I Know This Much is True is described as an epic family saga that explores the American identity following the parallel lives of twin brothers Dominick and Thomas Birdsey throughout the latter half of the 20th century.

Season 01, Episode 01
Series premiere. Paranoid schizophrenic Thomas Birdsey has a violent public breakdown, and Dominick Birdsey finds himself stepping up to defend his identical twin brother in unexpected ways. As he navigates the fallout of Thomas’ actions, Dominick reflects on their childhood growing up under the tyrannical rule of their volatile stepfather, Ray, and their persistent desire to know the identity of their biological father.

Season 01, Episode 02
Tensions rise between Dominick and his live-in girlfriend, Joy, as the media begins to take an interest in Thomas’ case. In his attempt to have Thomas released from the Hatch forensic institute for the criminally insane, Dominick finds a potential ally in social worker Lisa Sheffer, but learns that helping his brother may be more difficult than he thought. Dominick clashes with Thomas’ new psychiatrist, Dr. Patel, as she begins to probe into his past.

Season 01, Episode 03
Sheffer preps Dominick for a pivotal hearing with Hatch’s review board that could decide Thomas’ fate. A chance encounter with an old classmate brings painful childhood memories to the surface. Dominick reflects on his and Thomas’ time together at college, during which he met Dessa and the signs of his brother’s illness first began to manifest. Joy attempts to remedy the problems in her and Dominick’s relationship.

Season 01, Episode 04
Despite the protestations of those closest to him, Dominick returns to work before fully recovering from his accident. Heavily medicated, Dominick recalls the disturbing incident that lead to Thomas’ first hospitalization while counting down the hours to Thomas’ hearing with the Hatch review board.

Season 01, Episode 05
Mark Ruffalo plays two identical twins with a troubled relationship in this story of betrayal, sacrifice, and forgiveness.

Season 01, Episode 06
Series finale. A lifetime of animosity between Dominick and Ray spills over in public at an inopportune time. After an unexpected tragedy, Dominick seeks reconciliation with those he has hurt, and the question that has plagued Dominick all his life is finally answered.

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