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The reality of having a baby begins to settle in for both J.D. and Elliot while Lucy struggles with the reality of operating on people.
Lucy struggles to acknowledge that she likes Cole, Dr. Cox and Dr. Turk's rivalry is put aside for a gravely ill patient, and Denise plays a prank on the security guards at the hospital.
A case of guilty conscience plagues the med school when a student cheats on an exam and Dr. Cox takes it out on the entire class. Meanwhile, Denise makes a startling admission of her own.