When Keith leaves town for a few days, J.D. expects that he'll finally be able to spend some quality time with Elliot. But he doesn't anticipate Elliot's old college friend dropping by. J.D. switches between hitting on her and competing with her for Elliot's attention. Meanwhile, Turk and Dr. Cox volley a hypochondriac patient back and forth since there's nothing wrong with him.

J.D. tries to get together with Elliot's sorority sister Melody, but she just wants to make out with him without going further. Meanwhile, Keith re-proposes to Elliot after she gets to make everything perfect, while everyone has fantasies about being married to Elliot. Elliot and Carla are having problems figuring out what is wrong with two elderly patients, who show the same symptoms but have no obvious connection.