Dr. Kevin Casey has come to Sacred Heart; he's regarded as a Handicapped Badass and Inspirationally Disadvantaged due to the fact that he's a super-competent doctor and precise surgeon despite severe OCD. Dr. Cox can't wait for a challenge against an old classmate, while J.D. wonders if Dr. Casey can be a mentor to him, and Turk wants to learn from the guy.
The Janitor offers to get rid of excess trash at Sacred Heart, for an extra fee. Dr. Kelso, not wanting to pay high fees, investigates where the trash is doing.
Ted is having a bad bout of depression. If one more person is mean to him, then he will jump off the top of Sacred Heart.
Tropes for this episode include:
- Awesomeness by Analysis: Dr. Casey only needs to sniff the hospital oatmeal to deduce that the kitchen staff didn't use enough butter. Dr. Cox can't figure out how he did that.
- Beware the Nice Ones: J.D. makes Dr. Cox lose the impromptu rounds competition against Dr. Casey by asking him about metabolic diseases. He gives a glance showing it's very much on purpose.
- Broken Ace: Dr. Casey is charming, kind and brilliant at both medicine and surgery, but his OCD is so severe that he becomes trapped compulsively washing his hands outside the operating room. He's driven to frustrated tears because he can't make himself stop even though his last procedure wrapped up hours ago.
- Coin Walk Flexing: Turk sees Dr. Casey doing a coin walk in the lounge. Casey remarks on it being a good way to practice dexterity and notes that it can draw in the ladies, then tosses the coin to Turk. Near the end of the episode, Turk is practicing a coin roll when his girlfriend asks him to come to bed.
- Disability Superpower: At best deconstructed. Casey suffers from his extreme OCD. If it granted him any benefit, it never compensated for the pain it caused him.
- Don't You Dare Pity Me!: J.D. says, "I'm sorry" when seeing Dr. Casey struggle with stopping to wash his hands. He also preemptively apologized for the tongue-lashing, but fortunately decided not to go through with it. Dr. Casey then apologizes, saying no one is supposed to see this weak moment.
- Chekhov's Gag: Dr. Cox lies that he knows about metabolic diseases. J.D. uses it against him in the competition.
- Innocently Insensitive: Dr. Casey tells J.D. that he thinks that people who look for mentors are losers that don't know how to trust themselves. J.D. goes from happy to spending time with him to crestfallen.
- Inspirationally Disadvantaged: Subverted. Everyone assumes that Dr. Casey uses his OCD as a means to get further in his medical studies and surgical practice. It turns out that due to his independent streak, he doesn't like relying on anyone or showing weakness; he explains to J.D. when dealing with a handwashing compulsion that he's too used to people feeling sorry for him and trying to shoulder his burdens. His OCD doesn't help him improve at medicine; far from it, it impedes him by making him engage in time-consuming rituals and he cannot control it. Not to mention that Dr. Casey does have a case of No Social Skills and doesn't recognize that J.D. wants to look up to him.
- Moment of Weakness: Dr. Casey screams in frustration when he's stuck washing his hands in a loop and can't go home. He then apologizes to J.D. for showing this side of him.
- Oh, Crap!: Dr. Cox has this reaction when J.D. deliberately asks him a question about metabolic diseases, knowing that he can't answer it.
- Suicide as Comedy: Ted's attempt to jump off the Sacred Heart Building is Played for Laughs. In the end, he can't do it, but Kelso scares him into falling using an airhorn. Ted lands safely on a huge pile of trash.
- Surprisingly Realistic Outcome: OCD isn't a super power. It's a debilitating illness that can cause you immense pain. Casey ends up trapped in the washroom washing his hands over and over and over for hours. All of the main cast recognize that they can't unload their problems on him because he has problems of his own.
- Tall Poppy Syndrome: In the end, the three main male cast members are jealous of Dr. Casey over how good he is. They all decide to chew him out over jealousy...only to decide not to do it when they see him washing his hands. J.D. spends a few hours with him, saying nothing but keeping him company.
- Vitriolic Best Buds: If you're friends with Dr. Cox, safe to say you have to be this. He ribs Dr. Casey and the guy is willing to dish it back.
- "Well Done, Son" Guy: JD has this, of course, and Casey lampshades it. It's why JD goes to confront Casey along with everyone else.
- With Friends Like These...: An old friend of yours has OCD, and you have Green-Eyed Monster. Naturally, you subject him to a spontaneous competition on medical knowledge to show you are the better doctor. Dr. Casey wins without even trying.
