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How bad is solitary confinement that a prison inmate would swallow a razor blade in order to take a "field trip" to the hospital? And how do prison inmates acquire razor blades in the first place?
The latter question is never addressed, but Constance Ferguson, a convicted murderer and loudmouth to boot, swallowed four of them and finds herself in the care of unsympathetic Dr. Yang. After Cristina helps Dr. Bailey perform surgery to remove them, Constance ups the ante by swallowing a light bulb. Dr. Burke rushes in to save the day, and Cristina finally feels a shred of sorrow for the troubled woman, deciding to keep her under observation and allowing her to extend her stay at SGH for two weeks.
Alex is chastised a second time by Derek for his mismanagement of Robert Martin, the patient he gave an incorrect dosage of medication to, and whose brain stopped functioning as a result. And that's nothing compared to the wrath Dr. Karev receives from Izzie, livid at his cheating with Olivia. A failure in all aspects of life (at least at present), Alex is emotionally distraught but insists on staying by Mr. Martin's side, even if he stands little to no hope of recovery.
Meanwhile, the interns all keep careful watch on the family of premature quintuplets born with a variety of serious health challenges. Their mother, Dory, suffers postpartum depression and is unable to face the reality of possibly losing multiple children. Seeing the degree to which Izzie becomes attached to her patients (foreshadowing, to say the least), Addison decides to teach her a very painful lesson.
Which Richard's blessing, Addison leaves Izzie in charge of one quint with no chance of survival, effectively setting her up to fail. Addison learned the same lesson from Richard back in the day, and believes it helped her become a better surgeon as a result. After desperately and exhaustively treating the premature baby through the night, Izzie falls asleep and awakes to learn that it died on her watch.
All is not lost, however, as Meredith and Dr. Bailey are able to save the lives of four out of five quints (we think).