Wise to Sawyer's plans to escape, the Others pull him from his cage and bring him to an operating theater. Sawyer awakes and sees a bandage on his chest. Benjamin tells him they've implanted a pacemaker. If Sawyer's pulse races beyond a certain point, his heart will explode. This should put a stop to any fighting with guards and planning to escape. Benjamin says the Others will perform the same operation on Kate if necessary.
Sawyer is returned to his cage and Kate questions why he's given up escaping.
Meanwhile, the Others force Jack to operate on their member Colleen, who was shot by Sun. Working in primitive conditions and doing his best, Jack is unable to save her.
Picket, Colleen's boyfriend (husband?) becomes enraged and vows to get revenge on the passengers. He beats up Sawyer in retribution but stops short of killing him.
In flashback, we see Sawyer in prison. His sentence is cut short when he informs on another prisoner. He also learns he has a baby daugher, but is determined not to become part of her life.
At episode's end, Benjamin takes Sawyer up on a rise to look over the ocean. Sawyer sees that he, Kate and Jack are being kept on a different island from the one their fellow passengers are on. He sees escape would be more difficult than he'd imagined. Benjamin tells Sawyer that the pacemaker operation was a sham to keep him in line. The Others conned the con man--the only way to earn his respect.
Clues, observations, speculation:
* Desmond sees the future again and erects a makeshift lightning rod from a golf club, which keeps Claire and Charlie from getting zapped.
* The Others say Colleen and her crew are back on the "sub." Do they really have a submarine?
* Juliet tells Jack she's a fertility expert. Does this have something to do with the Others and their weirdness with children, i.e. Claire's baby, Walt, the child passengers that were abducted? Speaking of which, where are the kids we saw last season? Are they with Benjamin's group or some other Others?
* In the operating room, Jack spies x-ray images on the wall. They show a tumor on someone's spine. Later he confronts Juliet about this. He's a spinal surgeon, so who did they bring him there to operate on? Is it Benjamin? Is this the "one thing" he asked Jack to do for him (in episode 2 this season) in exchange for freedom?
* Sawyer is seen reading "Of Mice and Men" and later quotes from the book, as does Benjamin.
* Is the Others' island Pala Island? Last season they mentioned the Pala Ferry? Could this refer to the sub? Why can't the crash survivors see this island from where they are?
* Tom, aka "Mr. Friendly," tells Benjamin "Since the sky turned purple 2 days ago, I haven't been able to re-establish the comms." Who are they communicating to? How are they blind? And is this a reference to the whiteout caused by the Hatch implosion?