JD's imagination is sparked by a patient, a sitcom writer, who is about to receive some very bad news. JD ponders how the lives of everyone at Sacred Heart, including his patient, would turn out if left in the hands of the writer. In his fantasy Sacred Heart features low-cut outfits for the female characters, a less realistic hospital set, brighter lighting, broader humor, a fairly contrived plot, and a cheesy guest star, plus multiple cameras and an audience.
Elsewhere, Turk and Carla are struggling to keep the romance in their relationship as they witness Kylie and JD's ultra-cute relationship blossom. While Dr. Cox and Dr. Kelso continue their one-upmanship over whose job is harder. Plus an E-Coli scare brings a massive amount of people to the hospital looking for treatment.
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