 Jim, his wife Christine and Dr. Samuel Bruelsmann sit in the doctor s office. Christine asks some questions and then leaves the office. Jim pulls Sam towards him. A loud shot is heard and Sam s limp body slides to the floor. Another shot is heard. Jim slumps to the floor. A montage of family footage is shown and the story begins again in the doctor s office, twenty-four hours earlier. Jim sits in Sam s office. Jim has no possibility for cure. The results of genetic testing confirm that Jim s only child, Nathan, is an unsuitable donor. Sam states that Jim must tell his wife the news and bring her to the office tomorrow to discuss palliative therapy. Jim sits in the living room editing his home movies. His son Nathan walks in. Jim tries to express his feelings for Nathan. Later that night Jim tells Christine that he is dying. Jim and Christine sit in the doctor s office and an identical scene plays out as in the opening scene, the audience is now made aware that the murder in that scene was a dream sequence. Jim is dreaming of killing Sam, it is unclear why until Sam speaks. Sam states that he must confess to having an affair with Christine. Nathan is Sam s son, there was no possibility of a donor for Jim. Surprisingly Jim states that he already knew. Jim points to the doctor s plaque and says remember your oath "Primum Non Nocere, above all do no harm".