Beth wakes up on a hospital bed with her arm in a cast and sutures on her cheek. She gets up and looks out the window, and finds herself in Atlanta. Beth bangs the door, asking for help. Someone opens the door, and Beth steps back. A doctor and a female cop enter the room and introduce themselves as Dr. Steven Edwards and Officer Dawn Lerner. They tell Beth that she is in Grady Memorial Hospital in Atlanta and she was found on the road, wrist broken and was alone when they found her (possibly contradicting what truly happened when she was abducted). In an ominous tone, Dawn tells Beth, "You owe us."
Beth accompanies Steven as he makes his rounds. His first stop is a man they found under a bridge. He unceremoniously pulls the plug and stabs his brain. He explains that resources are scarce; if a patient doesn't improve almost immediately, they have to cut them off. They take the body for disposal. "Come on, the body’s getting cold," Dawn says. They take the body and drop it down an elevator shaft to the basement. Steven explains that if the body is still warm, the rotters will take care of most of it.
When Beth gets food from the designated eating area, she runs into Gorman, who states that he was the one who found and saved her. He reminds her that everything costs something as she gets her food and suggests that she be a bit friendlier. On her way to the Dr. Edwards' office, Beth passes Dawn’s office and hears Dawn lecture Noah about how to do her laundry. "If you’re safe enough to be bored, you’re lucky," Beth tells Dr. Edwards when he complains about his job.
A new patient is whisked in, Gavin Trevitt, who fell from a second floor window. The officer who brings him in whispers to Dawn, who suddenly becomes much more involved. Dr. Edwards says that it’s a losing battle but Dawn insists that he try anyway. Things aren't looking good. The doctor shows Dawn his bruised stomach and that he is suffering from too much internal bleeding. When the doctor delivers the bad news, Dawn lashes out and slaps Beth, reopening her sutured cheek. Dawn tells the doctor "See? Try to grasp the stakes here."
Dr. Edwards re-stitches Beth’s cheek and leaves so she can put on a fresh shirt that Noah left for her. She finds a lollipop in the pocket and smiles. Beth and Dr Edwards are called to a patient down the hall and finds a woman, Joan, who's been bitten. Her arm has to be amputated but she refuses treatment and was caught trying to leave the hospital. Beth is forced to help hold her down while the doctors saw her arm off.
Beth goes to the laundry room with her bloody clothes and meets Noah, who left her the lollipop. Beth wonders why Joan would try to escape and why couldn't she just work off her debt and leave. Noah informs her that they tend to save people that are weak and unable to fight. They save them and force them to stay until they've worked off their debt, he implies that people don't actually get to leave. Noah states that he was from a walled community in Richmond, Virginia, and he's taking off when he gets the chance.
Dawn brings Beth some food and Beth tells her she's not staying any longer than they make her. Dawn tries to sell her on staying at the hospital. She thinks that the world will return to normal and it's important to keep safety and order. "Try to look at the good we're doing." she tells Beth. Beth eats the food but doesn't seem to change her decision to leave.
Beth hums to herself as she mops up blood in newly-amputated Joan's room as Joan wakes up. She tells Beth that Dawn could control her men, but she doesn't because it's easier. She refuses to tell Beth what they did to her and tells her, "It doesn't matter. I guess it's easier to make a deal with the devil when you're not the one paying the price."
Back in her room, Beth looks for her lollipop under the mattress. Officer Gorman walks in with it in his mouth. "Lost something?" He offers Beth a taste and forcefully pushes it in her mouth. Dr. Edwards comes in before the situation escalates. "Girl should've been mine," Gorman says. Dr. Edwards challenges him on this and on his "ownership" of Joan, telling him that no one belongs to him. Dawn comes by and Gorman threatens the doctor by saying Dawn won't always be in charge. When they all leave, Beth asks the doctor why he stays. In response, he takes her to the ground floor.
He bangs on the metal shutters with a pipe. Walkers immediately attack. He explains how it would be nearly impossible to leave with the city the way it is. They head up to the roof and Edwards tells her how it all started, with Atlanta destroyed, they started to trade care for service. The man in charge, Hanson, started to crack and got people killed. Dawn "took care of him" and kept them safe. "As bad as it gets, it's still better than down there."
Dr. Edwards tells Beth to check on Mr. Trevitt and instructs her to give him 75mg of Clozapine (an anti-psychotic). Beth goes down and injects it. Noah stops by just as Trevitt starts to seize and flat-lines. Lerner comes in and stabs the dead man in the head, ordering for his body to be removed. When Dawn demands to know what happened, Noah takes the blame, saying he accidentally unplugged the ventilator. Dawn tells an officer to take Noah to her office. When Beth tries to explain what happened to Dr. Edwards, he says, "You gave him Clonazepam (a different drug, a sedative), right?" Beth is confused and hears Noah being beaten in the other room. Edwards tells her that she gave him the wrong medicine and that the overdose killed him.
Later, Dawn comes to Beth's room. She knows that Noah didn't unplug the ventilator. She says she had to beat Noah for his dishonesty and to keep him in line. She proceeds to tell Beth that she isn't the greater good and hence isn't keeping her worth. "The wards keep my officers happy. The happier my officers are, the harder they work to keep us going." Beth goes to see Noah, who had sustained a laceration on the eyebrow and a black eye. He says that "it's not as bad as it looks". He tells her that he knows that Trevitt was important to Dawn for some reason. Beth says she'll leave with him. He tells Beth that he'll distract Dawn while she makes a play for her spare elevator key.
