After Thomas Birdsey, who has schizophrenia, has a violent breakdown, his twin Dominick finds himself stepping up to defend Thomas in unexpected ways. Dominick reflects on their childhood growing up under the tyrannical rule of their stepfather.

Tensions arise between Dominick and his girlfriend Joy as the media take an interest in Thomas' case; Dominick finds a potential ally in social worker Lisa Sheffer but clashes with Thomas' psychiatrist Dr Patel.

Lisa Sheffer preps Dominick for a hearing with Hatch's review board that could decide Thomas' fate; an encounter with an old classmate brings painful childhood memories to the surface; Dominick reflects on his and Thomas' time together at college.

Dominick returns to work before fully recovering from his accident; heavily medicated, Dominick recalls the disturbing incident that lead to Thomas' first hospitalisation while counting down the hours to Thomas' hearing with the Hatch review board.

Dominick learns the details of his Sicilian grandfather's arrival to Three Rivers in the early 1900s, and becomes convinced his family is cursed; a startling update about Thomas from an unlikely source prompts Dominick to take drastic action.

A lifetime of animosity between Dominick and Ray erupts in public at an inopportune time; Dominick seeks reconciliation with those he's hurt after an unexpected tragedy; Dominick gets answers.