When Dean is accidentally electrocuted fighting a monster, he permanently damages his heart. When he’s diagnosed as only having a month, at most, to live, Sam searches for a means to save him and finds Roy Le Grange, a faith healer who may actually be the real deal. After Le Grange heals Dean, the brothers discover that Le Grange is using black magic to bind a “Reaper” to do his bidding…and each healing comes with a terrible price.
Dean and Sam pull up to a house and, armed with tasers, go in after a monster. Going down to the basement, they find two children in a closet and lead them out. They head up the stairs when the creature grabs Sam through the stairs and Dean fires at the creature. Dean sends Sam out with the children while he goes after the monster, managing to taser it. But it’s standing in water along with Dean and the conducted electricity injures him as well.
Sam is at the hospital trying to handle insurance and covering with the police. The doctor reveals Dean suffered a major heart attack and is clearly concerned they can’t continue on. Sam calls their dad’s answering machine and asks for help. Dean checks himself out and they reunite, but Sam’s had no luck finding a way to help him. They do track down a friend of their dad’s, Joshua, in Nebraska and head there. The place is a faith healer belonging to Roy Le Grange, and Dean is skeptical. A woman, Layla, talks with them briefly and then they get an up-front seat.
Dean catches Le Grange’s attention during his sermon and is called up front. Dean reluctantly goes up and everyone prays as Le Grange lays hands upon Dean. After a minute Dean collapses but when he wakes up he see the image of an old man standing behind Le Grange.
At the hospital the doctor confirms that Dean is healed, but notes that another young man had a heart attack that day and died. Dean is skeptical and feels it wasn’t “right,” and goes to talk to Le Grange and his wife Sue Ann. Le Grange woke up one day blind and with cancer, prayed, and went into a coma. When he awoke he was cured and could heal people. Le Grange says he picked Dean because he saw he had a purpose and a future. Sam checks out the dead man, Marshall, and notices a clock that stopped at the exact time Dean was healed…and Marshall died.
Dean runs into Layla and her mother coming to visit Le Grange and it becomes clear Layla needs healing from a brain tumor and she has six months to live. Layla is resolved but her mother is upset and angry at Dean for being chosen. Sam checks and determines that every time Le Grange has healed someone, another person has died of the exact same symptoms. As they speak, Le Grange is healing another person…and a jogger in the woods is attacked by the same old man and dies of the same symptoms when it touches her – which Dean recognizes from the description as a Reaper.
Dean determines the Reaper can only be seen when they come from someone, and Sam remembers the cross at the revival show – a clock he recognizes from the Death card of the Tarot. Dean resolves to kill Le Grange but Sam proposes they break the spell. Sam looks for the spell book while Dean tries to stall him before his next healing. Sam finds newspaper clippings mentioning those who have died, which Le Grange apparently believed were “immoral.” They believe his next victim will be a protestor in the parking lot that they’ve met. Meanwhile Le Grange calls up…Layla. Dean tries to stop her without success, while in the parking lot Sam hears the protestor cry out and tries to get him away from the Reaper that he can’t see. Sam calls out a fire before Le Grange can finish the healing, but the protestor collapses.
Sam is puzzled, but Dean sees Sue Ann using a Coptic cross and interrupts her. The Reaper withdraws as the police take Dean away. Sue Ann denies everything but doesn’t press charges. Dean tries to explain to Layla but can’t, while Le Grange and Sue Ann promise Layla will get a private session that night. It becomes clear Le Grange doesn’t know what his wife is up to, and Sam finds a book from Le Grange’s library identifying how to bind the Reaper with a dark altar and keep it away from her husband then take out immoral people. They need to destroy the altar and the Coptic cross, while Dean wonders if they should wait until Layla is healed. Sam points out they can’t play god and Sam tries to find Sue Ann while Dean draws the police off. Sam breaks into the Le Grange basement and fines the black shrine, complete with a marked picture of Dean. Sue Ann confronts him and then locks him in the cellar, warnign that Dean as one of the wicked is to be killed. Le Grange begins his healing of Layla, while near Dean the lights go out and the Reaper appears before him.
Sue Ann prays over her Coptic cross while the Reaper grabs Dean. Both Layla and Dean collapse but Sam manages to break out and destroy the cross. The healing fails as the Reaper, freed, goes after Sue Ann and inflicts Layla’s illness on her. Sam and Dean go back to their hotel where Dean wonders if they did the right thing. Layla visits and tells Dean of how she wasn’t healed, and that you have to have faith even with the miracles don’t happen. Dean promises he’ll pray for her.