After being punched in the nose by Dr. Cox in the previous episode, Dr. Kelso is now detectable from a distance as he makes a whistling sound when he breathes, and so everyone, particularly Ted, takes advantage by slacking off when he's not around. However, as no one will admit to seeing the incident, Dr. Kelso can't fire Dr. Cox and therefore takes his anger out on him by making him spend his weekend giving prisoners their yearly physicals, forcing him to spend his free time away from his new son, Jack.
Resentful that helping Elliot out has cost him time with his son, Dr. Cox refuses to help J.D. with a particularly troublesome patient. Unfortunately for J.D., the only ones willing to help him are Turk, Carla, and Elliot — although she is so deep in a personal rut that she would be more a hindrance than a help.
After much soul searching, Elliot decides she has to turn herself around and, after getting a completely new look, marches into the hospital and forces the petulant head of Radiology to test J.D.'s patient. Finally, with some gentle coaxing from Dr. Cox, J.D. figures out the woman's illness.
Dr. Cox fixes Kelso's nose and Elliot meets back up with her old boyfriend, Sean. During the end narration, J.D. strongly implies that after Elliot's makeover, he has fallen in love with her again.
Plot Summary Via Wikipedia