Sean is a bit surprised and disturbed to learn about Elliot and J.D.'s history together, but it turns out that his anger is really a cover up for his upcoming six month long trip and he doesn't want Elliot to explode. Dr. Cox. is forced to swallow his pride and actually ask for help when he decides to throw his hat in the ring for the Residency Director position at the hospital. Carla picks up an extra shift as a surgical nurse, which allows her to spend the day working alongside with Turk, to his great annoyance.