The episode opens with J.D. eagerly anticipating his first day as Chief. He and Turk are both excited about the welcome dinner and their partnership as two Chiefs. In celebration, Turk gifts him friendship bracelets inscribed with "two chiefs" - a symbol of their bond.
The day begins well, with J.D. conducting the first rounds with the interns, trying to figure out his teaching style. He tries to be fun and friendly, using nicknames, but Sibby swiftly puts a stop to that. As the day progresses, J.D. realizes that Dr. Park is out to get him, but he remains optimistic that he has the situation under control.
Meanwhile, Asher gets a new patient, Stanley, who is on heart medication. Unfortunately, it turns out that Stanley has been lying about taking his medication. He has only been taking two pills a week instead of the daily dosage to save on medical bills. Still riding the high of his new position, J.D. encourages Asher to call Stanley's insurance and work something out.
At the same time, Elliot asks J.D. to get the hospital's new mannequins for the simulation programs. J.D. agrees and figures that cutting-edge technology will be a great teaching experience for the interns. However, Turk was already excited about the surgical robot his department was getting, and this excitement is dampened when Dr. Park interferes and gets everyone - Turk, Eliot, and Sibby - angry at J.D. It turns out that the hospital budget can only allow for one upgrade. Sibby is also unhappy about Asher's rude call to the insurance company and blames J.D.
In another part of the story, Dashana accidentally hurts Tosh's feelings by mocking her content creator side-hustle. Thankfully, Tosh quickly forgives her and reveals that her side hustle pays all her medical student loans.
After getting on everyone's bad side and learning that a few people think he cheated on his ex-wife, Elliot, J.D. realizes he can't win everyone's love. He ultimately chooses Turk's robot because it will bring in more revenue for the hospital. Elliot is upset and accuses him of playing favorites. He also asks Asher to stop the war with Stanley's insurance company and discharge him.
Later, Elliot walks in on Turk and his team celebrating the news about the robotics. She brings up the favoritism angle again, and he confronts her. She opens up and admits that it is not about the robot but more about the divorce. She felt like Turk took sides and started avoiding her. Turk reflects on this and admits that he didn't know how to handle the situation. They quickly make up, and he promises to be a better friend to Elliot.
Although J.D. makes peace with being a villain, he still skips his welcome party and stays on the phone to speak to a representative from Stanley's insurance. He also calls a few doctors and gets Stanley three months of medicine from his concierge doctor friends. He realizes he can't run a hospital without hope.
However, he warns Asher that they can only do so much for everyone. They also have to take care of their mental health to prevent emotional burnout.
The episode ends with Turk dropping by J.D.'s office to bring him cake for his party. As they talk about the imaginary mistress J.D. supposedly had, Stanley's insurance representative finally calls.
