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Turk and Carla have started couples therapy but Turk isn't enjoying it at all. J.D. is trying to find an apartment. Turk has gotten over the J.D. and Carla kiss, but everytime he says bye to J.D. he hits him on the arm. Elliot is having trouble finding a man and Jake brings in her elderly neighbor Betty who had collapse. Elliot is immediately attracted to him. Jake needs to fly off to New Zealand for kayaking. Carla says she should have just asked him out. Dr. Cox recommends the opposite and just ignore him and discredits Carla as she's in couple theory.
At this therapy, Turk says he doesn't think anything is wrong with their relationship. J.D. tells Betty that her lungs have collapsed and that she will never leave the hospital. Her choices are either living with a breathing machine or making her as comfortable as possible before she dies. Betty wants to talk to Jake so J.D. persuades him to return. The janitor brings in his elderly lady and asks Elliot out to go clubbing. She declines. Jake returns to the hospital and Elliot uses Dr. Cox's method of ignoring him. Jake asks J.D. about her and he replies she is actually a him.
urk tells J.D. what his therapist says, that deep down inside he is still upset about the whole situation. Turk denies it so J.D. says 'Good Bye' and Turk hits his arm. The same happens two more times and Turk realizes he has been hitting him all this time. Betty talks with Jake and decides she wants to end her own life. Turk tells Carla he needs to skip the session tonight due to surgery which he purposely switched.
Betty's brother Dennis finds Jake and sues him for talking his sister into ending her life. Jake is upset and blames J.D. for the whole situation. Betty falls in a coma so J.D. tries to reason with Dennis. Elliot talks to Jake and continues the method Dr. Cox told her. Dennis doesn't want to change his mind about suing Jake. Dr. Kelso says these kind of things are normal around the hospital. J.D. agrees and there is very little humanity, so he tells Jake to take off as nobody really knows him around here. Dennis move Betty into another hospital. Jake comes back and tells Dennis what Betty told him.
Thus Turk finds the courage to talk in therapy. Dennis decides to make Betty as comfortable as possible after all. Dr. Cox tells Elliot to go for it with Jake, as he is about to leave. She goes up to him and asks him out for coffee. J.D. and a few guys help out an old lady change a tire but it doesn't hold. It still feels good nevertheless.