You better see this episode from the beginning, because if you start to watch it any later, you will be confused as to what is happening to Clark's life.

Yet, that is the twist; Clark is stuck in an alternate reality. Lana is devoted to him. Lex lost most of his legs and is in a wheelchair due to the bridge accident when he swerved to miss Clark in the pilot of the series. Martha is married to Lionel. About the only constant is his most loyal friend Chloe, who still believes in who he is. And, oh yeah, he doesn't have any superpowers. He is in a mental institution for putting himself in a fantasy world where he does have powers, and is ridiculed for believing so. Aside from Chloe, there is one mysterious figure who believes in Clark: a black man who in the alternate reality is also a resident of the institution, who believes he is from Mars.

Clark must stay true to everything he believes is actual reality, and not get brainwashed by the institution's psychiatrist, who is in fact the fourth Phantom Zone escapee.

This episode is utterly mind-blowing and shocking. Plus, it provides a fresh twist from the usual type of "Smallville" episode.
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[2].