Dana's former beauty queen patient doesn't think her husband finds her attractive and insists on having extensive plastic surgery. Dana refuses to perform the surgery but when Terri Ann lands in the ER, she begins to doubt her decision. Peter tries to figure out why a transvestal is having side effects of menopause and counsels Marc about one of the stickier issues of adolescence. Lu and Lana try to find an appropriate punishment for two young teenagers who spray graffiti outside the hospital.