Roy is horribly sick with AIDS and is checked into the hospital.
He's mean and racist to Belize, his nurse, who is just trying to help him out and give him some medical advice.
Roy blackmails Martin into getting him a ton of AZT.
Still in the hospital, he talks on the phone a lot, trying to keep from being disbarred.
When Belize asks for some of his AZT stash (to give to Prior) Roy refuses. He eventually relinquishes a bottle or two after provoking Belize to anti-Semitism.
He listens to Belize describe Heaven.
When Joe comes to visit him in the hospital, Roy freaks out when Joe tells him he's been living with a man. He orders Joe to go back to Harper.
As he's dying, Roy tricks the ghost of Ethel Rosenberg into singing him a lullaby, only to make fun of Ethel for her kindness.
Soon after, Roy dies.
Roy appears as a ghost to Joe.
In the afterlife, Roy becomes God's lawyer, promising to get the Almighty out of trouble for abandoning humanity.