The FBI is still in hot pursuit of the Chesapeake Ripper, but he a new murder confounds them. They can't figure out whether the Ripper really would kill a man for his kidney in a hotel room like a sub-plot to a really bad episode of Vegas. Graham is convinced it's not the Ripper, but other members on the team think it could be. When Graham passes along details of the murder to Lecter during one of their informal "conversations" (read: not therapy sessions) Hannibal Lecter knows what he has to do. To prove that he is not nearly that sloppy, Lecter, a.k.a. the man we know to be the real Chesapeake Ripper, goes on a killing spree, pulling names out of his Rolodex and pulling organs out of his victims. Unsurprisingly, Lecter also starts hosting dinner parties again, serving up an awful lot of offal to his unsuspecting and grateful dinner guests.
Crawford is becoming increasingly unsettled, although nightmares seem like a natural reaction to having his former trainee's arm call you repeatedly before waiting for him at an observatory like a grisly version of Sleepless in Seattle. Graham warns him not to fall into the Ripper's trap, but it's clearly too late for the G-man.
Amid all his dinner party prep, Lecter takes the time to befriend Dr. Alana Bloom even giving her some of his special homebrew. It's not clear whether the secret ingredient is body parts, but it could be! Lecter may be wooing Bloom, but he may also be trying to dig for information on Graham and the various murder investigations. We also find out that Lecter has his own psychiatrist, played by Gillian Anderson, although it must be said that she must not be a very good therapist because she doesn't seem to notice that Lecter is a full on psycho.
As the bodies pile up, Crawford finally has an idea about the killer. He tracks down an ambulance driver who wants to be a doctor. Sure enough the guy has been making some extra moolah by extracting organs for impatient people in need of new body parts. The FBI nabs the guy while he is elbow deep in a victim and Hannibal is forced to jump in and save the man's life.
William Graham is teaching a class on the Chesapeake Ripper at the FBI Academy. As he counts down the Ripper's victims and the gory details of their murders, he notices Jack Crawford in the corner watching and listening. Without missing a beat, he details the execution of Miriam. She was Crawford's young recruit who Lecter killed while she was investigating the Ripper's crimes many years ago. Graham reminds us - and his class - that the only evidence of the crime they ever found was the detached arm that the Ripper left for them just last week.
In summation Graham notes that the killer has remained consistently theatric. As if the show was capable of poking fun at itself, the camera cuts to a shot of someone's vocal chords singing opera. Of course Hannibal Lecter enjoys the opera. All classy serial killers (and my grandfather!) do. At the opera, Lecter's friends (one of whom was played by the always delightful Ellen Green from Pushing Daisies and other stuff, but mostly Pushing Daisies) are angry with him for not inviting them to dinner more often. During their chat, one especially delightful specimen catches Lecter's eye. Guess dinner is back on the agenda.
Crawford awakes from bad dreams to a nightmare: The Ripper may be back in action. He picks up Graham and they head to the crime scene. On the way, Graham cautions Crawford not to get stirred up by the Ripper. He returned Miriam's arm just to poke Crawford with it, which is an unintentionally hilarious mental image. Or maybe it was intentional... it's hard to tell with this show. Crawford thinks the Ripper is back in action and they will have another string of victims on their hands in no time.
At the hotel, the FBI crime scene team reports that the victim was operated on and then un-operated on. Only thing missing was a kidney, although his chest is gashed open too. This show sure is good with the gross. Everyone leaves the room so Graham can do his thing. He envisions the crime and realizes that the victim was sedated and awoke from sedation to find his kidney removed, which would seriously be a bummer and is also why I never drink to excess (listen to grandma, kids). Graham realizes that the killer murdered the guy by stopping the victim's heart with his bare hand. Or maybe gloved hand. Who knows about his hygiene level? Graham however knows that the killer was actually trying to save the man's life and hence is not the Chesapeake Ripper. Crawford doesn't believe him and neither does some other pointless team member. Graham locks that guy out of the room and calmly tells Crawford all the reasons that this murderer was not the Ripper. Graham thinks it was a medical student trying to make some pin money with a back alley kidney removal that went badly for some unknown and completely unforeseeable reason. I mean why would a kidney removal in a Best Western go badly?