Young billionaire Clay Beresford Jr. is secretly in a relationship with Samantha "Sam" Lockwood, his mother Lilith's
personal assistant. Despite opposition from the controlling Lilith, he plans to marry Sam and undergo a
heart transplant under the care of his trusted friend and surgeon, Dr. Jack Harper. Before the operation, Jack goes through the list of possible outcomes and has him lie on a bed so Clay can visualise the procedure. Lilith catches Clay as he is leaving work, from her limousine. Inside, she introduces him to another heart surgeon, Dr. Jonathan Neyer. Lilith and Neyer point out his high-profile clients, including past
POTUSes. Sam continually pressures Clay to officially inform Lilith of their year-long relationship and 6-month engagement. When they do, she tells him it is too soon. Lilith threatens to cut him off, but he leaves anyway. Shortly after a private midnight wedding, which Jack helps facilitate, Clay is admitted to the hospital for the operation. Lilith shows up at the hospital with the surgeon she wants to perform the operation. He points out Jack has an expensive life due to multiple divorces, she mentions he has four malpractice lawsuits pending. Clay and Lilith step aside to discuss it quietly, where she tries to wield her authority, but he puts his foot down. During surgery, Clay experiences
anesthesia awareness, a rare condition where he remains conscious but paralyzed. While enduring the surgical pain, he tries to distract himself with positive memories of Sam. However, his memories float to less pleasant ones. Meanwhile, in the waiting room, when a hospital employee hits on her, Sam shows him her wedding and engagement rings. Lilith sees, asking when they had the ceremony. After she is told it was just before the call for the transplant, she falls silent. Clay overhears Jack and his surgical team colluding to murder him, first by moving him down the donation list, then by sabotaging the transplant with a poisoned donor heart. As a result, he has an
out-of-body experience and can watch detached as the conspiracy plan against him is discussed in the OR. Their plan involves injecting the heart with
Adriamycin, a
chemotherapy drug that would cause the transplant to fail, allowing them to collect a large life insurance payout to cover Harper’s malpractice debts. As Clay observes, then replays memories, he realises that Sam is very involved. Jack is the mastermind, who recruited everyone. Once Clay had been brought in for heart problems over a year ago, he brought in 'Sam' who invented a persona that soon captivated Clay. He might have used nurse Penny, but she got pregnant. As expected, as Sam had ensured the heart was unviable, it failed to start. Jack goes with the unknowing anaethesiologist to inform Lilith. As she suspects foul play, she sacrifices herself by suicide, which allows her heart to be used in place of the sabotaged donor organ. Meanwhile, Sam attempts to cover her involvement, but Harper, overwhelmed by guilt, preserves evidence implicating her in the conspiracy. A new surgical team, led by Dr. Neyer, intervenes and prepares Lilith’s heart for transplant, while the police arrive to arrest the conspirators. As the operation continues, Clay's spirit remains in a liminal state. He experiences a final vision of his childhood, during which he witnesses Lilith killing his abusive father—a
repressed memory that provides him emotional closure. Initially resistant to returning to life, Clay eventually accepts his mother’s sacrifice and allows the transplant to succeed. As the surgeons remove his eye tape, Clay regains consciousness, and Dr. Harper's voice narrates the final words: “He is awake.” ==Cast==