The episode starts with the show's principal character, John Michael Dorian (J.D., for short) explaining in a unique way, by narrating everything that goes around him, that he has been able to sleep through anything, storms, sirens, etc. But, that that same night he was unable to sleep, this is due to the fact that this is his first day at Sacred Heart Hospital. He seems to be quite happy and cool with his new experience, however, the moment he enters to the hospital full of people with pain, blood, and screams, and a nurse hands him what he has to do, his happiness disappears almost instantly.
(J.D. recalls his day of orientation the previous day)
Ted Buckland, the hospital's lawyer, is telling all the interns that being sued is not a good thing. He eventually tries to take out some fun about his work, but he ends up sitting sadly and weakly. J.D. is with Turk, where he talks about how he has been Turk's friend since college, med school, and now, the hospital. Dr. Bob Kelso, the Chief of Medicine, gives the interns words of encouragement and all of the interns seem happy about it.
Turk and J.D. are at the doctor's lounge, where another medical intern, Elliot Reid, appears. J.D. seems to like her, and so they begin to talk as they move up through the hospital. When they are at the stairs, Elliot begins running where J.D. imagines himself winning the race in a desperate and glorious ending, where everyone in the staff congratulates him. Dr. Steadman appears and gives both of them beepers stating that they are now controlling their lives.
(Back to present day)
J.D. catches up with Carla and a patient. Suddenly, Dr. Perry Cox appears and asks J.D. to inset an IV to the patient, unfortunately, he is unable to peak the needle through the patient's skin. Dr. Cox asks Carla to do it, and when Cox asks the patient why does he always have to try to die when is his lunch, J.D. says timidly that it is a little insensitive. Immediately, he understands that it was a mistake and after the first of Dr. Cox's long, sarcastic speeches, he tells J.D. that he is never going to talk again if they are in the same room.
J.D. is in rounds with Dr. Kelso and J.D. tells a right answer, that impresses him. Elliot appears and when Kelso asks her a question, J.D. inadvertently tells her the answer so she can answer to him. When Elliot thanks him, J.D. invites her to dinner out, to what she accepts gladly. J.D. imagines him and Elliot being married at the set of "My Wife and Kids" telling his 'son' how did he married Elliot. However, his fantasy is interrupted when Dr. Cox appears, angry, that J.D. page him for something simple. J.D. tells him about how does Kelso always tells them to stay positive, and Cox replies by saying that Dr. Kelso is the most vile person on the planet. When J.D. tells him that the hospital is not what he expected, Dr. Cox tells him that he has to stay sane enough to when a real emergency comes. When he is about to leave, he tells him that if anyone discovers that nurses are doing J.D.'s procedures he is going to be fired.
J.D. thinks that Turk may be having the same day as him. However, Turk seems to be doing fine, he also meets Todd, who surprises him with a strong high five. J.D. analyzes his situation like being at high school, where surgical interns were the jocks and the medical the chess club. J.D. is moving his patient toward his room where he asks what is wrong with him. J.D. tries to tell him what it is, and both of them seem to like each other.
The second day arrives, with J.D. waiting for someone at the door where he meets the Janitor, who is fixing the door. J.D. tells him that there might a penny stuck in the door. Janitor asks why a penny, to which J.D. replies that he, was doing small talk. The Janitor tells him that if he finds a penny on the door he is going to bring J.D. down. Rounds are again, and Dr. Kelso asks J.D. something that he does not know, when he asks Elliot for help, she does not know, but when Kelso asks her, she gives the correct answer. To what J.D. is mad at.
J.D. tries to insert a needle in a patient's abdomen, where Turk easily does. However, the needle was just to big and that causes a cut. J.D. tries to make Turk to move in with him, but Turk says that they need to separate a little. J.D. is moving his patient again saying that he is disappointed the way the hospital is going on. He soon receives his first page, but instead he hides in the closet, where Elliot is hiding. They argue, and Dr. Cox appears and wants a kit. J.D. tells Elliot that their date is canceled.
J.D. is outside of the door sitting on the floor. Carla and Turk are kissing and undressing inside the room, but Carla has to get back to the work so she abandons Turk. J.D. goes with Dr. Cox and rattles Turk out about having sex. Dr. Cox says that J.D. is worried about being on call that night, and J.D. tries to make Cox help him, but he just tells him to go out and hide in the closet again. Elliot comes on with Carla, but she just gets Carla mad after she says about her and Turk.
J.D. is sitting on a couch, being scared of being on call, Dr. Kelso appears and tries to encourage him. He asks J.D., nicely, to keep doing a patient's dialysis. J.D. has a terrible night on call, and Nurse Laverne calls him to take him to one of J.D.'s patient's room where he discovers that he is dead. J.D. says that he is never going to forget that exact moment where the patient was dead; he pronounces his date of death, and walks out.
J.D. is on a EKG room with a patient, where Turk appears and tells him how scare he was before. J.D. tells him to move on with him, to which Turk replies he already has the keys. The next day, J.D. gets the second wind when he passes by the Janitor he replies with one "I'm watching you" with a penny on his hand. J.D. is on the couch when Dr. Kelso appears again. J.D. thinks that he is his safety net, so he tells him about the transplant list to a patient without insurance and about not being able to talk a family about a patient's dead, and that is when Dr. Kelso shows his true dark and careless side telling J.D. that they only treat patients with insurance and that when someone dies they must get an autopsy. Elliot is in the scene and sees everything happening.
J.D. asks himself that if Dr. Kelso is the jerk, then who is the good guy. J.D. gets page and is asked by Dr. Cox to cut down a patient with the scalpel. J.D. seems doubtful, and finally manages to do it, and not only that, also save his life. He gets overexcited. When he is about to leave, Elliot catches up with him telling him that she already get the family's permission for the autopsy. J.D. forgives her. When he is about to leave the building, he is just glad that he was able to went through three days without looking like an idiot. Right at that moment, he crashes against the door and faints.