and the Heck Brothers Old-Timey Barbecue Sauce is born; and Sue is floored when she's asked to her senior prom by a hunky mall store greeter. But she has to figure out a way to get out of work early in order to attend.
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