A patient has died in the hospital, a Mr. Foster. That shouldn't be an extraordinary occurrence, except that their case becomes the focus of a Morbidity and Mortality conference, a teaching tool at academic hospitals like Sacred Heart. Someone in J.D.'s friend group is responsible for Mr. Foster's death, and it might be him! Everyone has to go into what they were doing the day before:
J.D. is put out when a garbageman (played by Jason Bateman) won't thank him for saving his life. He and Turk try to track down the man and demand a bit of gratitude. They end up missing their shifts as a result.
Elliott was hooking up with a patient who lied his wife was dead. She finds out that his wife is very alive and very angry to learn that one of the doctors is a "WHORE!"
Carla is excited about the lottery. She gets all the nurses to buy tickets to even their odds, blowing off the interns' worries.
Tropes for this episode include:
- Big Damn Heroes: Doug ends up saving the group from receiving official sanctions by revealing that Mr. Foster's MRI was screwed up, meaning that he was receiving care based on a faulty examination. Namely, the embolism was too far to treat after he had received a clean bill of health.
- Brick Joke: Elliot and Carla talk about shoes to get JD and Turk to zone out so they can have a conversation. Elliot tries it again at the M&M, but Cox is wise to this trick and calls her on it.
- Cloud Cuckoolander: J.D. and the Janitor's fantasies (floating head doctor and trained shark attacking J.D. at a pool party respectively).
- Didn't Think This Through: When Elliott finds out the guy she made it out with is married, she tells him to come clean to her wife. He paints her as the seductress, and she has to spend the day running from his angry wife. When she attempts to apologize, she does so without hospital security and ends up duct-taped to a wall with a sign saying "HI, I'M A WHORE!" next to her.
- Downer Ending: By the end of the episode, the gang are left seriously reflecting on the mistakes they made in this episode. The final shot shows each of them returning to work, taking their duties seriously, whilst being followed by a ghost of Mr Foster. This symbolically indicates that they will be haunted by their failure and have to carry that burden with them for the rest of their lives/careers. The sombre music during this scene does not help.
- Hidden Depths: Dr Kelso is able to imitate J.D's summary skills flawlessly.
- Hypocritical Humor: Turk snickers at J.D. forgetting to remove his Sasha bracelet before Mr Foster's radiology exam. Then he gets stuck to the machine as well because he forgot to remove his watch.
- If I Were a Rich Man: Most of the cast has an Imagine Spot about what they would do with the winning lottery ticket. Some are quite Not So Above It All:
- Carla would pay for Turk to carry their baby as a surrogate.
- J.D. would separate his head from his body so that he could be in two places at once.
- The Janitor would train a shark to attack J.D. at a pool party.
- Dr Cox would get a glass box to lock up Jordan while he's watching his games, with an emergency hammer if she's feeling sexy.
- Jerkass Ball: Subverted with Dr Cox coming down hard on the four main characters during and after the morbidity and mortality conference. It turns out he was legitimately angry with them for letting their selfishness get in the way of a man losing his life. While it turns out they didn't know he had a fatal embolism, he points out that it could have been directly their fault if not for Dr Flannery.
- Karma Houdini: The police get no comeuppance for destroying Sasha.
- Millie Brown, the woman who chased and eventually incapacitated Elliot, put all of Elliot's patients' lives in mortal danger by beating and tying her up. She should have been arrested for assault and putting people's lives in jeopardy but is never shown getting into trouble.
- Likewise, given Millie's misplaced retribution, it is safe to say that her husband got away with his cheating.
- Karma Houdini Warranty: The terrible radiologist Dr Flannery from season three gets an official investigation for screwing up Mr Foster's MRI.
- In a way, this also happens to the gang as well. After the hearing, Dr Cox clearly thinks that the group got off lightly and can tell that they have not learned their lesson. He gives them a harsh wake-up call, with a brief but short "Reason You Suck" Speech.
- Killer Rabbit: The ostriches successfully thrash J.D. and Turk when they try to move past them ending with the duo separately flying through windows of Mr. Sutton's house.
- Leaning on the Fourth Wall: J.D. starts his usual ending monologue, only for Dr Kelso to interrupt him. When J.D. explains that he sometimes summarizes how a day went, Dr Kelso takes over quite smoothly.
- Left the Background Music On: Turk's cellphone has a ringtone for Beethoven's fifth, right when the gang is being approved. Aww, it's his mother calling.
- Mood Whiplash: Dr Cox does this to the gang at the end of the episode. After the hearing, the group go down to the pub to celebrate their good fortune. Cox, who is clearly not happy that the gang essentially got away with a small slap on the wrist, crashes the celebration. After reminding them about the dead man's widow and kids, he proceeds to shut down the celebration permanently by effectively saying that whilst they didn't kill him, they didn't do anything to help him either. The group were so focused on their own selfish problems that they neglected somebody in their care, causing that innocent man to pay the ultimate price. The gang have no retort for this, because, as J.D. points out in his voice-over, they know he is right.
