The BAU is called in when a man is found in a hotel room bathtub with his kidney removed and Graham must determine whether this is the act of an organ harvester or if the Chesapeake Ripper has claimed his first victim in two years. Meanwhile, Crawford continues to be haunted by the discovery of Miriam Lass's arm. Dr. Bloom suspects that Crawford has become obsessed with catching the Ripper, and is putting Graham in danger by making him chase the Ripper. Lecter murders a medical examiner who once treated him rudely and removes his heart. When his body is found displayed on a bus, Graham becomes convinced that the latest victim was the work of the real Ripper, while the first was not. Lecter takes another four victims and harvests their organs for use in a dinner party. Through hotel security footage, the BAU team discovers that the organ harvester is a part-time paramedic, Devon Silvestri, who aspires to be a doctor. They track his ambulance in time to save the life of his latest victim, but his arrest solidifies Graham's opinion that there is only one Chesapeake Ripper, who was responsible for all of the murders except the first.