Family man Abel Plenkov (Raul Esparza), a sufferer of schizophrenia, accidentally discovers that he is the Riverton Ripper, a local, masked serial killer. After killing his pregnant wife, Sarah (Alexandra Wilson), and then his psychiatrist, he is shot down and carted away in an ambulance, leaving his young daughter Leah and premature son orphaned. On the way to the hospital, a paramedic (Danai Gurira) suggests that Plenkov himself is innocent but that he houses multiple souls, with the Ripper's being one of them. Near death, Plenkov unexpectedly revives, slashing the paramedic in the throat, causing the ambulance to crash and burn and seemingly escapes.