Cole Charles Pecker does not remember the sin that led to his committal at the Reparative Retreat, but his therapist Dr. Hutmacher believes that if Cole probes his past, she might help him unlock the childhood trauma that led to the unspeakable act at his mother's funeral. When a patient calling himself the Fifth Horseman of God arrives at the Reparative Retreat preaching end-time prophecy, Cole becomes an easy target for the much more worldly man.

As Cole's treatments become much more dangerous, he must decide if he should succumb to radical repair or if he should form an unlikely alliance with his worst enemy and make his escape.