J.D. asks Dr. Cox to give his residents a pep talk to boost their courage. But instead of giving a rousing speech, Cox tells them that all of them will most likely kill a patient (either through neglect or not reacting quick enough to something) during their residency. This of course creates a mild panic among the doctors. J.D. doesn't think he has directly caused a patient's death, but Turk, Elliot and other doctors, admitted that they all had. Dr. Cox proved to be the one exception. Now J.D. is afraid that he will kill a patient in the near future.

His patient, Mr. Daniels, needs to have fluid drained from his heart using a long, thin needle, but J.D. is afraid that he might kill him, so he tries to dissuade him from having the procedure.

Meanwhile, Elliot and Molly are becoming fast friends. Elliot even invites her to Karaoke night, even though she's a little shy about revealing her off-key singing and quirky movements. Elliot receives support from Molly when she has to present one of her patients, Dean Phillips, to the ethics committee. Daniel needs a heart valve replacement, but his heroin use would destroy any benefits the surgery would provide. Despite that, Elliot is willing to fight for him to get the surgery.

But Molly surprises her when she testifies that she doesn't think Dean should have the surgery because of his many drug relapses. Despite Molly's testimony, the committee votes to let him get the heart valve anyway. But, Dean ends up missing his rehab appointments and then just disappears completely.

Molly and Elliot make up and go to Karaoke later that night.

Carla hurts Turks feelings when she demands that Rowdy the dog be kept out of the apartment. Things get worse when she accidentally leaves Rowdy on the roof of her car and he flies off, landing on the ground somewhere. Luckily, the Janitor does taxidermy as a hobby and is able to get a replacement Rowdy.