While battling a demon, Dean is electrocuted, resulting in permanent damage to his heart and leaving him with only a couple of months to live. A despondent Sam searches desperately for a way to save his brother and believes he may have found an answer through a preacher who claims to heal the incurable. However, Dean and Sam discover that the preacher is getting help from the Grim Reaper who is trading one life for another he feels is less worthy.

Sam has a premonition in which a man is killed, but the murder is made to look like a suicide. Sam convinces Dean that they must investigate the case, but the two are puzzled when they fail to find anything that indicates that the death was supernatural in nature. That is, until they find out that Max, the reclusive son of the first victim, has been using his recently acquired power of telekinesis to kill the family members that once abused him. Sam also discovers Max's mother was killed by the same fiery demon that took his own mom.