Steven Murphy, a skilled cardiothoracic surgeon, finishes an open heart surgery, and later goes to a diner where he meets a teenage boy named Martin. The precise nature of their relationship is unexplained. Afterward, Steven returns home to his wife, Anna, and their children, Kim and Bob. The next day, Steven reveals his connection to Martin, claiming he is a schoolmate of Kim's, when Martin unexpectedly comes to speak with Steven at the hospital. Steven later privately tells Anna that Martin's father died in a car accident ten years earlier, and that he has taken an interest in the boy to help him grieve. At Steven's suggestion, Martin comes to the Murphy household for dinner; Kim seems particularly taken with him.
Martin returns the favor by inviting Steven to his mother's home for dinner. After the meal, Steven attempts to leave, but Martin insists he stay and watch a movie with them. Martin leaves halfway through the film, and his mother makes a sexual advance on Steven, who quickly rebuffs her and goes home. Over the next few days, Martin's demands on Steven's time grow increasingly frequent and desperate, but Steven does not reply. One morning Bob awakens and finds he cannot feel his legs—he has become paralyzed. Steven and Anna rush him to the hospital, where a full neurological examination reveals that nothing is physically wrong. Though he briefly recovers, Bob remains unable to walk. While the elder Murphys tend to Bob, Kim meets with Martin for a date.
The next morning, Martin visits Bob in the hospital and demands that Steven speak to him in private. The two retreat to the cafeteria, where Martin reveals the truth: his father did not die immediately, as Steven told his wife, but during surgery that Steven himself performed after the crash. Steven failed to save Martin's father, and the boy bluntly tells Steven that he blames the surgeon for the death. He further explains that, to "balance" the act of destroying a family, Steven must kill one of the members of his own. Martin goes on to explain that he has placed a curse upon the Murphys that will gradually kill them through a series of stages unless Steven makes his choice and murders one of them; the paralysis is the first of these four stages. Steven attempts to dismiss these seemingly wild claims, but later finds that Bob is refusing food—this is the second stage of Martin's curse. Kim later loses the use of her legs during a choir practice and also will not eat.
Kim receives a phone call from Martin at the hospital. During the conversation, Kim abruptly regains the use of her legs, only to lose mobility again when the connection is broken. This seems to convince Anna of Martin's power, and she travels to his home to directly ask why she and her children must suffer for Steven's mistakes. The unrepentant Martin cannot answer, simply remarking that "it's the only thing I can think of that's close to justice". Anna, further suspecting that her formerly alcoholic husband may have imbibed on the day of the operation, speaks to Steven's anesthesiologist, who reveals that Steven did in fact have a few drinks that morning, with Anna sexually gratifying him as payment for the information. At Anna's insistence, the children are transported to their home, where they are continually fed through a nasogastric tube. Anna and Steven fight over the situation, with Steven refusing to believe that anything supernatural is happening. That night, he kidnaps Martin and binds him to a chair in the basement, brutally beating him and demanding that he undo his hold on the children. Martin remains unflappable, warning Steven that time is running out.
Martin's presence only exacerbates the tension in the household: Kim and Bob argue with each other over who their father will choose; Steven tries to gather information to make the decision; and Anna claims that killing one of the children is clearly the only option, as they can have another. Kim attempts to save herself by traveling to the basement to see Martin, demanding that he free her again so that they may run away together. Her strategy fails and she tries to escape herself by crawling through the neighborhood. Steven and Anna save her. The next morning, Anna releases Martin while Steven sleeps, pointing out that holding him captive was of no use. Later that day, Bob begins bleeding from the eyes—the final stage of the curse before death. Rather than choose, Steven binds Kim, Bob, and Anna to chairs in the living room, covers their heads, and pulls a black woolen mask over his own face. He next loads a rifle, spins uncontrollably, and fires. The first two shots miss, but the third pierces Bob's heart and kills him.
Some time later, the family visits the same diner where Steven previously met with Martin. As they sit in silence, Martin enters and stares at them; he and the family briefly lock eyes and Kim begins eating before they stand and leave. Martin gazes after them as they walk through the door.
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