When a boy's mutilated body is found on a bridge, alienist Dr. Kreizler notices similarities to an unsolved murder involving a former patient of his.
Giorgio's brother shares with Sara a revealing comment the police made to his family. Kreizler calls a team meeting. John investigates at the brothel.
Sally helps Kreizler better understand the victims' relationship to the killer. When another body is found, Sara notices its location fits a pattern.
Kreizler visits a former patient to get inside a sadist's mind. John develops a theory about the silver smile. Mrs. Santorelli gets a horrific letter.
A detail in the letter leads Kreizler to the date of the next murder. Roosevelt learns of Willem Van Bergen and takes matters into his own hands.
Hoping to lure the killer, the team uses Stevie as bait. Sara catches Kreizler in a strange lie and confronts him. Connor learns Willem is on the run.
Mutilations on the latest body suggest the killer may be linked to the Old West. Kreizler is forced to rethink how he treats those in his household.
At St. Elizabeths, Kreizler and John learn of a soldier fitting their profile. Hearing their news, Sara visits the suspect's hometown in upstate N.Y.
As Cyrus plans to get revenge against Connor, Sara takes the team to the Census Bureau, where they get a lead on their suspect's whereabouts.
When Joseph goes missing, John fears the worst and pours his heart out to Sara. Kreizler and Sara share past traumas. Kreizler confronts the killer.