Larrity is at the doctor's office, where the doctor tells him that his syphilis has cleared up, but then diagnoses him with butthole cancer, a disease which affects 99% of CEOs and 100% of politicians at some point in their lives. To prevent him from dying, the doctor suggests they remove his butthole before the cancer can spread. Larrity agrees, wondering what the big deal is, and asks if their are any side effects, but the scene changes before the doctor has a chance to answer.
Back at GameAVision, Larrity is surprisingly nice to everyone, going out of his way to compliment employees, and even buys a kimono for Clarence ("with the patch in the back for easy access"). He eventually realizes that, without his anus, he has become soft. He gathers the staff in the pitch room, with a hospital drip filled with a rage drug hooked up to his butthole, and asks someone to donate their anus, offering a "certificate of appreciation, worth four percent of [his] respect" to the first person to volunteer. Clarence volunteers, but Larrity turns him down. He notices an Asian non-employee, who Todd introduces as Ping, and that he
bought married her.
Larrity jumps to the top of the donor list, and the doctor offers to give him the buttocks of a black woman. As he walks back to GameAVision, various construction workers whistle at him, confusing his donated butt for a legitimate one.
Back at GameAVision, Larrity is still surprisingly nice, until Dave starts stacking things on his abnormally large butt. Black Steve enters with his new stereo system, playing a new song by MWA (Motherf***er With an Attitude). Larrity starts dancing uncontrollably, prompting Dave to remark that the butt has a mind of its own. Dean tries to turn off the stereo, but can't because things with more than one button confuse him.
Later on, Larrity starts getting sick again. After being rushed to the hospital, the Doctor claims that his body has rejected his new ass. Dave's ass is taken from him (which incidentally has Herpes), and Dave gets the ass of a new cheerleader. Dave is excited, thinking he can now fondle himself as the episode ends.
- In Todd's fantasy where both he and Larrity die, Dave performs a Norse Funeral which was practiced by Viking age Scandinavians.
- Ebony & Ivory, which appears on the headline when Larrity promotes Black Steve is a number one single performed by Paul McCartney and Stevie Wonder in 1982.
- Wookie in a Wheelchair from the episode E.T. is seen in the waiting room when Larrity returns to receive his Big Black Ass.
- Dean rides Falkor from The Neverending Story in his "dragon dream" about Larrity dying.
- Dr. Asshat's video explaining Larrity's diagnosis is a nod to Pac-Man.
- The artist that did the song Larrity dances to in the episode is called M.F.W.A. This is most likely a reference to gangsta rap group N.W.A, which was popular in the late 80s and early 90s, best known for their album Straight Outta Compton.