J.D.'s imagination is sparked by a patient, a sitcom writer, who is about to receive some very bad news. J.D. ponders how the lives of everyone at Sacred Heart, including his patient, would turn out if left in the hands of the writer. Elsewhere, Turk and Carla are struggling to keep the romance in their relationship while Dr. Cox and Dr. Kelso continue their one-upmanship over whose job is harder. Portions of this episode were shot in front of a live studio audience in the manner of a traditional sitcom.

After a month of dating, J.D. is a bit frustrated that Kylie still doesn't want him to spend the night. That frustration leads to temptation when kooky psychiatrist Dr. Molly Clock returns to Sacred Heart to check on a patient. While J.D. struggles with whether or not to act on his residual feelings for Molly, Carla tries to hold back her true feelings when she learns that Turk is still talking to his ex-girlfriend. Meanwhile, Dr. Cox and the Janitor enter into a friendly wager over whether or not the Janitor can get Elliot to go out with him.