In Baltimore, George Usher, a middle-aged businessman, arrives at his office building to work late. He is watched by someone with strange green eyes in a storm drain. The assailant sneaks into the building through the ventilation system, killing Usher by removing his liver.
The investigation of Usher's murder—the latest of three—is assigned to FBI agent Tom Colton, who turns to academy colleague Dana Scully for help. The case baffles Colton, in that the only common elements in the murders is their lack of entry points and the removal of the livers with bare hands. Fox Mulder looks over the case and notes their similarity to other murder sprees that occurred in 1933 and 1963. At the crime scene, Mulder finds an elongated fingerprint on the air vent. He comes to believe that because five murders occurred during the earlier sprees, the investigators should expect two more.
Scully's profile suggests that the killer will return to the scenes of his earlier crimes. She and Mulder wait in the parking garage of Usher's office building, where they catch a man named Eugene Victor Tooms climbing through the air vents. When Tooms is given a polygraph test, Mulder questions him about whether he was involved in murders dating as far back as 1903. Colton doubts Mulder's queries and lets Tooms go. However, Mulder shows Scully that Tooms' fingerprints match those from past cases if elongated and thinned, believing that Tooms is able to stretch and squeeze his body. That night, Tooms demonstrates this ability by squeezing down a chimney to claim another victim.
Mulder and Scully research Tooms, finding no certificate of birth or marriage. They visit Frank Briggs, a former detective who recounts his experiences investigating the 1933 murders. He shows them old pictures of Tooms—showing he hasn't aged—and divulges that he resided at an apartment building at 66 Exeter Street. The agents head there, eventually finding a "nest" constructed out of newspaper and bile in the building's crawl space. They also find several trophy items taken from the victims. Mulder suspects that Tooms is a mutant who can hibernate in his nest for thirty years after consuming five human livers. As the two leave, Tooms, who is hiding in the rafters, takes Scully's necklace from around her neck.
Mulder and Scully stake out at the apartment, but Colton gets them pulled off the job. Scully tries to call Mulder to inform him of the situation, but Tooms has cut her phone lines. Tooms breaks into her apartment through an impossibly small air vent, attacking her. However, Mulder has visited Tooms's apartment and found Scully's necklace there, causing him to race to her apartment and apprehend Tooms before he can kill her.
Tooms is put in an institution for the criminally insane. While outside Tooms's cell, Scully informs Mulder that medical tests on Tooms show an abnormal skeletal and muscle system, as well as a rapidly declining metabolism. When a guard slides food for Tooms through a slot in the door, Tooms stares at the thin slot and grins.
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