Sheffer preps Dominick for a pivotal hearing with Hatch’s review board that could decide Thomas’ fate. A chance encounter with an old classmate brings painful childhood memories to the surface. Dominick reflects on his and Thomas’ time together at college, during which he met Dessa and the signs of his brother’s illness first began to manifest. Joy attempts to remedy the problems in her and Dominick’s relationship.

Despite the protestations of those closest to him, Dominick returns to work before fully recovering from his accident. Heavily medicated, Dominick recalls the disturbing incident that lead to Thomas’ first hospitalization while counting down the hours to Thomas’ hearing with the Hatch review board.

Upon learning the details of his Sicilian grandfather's arrival in the early 1900s to Three Rivers, Dominick becomes convinced his family is cursed. A startling update on Thomas from an unlikely source prompts Dominick to take drastic action.

A lifetime of animosity between Dominick and Ray spills over in public at an inopportune time. After an unexpected tragedy, Dominick seeks reconciliation with those he has hurt. Series finale.