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A strain of Russian flu sweeps through Cicely, and Joel (Rob Morrow) finds himself overwhelmed by the patient turnout. As it develops, the most effective cure for the flu is nurse Marilyn's (Elaine Miles) homemade Eskimo herbal medicine, "Hi-oh-hi-oh-ipsinio" -- which unfortunately stinks to high heaven. The epidemic not only takes a toll on Joel's time and talent but also his love life: his New York fiancée, Elaine Schulman (Jessica Lundy), has just arrived in town. The many references to David Lynch's Twin Peaks in this episode were part of an elaborate joke perpetrated by the producers of Northern Exposure upon the editors of TV Guide. (You had to be there.)