In 1997, forensic psychiatry Dr. Jack Gramm (Al Pacino) testifies at the trial of suspected serial killer Jon Forster (Neal McDonough), dubbed "The Seattle Slayer" by police. Gramm's testimony and expert witness are crucial in the conviction of Forster for the attempted killing of Janie Cates and the murder of her sister Joanie, who was drugged, hanged upside down and killed after the killer invaded the sisters' apartment. Upon receiving a guilty verdict from the jury, Forster taunts Gramm, saying "Tick-tock, Doc."