J.D. treats a deaf patient and learns that the Janitor knows sign language. They are shocked when the father, also deaf, refuses a surgical implant that would allow his son to hear. After saying goodbye to Nurse Roberts, the Sacred Heart staff institutes some of her lessons into their lives. Though Carla thinks they've all forgotten, Dr. Cox takes time to reflect on his purpose; Elliot opens her heart to Keith; and J.D. and Turk learn compassion.