After the events of Discord's game, Spike is taken to a mental asylum. He was considered to dangerous to be around for the time being. As such, Twilight and her friends are working to get him out. Meanwhile, Celestia and Luna are wondering if he should be freed.

As for the Cutie Mark Crusaders, they're taken there to talk to a psychiatrist about what they had witnessed in Discord's game. While they're there, they see someone they never thought they'd see.

Meanwhile, Spike is taking Pinkamena's words to heart and debating whether or not he should expose the hypocrisy of the Princesses of Equestria.

1/12/19: This particular portion of the story is complete. There will be a fourth part in the future. (Sadness is Universal, A Fun Little Game, and Patients are all connected.)