A couple stops at a gas station, where their 6 y.o. daughter's arm is fractured. They hurry to a hospital. Something strange is going on there. The wife and daughter go missing.
Driving cross-country, Ray and his wife and daughter stop at a highway rest area where his daughter falls and breaks her arm. After a frantic rush to the hospital and a clash with the check-in nurse, Ray is finally able to get her to a doctor. While the wife and daughter go downstairs for an MRI, Ray, exhausted, passes out in a chair in the lobby. Upon waking up, they have no record or knowledge of Ray's family ever being checked in.—Alan B. McElroy
While driving back from a Thanksgiving visit to Joanne's (Lily Rabe) parents, she and her husband, Ray (Sam Worthington), argue about the state of their relationship. Ray is irritated with Joanne's constant nagging about every small little thing and then blaming it all on him. Joanne complains that Ray doesn't fight for anything anymore.Peri has to go to the potty and Ray pulls in at the next rest stop. Here Ray buys a coke for Joanne and a pack of AA batteries for Peri's Walkman. After returning from a restroom, their young daughter, Peri (Lucy Capri), loses her compact mirror, prompting the parents to look for it. While Ray is distracted, Peri is startled by a dog in an abandoned construction site.
Ray throws a rock to scare the dog, startling Peri, who falls into a pit. Ray, attempting to grab her, falls into the pit and hits his head, watching as a distressed Joanne climbs down, panicking over Peri. After his head clears, they arrive at a hospital to have Peri's injured arm examined. During the drive over, sometimes we see Joanne in the car's back seat, but not in the central rear-view mirror. Joanne urges Ray to drive fast to get to the hospital, prompting Ray to risk colliding with oncoming traffic.
During the long admissions process (again with Joanne goading Ray to "do something" to cut the waiting period and get medical attention for Peri), Ray and Joanne deny a request for Peri to be registered as an organ donor. Ray also sees 2 more bodies being brought into the hospital by an ambulance. Ray had a first wife named Abby, who is now deceased. He is married to Joanne for 6 years.Peri's arm is examined by a doctor, and decided it is fractured; Dr. Berthram (Stephen Tobolowsky) recommends a CAT scan in case of a head injury. Joanne accompanies her to the scanning facility in the lower basement as Ray falls asleep at the waiting area.
Ray awakens hours later with a sutured forehead and asks the hospital staff if he can see his wife and daughter, only to find that there's no such record. Ray rushes into the ER where Dr Bertram examined Peri and even the ER has no record of Peri. The only nurse Anne present from the earlier shift says that Ray came alone and was treated for a head wound, distressing him. Ray gets more and more agitated and believes that there is a conspiracy going on against his family.Ray is pepper-sprayed and restrained by security, who sedate him and lock him in a room. He takes several adrenaline Autoinjectors from a medicine cabinet to counteract the sedative and escape to the parking lot. He waves down two police officers, who agree to investigate. Ray claims that the hospital did something to Peri and Joanne and now they are trying to cover it up.
A doctor directs the two officers and Ray to the imaging lab on the third floor, not the basement. Ray becomes agitated as the nurse recalled what really happened with him.Dr. Berthram claims that Ray stated his intent to wait for his deceased first wife, confusing him. He asserts that Abby is dead and tries reminding Dr. Berthram of the conversation that Peri had with him when he was examining her.
The security officer reviews footage from a delayed security system, seeing no sign of Joanne and Peri. Ray, in a rage, remembers the cashier of the gas station as a witness, and the officers agree to track her down. Ray finds Peri's bloodstained scarf.
Dr. Jacobs (Adjoa Andoh) questions Ray about the car accident that his file says he was treated for; it also mentions alcoholism, which Ray counters by citing he's been sober for eight years, though further questions the possibility that his alcoholism started this delusion, which he denies. Dr. Jacobs suggests that Ray accompany her and the police to the construction site, noting to Berthram that Joanne and Peri might be there, only for Ray to accuse the staff and police of covering up their disappearance.
A K-9 unit finds Peri's shattered compact mirror and a large pool of blood. Accusations continue from Ray when the police officers express disbelief. Dr. Jones asks him to recount what led to the accident- he fabricates memories of the incident, leading the police officers to arrest Ray for murder.
Ray, after seeing an opportunity for distraction, holds Dr. Jacobs at gunpoint, demanding her hospital key-card. After disarming and locking the officers in the bathroom, Ray drives to the hospital, remembering the car crash that killed a pregnant Abby. He takes to the elevator disguised as a doctor, pulling a security guard in and choking him.
At the basement, Ray sees nurses carrying human organs, and corpses that have been disemboweled. He finds Peri surrounded by surgeons preparing to harvest her organs, with a sedated Joanne nearby. Ray breaks them out of the hospital despite surgeons' protest, reaching the car, getting to the road back home.
Ray wrongly interprets the reality of the situation; instead of saving Joanne and Peri, he took an unconscious patient. In reality, Ray startled Peri into a fatal fall into the pit; he suffered a severe head injury attempting to catch her. He then threw Joanne to the ground, impaling her head on a piece of re-bar. His perception then splitting from reality, Ray put their bodies in the trunk and drives towards the sunrise.
