Albert has been fascinated with death since he was a young boy watching a mouse attempt to eat peanut butter beneath a mousetrap, he admits to his psychiatrist. The psychiatrist at Eastern State Hospital in Medical Lake, Washington is trying to reveal his deepest darkest secrets detailing his father. But Dr Schwartz also has secrets to hide. Albert calls him "Herr Doctor."

Over the course of 30 years Albert details his 10 murders to Herr Doctor. He also rooms with another man who likes young girls in a most peculiar way.

All of this leads to a climatic conclusion with a very substantial twist at the end that makes everyone wonder, who really is crazy around here?