Ray tracked down the doctor and forced her to conduct the surgery or he would get her funding pulled. She reluctantly agreed to do the operation, and it saved Smitty's life.
Ray handed over the bar to Bunchy because he said he needed to leave for a few days. Bunchy then told Teresa to leave just as she was getting excited about the prospect of running a bar with him.
Mickey tried to turn the tables and get Ray arrested, but Daryll revealed the truth about the weapon and Ray handed it over to the FBI and Mickey might be given a life sentence or the electric chair.
Ray murdered Landry while in New York, and kept thinking about the past. He recalled everything that happened to him when he was younger and felt like his father was responsible for all of it.
In the end, Ray witnessed a ghost of Abby killing herself from jumping off a building, but when Ray wanted to do the same, he landed in the water, leaving it open to interpretation about whether he died.