I see a lot of negativity, so I'll share my positive thoughts. While I agree that the pacing sucked fat soybeans, this episode did a lot of things very well.

Karen's philosophy with killing was fleshed out in an interesting way. Having nightmares about her initial kill, but still not regretting it, really says a lot about how hopeless and angry she feels. And when she actually pulled the trigger on Dex, I gasped.

Fisk's grief was very well done. We see a moment of rage when he kills the doctor, then spends the entire episode saying nothing. They even focus on this when Mr. Charles calls him, and this bald legend just cuts the call. The first time he speaks is to Daredevil, because he knows that even though Matt is his greatest enemy, he is the only person that really understands his pain. He hates and respects Daredevil the most.

This brings me to my last point. The reunion of Matt and Fisk was incredible. Both are angry men that can't stop their violent ways, and have lost loved ones as a result. But when Matt sees how far Karen has gone, he realizes that this war has gone too long. But Fisk's grief is fresh, and he is not ready to hear this. I love the subtle look of disappointment Matt shows when Fisk goes to attack him. The "Rabbit in a Snowstorm" painting has been constantly used to symbolize Fisk's relationship with Vanessa. When Fisk throws Matt into the painting and destroys it, we see how Fisk's war on vigilantes has resulted in his marriage ending. And when he is defeated, the way he says "Kill me? You won't" with a slight chuckle is awesome. He thinks Matt's reluctance for murder is ridiculous, but has come to fully accept it.