After three episodes of talking about Sophia’s condition in SHU, we finally get to see it for ourselves for the first time. Without access to her hormone medication, Sophia’s voice is notably deeper, and she’s shed her normal weave as well. She begs to speak to Caputo, but is rebuffed, so she shoves her meal down her toilet with a towel in order to flood her cell.
Things are looking grim for Sophia, but Judy King seems to be having the time of her life in prison. She’s continuing to bond with Luschek, this time over comic books. When Healy sees the guard and inmate getting along so well, he very awkwardly tries to insert himself in the posse, but his severe lack of interpersonal skills leads him to make a lame joke about mucus. As he walks away from them, he hears Luschek call him Doctor Psycho, a Wonder Woman villain known for his hatred of women.
To shed some insight on Healy, we get some flashbacks to his pre-Litchfield life. We’ve already seen bits of his childhood earlier in the series, revealing that his mother had mental issues, and now we see more of that. Young Healy asks his father what’s wrong with his hospitalized mother, and he tells his son that she hears and sees things that aren’t really there, which seems to suggest schizophrenia. To treat it, Mrs. Healy has been undergoing electroshock therapy, but a bit later, she confides in her son that she is going to stop receiving the treatment because it’s making her unhappy. When her son tells her he doesn’t want her to stop the therapy, she runs away into the night.
Another woman set to make her escape soon is Aleida; her parole officer surprises her with the news that she’s up for early release due to good behavior. Initially, the news agitates the mother, who unloads all of her worries about not being able to get a job or regain custody of her children to Gloria, but her friend gives her a motivational speech that excites Aleida for her release. Daya is overjoyed to hear her mother is getting out too, because it means that someone will be looking after her daughter Amaria.
Oh, by the way, remember how Frieda told Alex that she wants to kill Lolly in the last episode? Yeah, Alex hasn’t forgotten either, and she brings Red in to help her come up with a plan to stop another murder from happening. Red calls all three of the women together for a “summit” to deal with the situation openly, but Lolly quickly goes off on a massive, paranoid rant about drones, the NSA, and a secret Las Vegas killing base. In the end, Red is forced to agree with Frieda: “We have to kill her.”
And Piper’s having her own issues with another inmate: Maria. When Piper confronts her about her friend (new inmate Ouija) taking panty fabric from the sewing room, Maria confirms that she is starting her own rival panty business. This freaks Piper out, and she has her Hawaiian bunkmate-turned-bodyguard tackle Ouija and steal her fabric. Maria responds by persuading Maritza and Flaca to leave Piper’s business and work for her instead. “I don’t want to start a war with you,” Piper says, confronting Maria. “This isn’t war; this is business,” Maria shoots back.
The real war is occurring in SHU, where Sophia’s flooding plan has finally gotten Caputo down to visit her cell. She demands to speak to her wife, and Caputo tells her that he’s already spoken with Crystal, but lies and says that she agrees with him that they need to wait until the right time to reintroduce Sophia to the prison’s general population. He then has Sophia moved to a new cell and leaves. Since water didn’t work, Sophia next turns to fire — she bursts a lightbulb and uses the heat to set her bed aflame, which causes all of SHU to be evacuated, including Nicky Nichols, whom we see for the first time since she was taken away last season.
Back in the general population at Litchfield, Healy has come up with the idea to let Judy King teach a cooking class for her fellow inmates, which is probably mostly a jealous attempt to limit her time hanging out with Luschek. Judy actually declines to teach the class, saying that she wants some respite from that life, but Healy forces her to do it. The class winds up going very well — Judy teaches the women how to make Filipino-style cornbread, and Caputo says that it’s the most well-attended course Litchfield has offered. Unfortunately for Healy, Caputo also delivers the news that Judy wants to drop him as a counselor.
In a flashback, we see Healy as an adult, and he sees a homeless woman that he believes to be his mother on the side of the street. He takes her to a restaurant and apologizes for not being there for her when she needed his support, but then notices her hospital bracelet says her name is Ellen, not Margaret, and she runs out of the restaurant.
Healy may have not gotten the closure he wanted, but Pennsatucky is finally coming forward about Coates’ sexual assault. Noticing that she’s been avoiding him, Coates asks Pennsatucky what’s been going on. After she asks, he tells her that he hasn’t had sex with Maritza, and she shyly says, “Just wanted to make sure you weren’t raping her, is all.” This stuns Coates, and he defends himself by saying that he didn’t rape Pennsatucky due to the fact that he loves her, but the inmate responds that it felt no different from rape, and walks away.
Finally, the climax of the episode comes when Lolly has a full-on psychotic break in the garden, thrashing around and screaming on the ground. Before Alex can get her to calm down, Piscatella notices and has her brought to the psych ward. While being escorted down the hallway, an agitated Lolly screams out “They’re going to electrocute me!” — which grabs Healy’s attention. Clearly seeing his mother in Lolly, Healy steps in and says he will counsel Lolly rather than having her sent to psych. In their session, Lolly actually reveals everything about the murdered hitman buried in the garden, but Healy assigns it to being part of her delusions and even convinces her that the murder only took place in her mind. Lolly leaves Healy’s office fully convinced that she imagined the whole murder, and apologizes to Alex for all the trouble her mental delusion has caused. Well, that certainly seems to have worked itself out!