Wrong Turn director Rob Schmidt takes the helm for this thriller inspired by the grim true-life exploits of an alphabet-obsessed New York serial killer and starring Timothy Hutton, Cary Elwes, Eliza Dushku, and Michael Ironside. When Rochester, NY-based police investigator Megan Paige (Dushku) discovers that ten year old Carla Castillo was brutally raped and murdered in nearby Churchville, she becomes convinced that the department is dealing with a serial killer. Paige is a driven detective whose devotion to her job often crosses the border into obsession. Her fiancé, Kenneth Shine (Elwes), is a lieutenant with the Rochester Police Department, and as both jockey for the same promotion, the cracks in their relationship begin to show. Later, when Megan becomes haunted by visions of Carla and fails to solve the case, a concerned Captain Gullikson (Tom Noonan) takes her off of the case. Suffering a nervous breakdown shortly thereafter, Megan is diagnosed with adult onset of paranoid schizophrenia and placed in a psychiatric hospital, where she promptly breaks off her engagement to Kenneth.
Two years later, Megan has returned to the precinct as a records clerk, and Kenneth is now the head of the department. Over time, Megan begins developing a friendship with wheelchair-bound Richard Ledge (Hutton). When a local girl named Wendy Walsh is abducted, raped, and murdered in Webster, Megan convinces Kenneth to let her ride along with Detective Steven Harper (Tom Malloy) as an advisor to the case. But the gruesome nature of the case once again prompts strange visions for Megan. Now she is haunted by two murder victims, and to make matters worse, she's beginning to develop embarrassing involuntary ticks and stops taking her medication. As the hallucinations get worse and the case starts to run cold, Megan struggles to find the one piece of evidence that will lead them to the killer before her dark side takes over once again.