- “Look, I'm just a janitor. I don't know much, but I do know this: You need surgery.”— Janitor
"My Way or the Highway" is the twentieth episode of Scrubs’s first season. J.D. fights against Turk and Janitor, both of whom advise everyone to get surgery. Elliot discovers she has a crush on her patient Sean Kelly (Scott Foley). Dr. Cox is angry at Dr. Kelso for firing two nurses for no good reason.
J.D. is upset that Turk always wins the games they play — ankles, steak, toss a hat on Rowdy, or even running into the hospital's front door in the morning. In return, J.D. suggests playing "tip over the trash can" much to the annoyance of Janitor.
Dr. Cox chastises J.D. for not offering Mr. Hoffner a surgical consult, and J.D. brings Turk in to do the consult, with the assurance that Turk will agree with J.D.'s non-surgical recommendations. However, Turk advises Mr. Hoffner to get surgery. J.D. and Turk argue about the best course of treatment in front of the patient but in the end Mr. Hoffner opts for surgery. When J.D. goes to talk to Dr. Cox about Mr. Hoffner's decision, Dr. Cox doesn't have time to listen. J.D. then talks to Mr. Hoffner himself, who says he made the decision based on advice from other people, including Janitor. When J.D. tries to convince his next patient that he should go the medical route, the patient is persuaded by J.D.'s new confidence — and a thumbs-up from Janitor.
Elliot is immediately attracted to her new patient, Sean Kelly. She flirts with him on the cardiograph machine and finds out he is single. Later, she takes Carla aside and asks why Sean didn't ask her out, even though she told him she was single. Carla tells her to wait and see what happens, but immediately afterward Sean is released from the hospital. When Elliot dresses up to impress him, Laverne interrupts her for immediate help with a patient. When she is through she is covered in trash, including poop, which leads into an awkward conversation about poop with Sean. In the parking lot, Elliot chases after Sean but is splashed by a puddle. She tastes it to prove to Sean that it's not poop, and then pulls him in for a kiss and the two gleefully agree to go on a date.
Dr. Cox is really happy with the coffee made by a special nurse when Carla mentions that Dr. Kelso has just fired two other nurses. Dr. Cox tells Dr. Kelso it was wrong to fire two good nurses and in return, Dr. Kelso fires the coffee nurse, drawing Carla's blame to Dr. Cox for arguing with him. The nurses are upset about the extra workload and give Dr. Cox the cold shoulder. Dr. Cox eventually publicly apologies to Dr. Kelso who rehires coffee nurse. Kelso takes the public credit of being a generous boss. Cox is furious but decides to not fight Kelso on this topic any further.
- Scrubs Side Story: Surgeons and doctors sing a chorus as rivals (similar to West Side Story); J.D. and Turk sing to each other on a balcony, saying they are "a surgeon and a doc above it all". A scene toward the end of the episode shows Dr. Cox and Dr. Wen singing the same song to each other.
- J.D. and Turk continue their song, but Turk throws J.D. from the balcony and makes J.D. admit to being his "biatch".
- J.D. runs to tell on Turk—to Dr. Cox, dressed up to be J.D.'s father. Between sobs, J.D. tells him the story as Dr. Cox comforts him.
- All of J.D.'s patients in the ward, and a nurse, declare that they are having surgery. Turk then appears with a large knife and a large smile.
J.D. tips over a trash bin, prompting Janitor to knock J.D.'s pile of paperwork over in retaliation. Janitor spends the rest of the day convincing all of J.D.'s patients that they need surgery.
J.D.'s and Turk's games
- J.D. and Turk play several games, dubbed "J.D. and Turk's games" throughout the episode:
Episode running gags
- After Dr. Cox embarrasses Dr. Kelso, and then later when he apologizes for it, the interns look away out of fear, except for Doug, who can't bring himself to because he is too enthralled.
- Charles Chun as Dr. Wen
- Scott Foley as Sean Kelly
- Charles C. Stevenson Jr. as Patient
- Richard Wells as Patient (My Way or the Highway)
- Helen Siff as Female patient
- Katie O'Rourke as Nurse Patti (Coffee nurse)
- Fred Stoller as Mr. Hoffner
- Paige Peterson as Shelly
- "Above It All" (a.k.a. "Scrubs Side Story"), performed by the cast
- “You're damn right I'm competitive. See, that's what makes me a good doctor—I want to win at everything every day, and you should, too.”— Turk
- “I love to poop.”— Sean
- “Oh my God, I can't believe I talked to Sean for ten minutes about poop.”— Elliot
- “He doesn't know that I cry sometimes because I'm not sure if there's a cat heaven.”— Carla
- First appearance of games that Turk and J.D. play: The First One to Throw the Hat on Rowdy, Steak, and Ankles.
- First notable appearance of Coleman Slawski, even though he only briefly appeared and without any speaking lines.
- When Turk wins Steak, there is actually a lot of steak left on his plate.
- First appearance of Sean Kelly.
- Scott Foley's Sean Kelly is one of only two male characters to receive the slow-mo intro, along with Dr. Matthews in "Her Story II".
- Carla reveals that she has had sex with patients "tons of times".
- Mr. Hoffner returns in "My Drive-By" to have his gallbladder removed.
- Mr. Hoffner and some other patients directly acknowledge Janitor, contrary to the Season One's idea of Janitor being a figment of J.D.'s imagination.
- Elliot demonstrates her gymnastic abilities (such as doing a split), which she demonstrates again in later episodes.
- When J.D. calls Turk "Benedict", he is referring to Benedict Arnold, who fought for American independence from the British Empire as a general in the Continental Army until he obtained command of the American fort at West Point, New York. He then switched sides, joining the British Empire.
- The fantasy where the surgical and medical interns dance is an allusion to West Side Story, in which there is an ongoing fight between Italian and Puerto Rican gangs to control the streets of New York. The opening scene of the movie shows the gangs walking/dancing toward each other with similar music.