Sean is a bit surprised and disturbed to learn about Elliot and JD's history together, but it turns out his anger is really a cover up for the fact that his "little" work trip is actually six months long and he doesn't want Elliot to explode. J.D., who has been watching their relationship develop, finally acknowledges that he still has feelings for Elliot and that he has to come to either accept her new relationship or do something about it. Meanwhile, 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.