After finding themselves in a compromising position J.D. contemplates his commitment to Kim and Elliot struggles with the idea of her upcoming marriage to Keith. Meanwhile, Carla, limits Turk's candy intake. Elsewhere, Dr. Cox tries to solve a patient's mysterious ailment. While the staffs at Sacred Heart debate their initial instincts, The Janitor follows his by entertaining a new lady friend.
J.D. and Kim go into labor, but the moment is tense as the two worry about their future as a couple and question what it means to be great parents. Meanwhile, the other staffers at Sacred Heart prove that parenting is all about sacrifice.
After watching "An Inconvenient Truth" the Janitor vows to save the world by becoming the Environmental Officer at Sacred Heart, but the staff soon finds out that his methods of motivation are a bit peculiar. Meanwhile, J.D. has to face his own inconvenient truth when his brother, Dan returns to town a changed man and tells him that it is time to "grow-up." Elsewhere, Elliot and Dr. Cox debate over the hypocrisy of their practice.
Carla worries that she is losing her identity and as a result, her daughter will not know her Latin heritage. Turk does not know how to assure his wife that their child will know about her lineage.
J.D. decides that it's time to stop acting like a baby so he can take care of one, but when he stops participating in pranks Turk starts a mission to bring his buddy back to immaturity.
Dr. Kelso signs Sacred Heart up for RateYourDoctor.org, a website where patients can evaluate and score their doctors, in hopes it will lead to better patient care.
It is the anniversary for Carla and Turk's first date and Turk decides to learn Spanish for her. He soon realizes that being bilingual works to his advantage when he finally understands everything Carla says behind his back and keeps his gift a secret.
J.D. becomes scared that he is not masculine enough to set an example for his son, especially after Dr. Cox gives him a hard time about being a whiney man-child.
Dr. Cox gets a visit from one of his recurring patients. This patient is a little different since Dr. Cox cannot seem to diagnose his problem. J.D. and Turk see this as an opportunity to show up Dr.
Elliott and J.D. seek out a former patient in order to give him compensation for prescribing a medication, which later was proved to have several negative side effects.
Dr. Cox recounts his tough day at the hospital to his son through an imaginative fairy tale. When Princess Eliot's handmaiden falls ill at the hands of an unknown monster the Village Idiot is summoned to help rescue her, but with the Dark Lord standing in their way, the duo can't do it alone.