Doggett and Reyes investigate the murder of a couple in West Virginia that has all the signs of a satanic ritual killing. They link the murder to a doctor who is incarcerated in a mental institute, and Doggett becomes convinced that the doctor is orchestrating the crimes from within the hospital.

Agent Reyes takes the lead while investigating an X-file case, surrounding a man found skinned alive after having visions of seeing other people appearing skinned alive. Reyes calls on Scully's expertise to help on the investigation, which pays off when Scully finds a link to a case from 1960.

Agent Harrison talks Doggett and Reyes into investigating a boy's claim that monsters killed his mother, who was officially determined to have stabbed herself repeatedly.