Two policemen investigate a possible break-in at an abandoned psychiatric asylum - rumoured to be haunted by the ghosts of the patients. After they leave, one of the men goes home and kills his wife in a fit of anger.
In a motel, Dean receives a message on his cellphone - a set of co-ordinates. They dont know who the call is from, but they realise that the co-ordinates lead to Rockford, Illinois, which is where the Roosevelt Asylum is that John has marked in his journal. They head to Rockford to take a look around. According to the information in the journal, in 1972, three kids broke into the South Wing of the asylum. Only one of them made it out, saying that his friend went nuts and started 'lighting up the place'. Dean and Sam head into the South Wing to look further and find a plaque naming a Psychiatrist there, Dr. Sanford Ellicott.
Sam makes an appointment to see another psychiatrist, Dr James Ellicott, son of Sanford. He tries to find out more information about the asylum and the riot that happened there, but Dr Ellicott encourages him to discuss his feelings, especially towards his brother. When he leaves, he tells Dean what he learned about the riot. In 1964, the riot led to several people dying and some of the bodies were never recovered, including that of Sanford Ellicott. Deciding that they need to destroy the bodies, Dean and Sam head back to the asylum that night.
Two teenagers, Gavin and Katrina, sneak into the asylum and start looking around. They split up and Gavin encounters the spirit of one of the deceased patients. Sam and Dean discover Kat hiding, scared out of her wits. She goes with Dean to find Gavin and Sam goes the other way. Sam manages to find Gavin, but Kat gets pulled into a room by one of the spirits. Sam arrives and shots at her to calm down. He explains that the spirit doesn't want to hurt her - it wants to tell her something. She obeys and the spirit tells her the number 137.
Dean finds the room and discovers some papers that belonged to Sanford, detailing gruesome procedures that he carried out on the patients. Meanwhile, Sam gets call from Dean saying that he's in the basement. He heads down there only to encounter the spirit of Sanford. When Dean gets back to Kat and Gavin, he realises that Sam has been tricked and rushes off after him. Sam, who has been affected by Sanfords spirit, is so full of anger that he attacks Dean, almost shooting him.
Dean manages to knock Sam out and searches for Sanfords body, knowing that burning it will be the only way to defeat him. Moments before he succeeds, Sanford's spirit attacks him, but Dean fights back and manages to set fire to the body, destroying Sanford once and for all.
They leave and head back to the motel, both in need of some sleep. When Dean's cellphone rings, Sam answers. "Dad?"