To get his son to fall asleep Dr. Cox tells him about his day at the hospital in the form of a fairy tale. The Village Idiot (J.D) is summoned to help Princess Elliott when she cannot figure out what is wrong with her handmaiden, with the help of the Giant (Janitor) and a little magic from Turla (Turk and Carla) and last but not least the Knight in shining armor of this fairytale (Dr. Cox) they may be able to defeat the Dark Lord (Dr. Kelso) and save the handmaiden.

Elliott and J.D gets in touch with an old patient of theirs to offer him some compensation as the medication they recommended had some bad side effects. Carla speaks to Turk about getting pregnant again while Dr. Cox likes his new title, but does he want all the responsibility and problems that comes with it?

When Dr. Cox is visited by one of his regular patients something strange happens, he can’t find out what is wrong with him, so J.D and Turk immediately try and find out what is wrong with Dr. Cox’s patient in order to once be better then him. Elliot and Carla sets out on a mission to get the board to let Dr. Kelso stay on as Chief Of Medicine while Dr. Kelso himself thinks about his time at Sacred Heart.

J.D. and Turk are both facing the same dilemma, appearing masculine. J.D. wants to set a manly example for his son, while Turk undergoes a surgical procedure that causes him to feel insecure. Meanwhile, a disagreement with Kelso has the Janitor creating a hospital newspaper.

Turk learns Spanish as an anniversary gift for Carla. Dr. Cox tries to help Dr. Kelso cut back on the sweets. J.D. and Elliot have conflicting opinions about dealing with a burn victim who is about to graduate high school.

Sacred Heart hospital is signed up for RateYourDoctor.org. a website where patients are able to grade their doctors, by Dr. Kelso. The use of the website does not have the effect Dr. Kelso was aiming for, now the doctors are just aiming to be number one. Elliot is having a dilemma when it is revealed to her that one of her terminal patients intentionally overdosed on medicine. Meanwhile the Janitor has a new girlfriend, and Carla tries to figure out what she sees in him.

J.D. decides to grow up in order to better care for his son, but when he stops engaging in Turk’s antics, Turk brings it upon himself to bring back J.D.’s immaturity. Meanwhile, Eliot decides to throw Kelso a birthday party, but when his age is revealed, big changes are made at Sacred Heart.

Carla worries that she’s losing her Latin identity and fears that her daughter may never learn about her heritage. J.D. lands himself in hot water when the staff realizes that he uses nicknames because he doesn’t know anyone’s real name. Upon hearing this, the Janitor proposes a challenge — J.D. must identify everyone by name in the hospital, and if he can’t he has to be a janitor for a day.

When the Janitor watches “An Inconvenient Truth,” he decides to become an Enviornmental Officer (with peculiar motivational methods) at Sacred Heart. J.D. must deal with an inconvenient truth of his own when Dan returns to town and tells him he has to grow up.

Kim goes into labor and both she and J.D. begin to worry about their future together as well as being parents. Dr. Cox refuses to give his daughter a shot, thinking she’ll always associate her father with pain; Turk and Carla try to complete a video game so it doesn’t distract them from being good parents; and Dr. Kelso helps his son recover from a broken heart.