A psychiatrist interviews Gacy, revealing disturbing details about his past; Tovar and Kozenczak confront the dark truths of the systemic failures that allowed Gacy to kill for so long; a love story unfolds between Billy Kindred and Maryjane.

In the past, an inebriated Gacy confesses to Sam the ways he groomed, sexually assaulted, tortured and killed countless boys and young men.