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.

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 conclusion that Dr. Patel pushes back against. A startling update on Thomas from an unlikely source prompts Dominick to take drastic action.