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The janitor gives the Sacred Heart staff a lesson in being environmentally conscious; J.D.'s brother (Tom Cavanagh) returns to town and tells him to grow up.
When Kim goes into labor, she and J.D. worry about their future as a couple; the Sacred Heart staffers prove that parenting is all about sacrifice.
Carla worries that she is losing her identity; J.D. angers the staff members when they realize that he uses nicknames because he doesn't remember their names.
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