When they get their chance, Beth goes through Dawn's drawers. She finds a wallet and finds an ID with St. Ignatius Hospital on the back. Then she looks over and finds the body of Joan on the floor. It is revealed that she killed herself by opening up the sutures on her amputation and bleeding out. The words "Fuck you" are written in front of Joan in her own blood, where she directed her final message to Gorman.
Ignoring the body, she finds the spare key in a drawer just as Gorman walks in. He offers to keep quiet if Beth will be "friendly". Beth looks over and sees Joan reanimating. She pretends to go along with Gorman and then smashes a jar (of lollipops) on his head, knocking him to the ground where he's bitten in the jugular by Joan. Beth grabs his gun and runs.
When she sees Dawn in the hallway, Beth tells her that Joan was looking for her and that she saw her and Gorman heading toward her office. Noah and Beth make a break for the elevator shaft while screams echo from Dawn's office. Noah lowers Beth down the shaft on a makeshift rope. As he climbs down the rope after her, a walker reaches through some partially open elevator doors. He falls into the pile of bodies at the bottom of the shaft. Beth jumps down after him.
Noah's leg is injured, but he can limp. They fight their way out of the basement into the parking lot and run past several vehicles with a white cross on the back window (implying that it was the hospital "crew" all along that took Beth). More walkers on the other side of the fence arrive. They climb through and Beth fights walkers while Noah squeezes through a gate on the other side. Beth, having been slowed down by walkers, is tackled by Officer O'Donnell. As she's wrestled to the ground, she sees Noah escaping and smiles.
Dawn dresses down Beth in her office with Gorman's body still on the floor. Beth pleads self defense. She accuses Dawn of letting these things happen. Dawn says she has to, but Beth declares "No one's coming, Dawn. We're all going to die and you let this happen for nothing." Dawn looks at the floor and sees a shattered picture of her and Hanson before lashing out at Beth again and knocking her out.
Later, Dr. Edwards is seen examining Beth's new forehead sutures. As he leaves the room, Beth confronts him, "How did you know Trevitt was a doctor?" Edwards pauses at this, and Beth continues: "That's why you had me give him the wrong meds, right? Why you had me kill him? 'Cause if he had lived there'd be another doctor and Dawn wouldn't need you." Dr Edwards admits that Trevitt was a doctor at St Ignatius (presumably it was Trevitt's St Ignatius ID card that Beth found in Dawn's office). He says they would have kicked him out or had him killed. He states, "When they arrested Christ, Peter denied being one of his disciples. He didn't have a choice, they would have crucified him too."
He leaves the room. Beth picks up a pair of scissors and follows him- very angry- down the hallway. She's clearly meaning to harm him - only pausing when she sees an unconscious Carol being brought in on a stretcher.
- Timothy Scott as Gavin Trevitt
- Amber Dawn Fox as Officer Bello
- Jarod Thompson as Officer Tanaka
- Sammy Hadid as Officer Alvarado
- Kent Wagner as "Dying Man"
- Unknown as Jeffries
- Unknown as Hanson
- Chris Harrelson as Walker
- First appearance of Grady Memorial Hospital.
- First appearance of Dawn Lerner.
- First appearance of Steven Edwards.
- First appearance of Tanaka.
- First appearance of Alvarado.
- First appearance of Noah.
- First appearance of O'Donnell.
- First appearance of Amanda Shepherd.
- First appearance of Bello.
- First (and last) appearance of Gorman.
- First (and last) appearance of Joan. (Alive and Zombified)
- First (and last) appearance of Gavin Trevitt.
- First (and last) appearance of Jeffries.
- First (and last) appearance of the Dying Man.
- This episode marks the return of Beth Greene since her disappearance in "Alone".
- This episode marks the first appearance of Atlanta since Season 2.
- This is the first episode Micheal Cudlitz, Josh McDermitt, Christian Serratos, Alanna Masterson and Seth Gilliam are credited in an episode, but they do not appear in.
- Beth is the only main character and member of Rick's group to feature lines in this episode.
- Slabtown or Slab Town was a red-light district established in Atlanta in the 1840s, and located off Decatur Street (on the present site of the Grady Memorial Hospital).
- The painting in Dr. Steven Edwards' room is The Denial of Saint Peter by Caravaggio.
- The clock in Beth's room when she first wakes up reads 5:04 pm-foreshadowing the episode number: 504.
- This is the first episode of Season 5 to feature songs:
- When Joan's body is discovered, the words "(F)uck You" can be distinctively seen where her left hand is.
- This is one of the ten episodes Rick Grimes does not appear in.
- As Beth backs away from the door shortly after waking up, she grabs the IV pole with her left hand, however when the camera switches to the front of her, she is holding it with her right hand.
- When Beth is looking for a key in Officer Dawn's office, she encounters Joan lying dead in the office from bleeding out, apparently from suicide with a pair of surgical scissors. Her left hand is covered in blood. But when Officer Gorman enters the room and Joan starts to turn into a walker, the blood on her hand has disappeared.
- When Gorman is killed his face is covered in blood, but when Dawn is having an argument with Beth in her office for helping Noah escape, Gorman's face isn't covered in any blood at all when it should be.