Three generations of Alvarezes--all prisoners at Oz--are united when the partiarch, Ricardo, is found face down in his cell, suffering from Alzheimer's disease. Meanwhile, Tobias Beecher, who as the neo-Nazi Schillinger's "girlfriend" has been forced to wear women's clothes, flips out after taking PCP and sends Schillinger to the hospital with an eye cut. Other inmates aren't exactly the picture of health, either. Mob boss Schibetta has stomach pains caused by ground glass intentionally mixed in with his food, and Muslim leader Kareem Said has a heart attack after refusing to take medication for high blood pressure.

Schilinger enlists Said to get him out of jail, but Said backs out. McManus decides not to incriminate Wittlesey in Ross's death. A recovered Schibetta edures more pain after being raped by Adebisi. Meanwhile, Alvarez is bumped out of the Latino power seat by Raoul Hernandez, a.k.a. El Cid. New inmate Jiggy Walker claims he was Gov. Devlin's personal crack dealer. The two go head-to-head in the media before Walker is discredited and sent to genpop. Reimondo finds out that Giles murdered the man who killed her husband and Dr. Nathan confronts O'Reily about her husband's death. Schillinger's plan to destroy Beecher approaches fruition when Beecher falls in love with Keller.