Karl is called up to Seattle where he is reunited with twisted serial killer Tommy Cummins. With the hopes of finally bringing closure to the families of Tommy's victims, Karl must piece together his sick puzzles. Back in Gibsons, Cassandra deals with council conflicts and an unexpected visit from her mother while the police squad struggles when one of their own is missing.
After receiving tragic news, Jake refuses to give up on a beloved patient, landing himself in conflict with several Westside surgeons and when Amy's neuro tests elicit memories of Danny, she pushes herself too far. Also, TJ and Sonya treat Dr. Peter Douglas for a painful condition and learn more about him than they ever wanted to know.