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Things are going great between J.D. and Kylie. Carla feels a little romantically competitive with Kylie around. She also tries to be as adorable as her. Kylie comes to visit at least once a day so they can kiss. There is a media report on NBC which usually means there are a lot people coming in the hospital who thinks they have it. And indeed there is a mass crowd rushing into the hospital and everybody has their hands full.
Dr. Cox is more relaxed as he has seen it all before. One of the people in the waiting from is Charles James, a former writer on Cheers. Dr. Kelso turns a few bathrooms into patient rooms and Carla doesn't understand why Dr. Cox doesn't get angry. He says he doesn't care. Jordan says he better get angry or she'll stop having sex and start making love. Turk and Carla have a kiss meeting like Kylie and J.D. usually have but they take a long time finding each and mistake people for the other.
In the cafeteria, Dr. Kelso goes over the budget report and needs to fire somebody. Dr. Cox says he can do it without firing somebody. However, after several hours he realizes he does need to fire somebody. Carla is angry that she was left alone with all the patients and that J.D. spent his time with Mr. James. He has a bad cough so they check it out. Turk and Carla both lie about their next kiss appointment.
Jordan tells Perry to be a man and fire somebody in the cafeteria. The janitor tells him about the people who work in the cafeteria, especially the last person that was hired. It turns out Mr. James has lung cancer, and he only has a few weeks to live. Turk and Carla realize their relationship is not as strong as their though. Dr. Kelso needs to talk to Kenny. J.D. wishes live would sometimes be more than a sitcom.
Mr. James makes a joke and Elliot laughs erradically. The screen turns to vivid colors and J.D. is seen through a camera with a voice over saying "J.D.'s sitcom fantasy will be back in a moment". Elliot suddenly wears a much shorter outfit and shows more of her cleavage. They decide they could take Mr. James on a balloon ride as he's never been on one. The janitor comes in and uses J.D. sweater as a mop.
Dr. Cox needs to have a chat with Kenny, but he tells him he is doing a great job instead of firing him. Dr. Cox asks why he is still here. They need to come up with $26,372 quickly and a worker posts a banner for a talent show for exactly that amount as the prize money. Dr. Cox tells everyone to enter the competition. Carla says Turk's best talent is not finding the time to kiss his wife. Turk says the same about her. J.D. and Elliot go off to the balloon ride.
When they come back, the talent show starts. Elliot performs Shakespeare in German, along with Carla. The janitor does some bad stand-up comedy. Turk & J.D. perform as the 'World's Most Giant Doctor Goes To The Farm'. The last contestant is Kenny who sings 'Isn't She Lovely' by Stevie Wonders, picked out by Turk as it's his and Carla's song. They go home for some good time. Kenny wins the competition and doesn't need to get fired. Elliot notices that Mr. James chart is James Charles and not Charles James and he doesn't have cancer after all. Mr. James is relieved but collapses.
J.D. notices this is all a fantasy and in the hospital not everything works out the way like in sitcoms. Carla & Turk still have their problems, Kenny is fired and Dr. Kelso tells Perry that's how his world is like, J.D. goes home and watches a sitcom to lift his spirits.