- Not Now, Kiddo: When Mr. Foster started crashing, Keith went to get Carla for help, but she waved him off because she was focused on the lottery. Thus why she was dragged before the inquiry.
- Only Sane Man: Dr. Cox and Dr. Kelso are a rare duo of being this, which shows how badly everyone screwed up. They stay out of J.D.'s desire for a thank-you from his patient and Carla's recent lotto fever. What's more, when Carla and Elliott try to make everyone zone out with the "shoe shopping excuse" during the conference, Dr. Cox reveals that he's immune.
- Police Are Useless: Zigzagged; several cops get J.D. out of danger when the store he's in has a convicted felon. They proceed to fire on Sasha long after the guy is arrested.
- "The Reason You Suck" Speech: Dr Cox does this to the main quartet at the end of the episode. As he explains to the group, to him it doesn't matter what Kelso or anybody else says. The gang screwed up, he knows it and they know it. J.D.'s comment after the talk shows just how accurate and deserved this statement was ...J.D.: It's never easy when somebody accuses you of screwing up, especially when you know it's true.
- Shaming the Mob: Dr Cox does this at the end of the episode.
- Surprisingly Realistic Outcome: What happens to the gang in this episode.
- Mr Foster's fate is a big warning to everybody. Firstly, no matter what your profession, never neglect your duty. Secondly, if you are going to do something, do it properly.
- As J.D.'s patient, Mr Sutton, shows us, even if you help someone, even if it involves saving their life, don't expect them to be grateful.
- Even though Elliot told Millie the truth, it didn't matter. She still kissed her husband, meaning ignorance is no excuse.
- Given everything that happened, Dr Kelso was well within his right to launch an inquiry into Mr Foster's death. It is made very clear that if not for that stroke of good fortune at the end, the gang would have lost their medical licenses.
- Following on from this, just because one person says you are not guilty doesn't mean that everybody else will share that opinion. Dr Cox makes this clear at the end of the episode, by pointing out that even though the main characters did not directly cause Mr Foster's death, they still contributed to it by not being there. The group cannot refute this, because they know he is right, they screwed up big time!
- J.D's take-home message at the end of the episode can also be seen as this. Don't let your personal life and feelings interfere with your work life. Also, learn from your mistakes, use them to better yourself and make sure it doesn't happen again!
- There Was a Door: Mr. Sutton says this after Turk comes flying in through the window of his house after Turk tried to escape via Sutton's car and found an ostrich hiding in there.
- Truth in Television: Of course, this is a staple of the series, with few exceptions. In this episode, the focus is on the Morbidity and Mortality conference (or M&M for short), where a panel of senior physicians analyze the evidence surrounding a patient who has become ill (morbidity) or died (mortality) while at a teaching hospital. The purpose is primarily educational, rather than being an attempt to find fault or lay blame, hence it's a conference attended by the many physicians and students at the hospital. The proceedings are confidential by law. The main four are on the spot, but unless they've seriously screwed up, there probably won't be serious professional consequences.
- Ungrateful Bastard: Downplayed with Mr. Sutton, the patient who didn't thank J.D. for treating him. When J.D. goes to his house to confront him about it, he responds by pointing out he's a garbage man, and that no one ever thanks him for doing his job, implying it's less that he's ungrateful and more that he's used to people doing their jobs without expecting thanks. It's also made very clear that J.D. was wrong to focus on this instead of treating Mr. Foster, the patient whose death warranted a morbidity and mortality conference.
- Unusually Uninteresting Sight: No one's really bothered by Elliot being duct taped to a wall, gagged and with a speech bubble saying "HI, I'M A WHORE!"
- Villain Has a Point: Although they are usually portrayed as the bad guys, Dr Cox and Dr Kelso raise some very valid points in this episode. See below in What the Hell Hero for further details.
- What Happened to the Mouse?: The gang each being followed by a "ghost" of Dr. Foster representing them being haunted by their failures in not saving his life and having to carry that burden for the rest of their lives/careers is never brought up again after this episode.
- Watch the Paint Job: J.D. just got Sasha out of the shop. A would-be robber uses her as cover from police. Needless to say, she goes down, which is why J.D. needs to bum a ride from Turk to talk to the garbageman.
- What the Hell, Hero?: Dr. Cox and Dr. Kelso deliver it at different points in the episode:
- Dr. Kelso pointedly notes that Elliott's selfishness in kissing a patient's father led to her being "incapacitated" when she should have done her job and focused on patients. J.D. prioritized hugging a garbageman over going to the hospital, and Turk enabled J.D. by bumming him a ride rather than staying for his shift. Carla was the most useless in that she endangered all of the patients by having the nurses buy lotto tickets.
- Meanwhile, Dr. Cox crashes the four getting celebratory drinks for keeping their licenses. He makes a sarcastic toast for Mr. Foster's widow and kids. When Elliott protests they weren't responsible, Dr. Cox retorts that that's because they got really lucky. If things had gone otherwise, they would have caused a man's death. This shames the rest of them. J.D. even flat out points out in his internal monologue that Dr. Cox's right.
