After a struggle, Scully kills Betts by pressing charged defibrillator paddles against his head. Scully remains silently stunned by Betts's suggestion that she has cancer.
However, after arriving at the hospital, Scully realizes that Betts has stowed himself away on the roof of the ambulance. Betts locks her inside the ambulance with him, calmly but apologetically telling her, like his earlier victim, that she has "something I need".