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"My Number One Doctor"

...And this is the Scrubs we've seen a little too much of, of late...good enough to watch, but only intermittently or fitfully funny, and perhaps not quite seemlessly mixing the frequent tragedy of medical life with the various sorts of comedy offered up.

A recap can be pretty quick on this episode, since the A, B, and C plotlines are pretty thin in outline: Elliot faces an ethical dilemma when she learns that one of her private-practice patients, dying of ALS, has landed in the hospital in a suicide attempt; Elliot is unsure as to whether to make the authorities and her patient's home-healthcare nurse aware of this, or to allow the patient to die on her own terms. JD suggests she should tell, for no better reason than that Elliot tends to let such things get under her skin; by episode's end, Elliot has decided to keep her patient's secret, having accidentally let the dying woman know how more effectively to drug herself to death. Meanwhile, JD, having discovered how insanely competitive Turk and Cox are, gloats when RateMyDoctor.org, which Kelso has just signed Sacred Heart Hospital with, consistently shows JD as the most popular of the hospital's doctors; they temporarily sabotage his rankings by having the Todd claim to be JD with his patients. And Carla, seeing the Janitor with his womanfriend Lady, named by her parents after the Disney cartoon dog, gets to know Lady slightly (and discovers that she is surprisingly normal-seeming) and then urges the Janitor to reveal his true nature to her, against Kelso's warning. When Lady can't believe the litany of eccentricity the Janitor spews about himself, Carla steps in to suggest that he's joking, much to Lady's relief; Carla then warns the Janitor to spill just a little of his craziness at a time.

Best (apparent) Neil Flynn improvisation in the episode: during his self-revelation to Lady, the Janitor notes that he doesn't "believe in the Moon." It's just the back of the Sun, don'cha know.

Least convincing aspect/dilemma: Well, perhaps I can buy the healthy-looking, spunky Lou Gehrig's disease sufferer...it helps make the point that she is about to lose all her physical faculties, and she is, after all, portrayed by a television actress of the typically pretty and slender sort (not quite model-anorectic, but close)...but Elliot's hang-wringing over her decision to end her life intentionally, a month or three before the disease would kill her anyway, didn't ring true for me. I'm reminded of a discussion I saw once of a M*A*S*H episode, wherein the doctors in the the episode anguish over removing the healthy appendix of a foolhardy frontline officer, to put him out of commission temporarily so that he wouldn't endanger more of his men. The writers and actors heard from their advisors after the episode aired that unlike the characters in the episode, real Army veteran doctors wouldn't've missed any sleep over performing such medically unnecessary but almost harmless surgery for the greater good. Elliot's crisis, such as it is, is a considerably lesser one. (And this is an example, folks who like to suggest that Scrubs is just a frothy clown show, of how it actually isn't...even if this isn't the best example of how the series has tackled some thorny issues.)

4th Wall Breaking: As commenters Jayhawk and SemperSF allude to below, there's a sequence in which the characters are apparently reacting to, and perhaps actually name-checking, some of their favorite online commentators on the series. An amusingly pomo touch.
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