Ryan Leo, a recent Ivy League graduate, starts his new job at a local psychiatric hospital, eager to put his hard-earned knowledge to use. He works long hours, dedicated to helping both his new and long-term patients. Everything is going well until a new patient is transferred in, a man moved from facility to facility, who harbors a dark secret. He is destined to be known as one of the most prolific killers in US history. Ryan takes a special interest in this patient, but he doesn't realize that the Stitch Ripper is just as intrigued by him. Ryan is the first person the killer has ever truly opened up to-the one person who may change everything.