When the hot pharmaceutical rep, Julie comes to Sacred Heart, all the doctors are smitten, except Dr. Cox, who detests her. When Dr. Kelso tells him to gather people up for the steak dinner the pharmacy are holding, Dr. Cox refuses to go along, while hiding his crush that grows unwillingly inside of him.
Elliot has to make a risky choice with a patient, and while J.D. tells her to wait and see, she goes ahead with the surgery, which consequently kills her patient. When J.D. tells her she should have gone along with his plan, she gets mad and storms up. At the C&C conference, Dr. Kelso congratulates Elliot on making the right call since her patient wouldn't have stood a chance without surgery either and says all "wait and see" approaches will never be respected doctors. Elliot then rubs this in J.D.'s face.
When J.D. inadvertently stops the Janitor from leaving for his child's apparent play, Janitor decides that J.D. is the boss of him and he has to run all his decisions by the doctor. When J.D. finally accepts this challenge and tells him not to talk, Janitor quits and starts a new game, forcing J.D. not to eat anything.
After Dr. Kelso yells at Carla for making a doctor's decision without permission, Turk gets Carla a Nurse Practitioner course, which she then resents him for. Confused, Turk tries to make it up to her by taking her to the dinner hosted by Plomox. He then eats his body weight in steak while Dr. Kelso (and Todd) can't keep his eyes off Julie who is now in full flirtation mode. When Turk's stomach almost explodes, he has to be taken to the hospital to get it pumped. Carla explains to Dr. Cox that she barely sees Turk as it is and if she took the course she'd never see her boyfriend.
Dr. Cox turns downs Julie so as not to lose his dignity and seem like a hypocrite for dating a woman that stands for everything he's against but opposites attract, and when he regrets his decision, he goes back to her.
J.D. confides in Elliot that he's always played it safe, and is even too scared to ask a girl out. Elliot then takes him bungee jumping to boost his confidence, and he realizes that taking risks is important in all aspects of life.