A doctor comes in to the waiting room and shakes his head at Sarah. Does he mean Alan, or Immie? Probably Alan, because Sarah goes into his room with Immie's case and locks the door … and when Alan comes to and rips out all his tubes, guess what he sees in the mirror? He's not happy about it, either. As for how he gets back to the island, why Kyle doesn't come with him and Soren, whether he's still alive (or where), and why he kept trying to kill Immortals when he's one himself, we don't know. It's the last time we see him ... and we don't know if Jules takes Caleb's blood serum to save herself, either, though if she knew Alan were still alive, she'd probably opt to save herself.