Victor's (Sam Rockwell) mother Ida (Angelica Huston) dies partially from choking on pudding Victor was feeding her. She had just told him his parentage; that she stole him from a stroller in Iowa and thus is not his true birth mother.
Paige Marshall (Kelly Macdonald) comes in to give CPR. It is here when Victor realizes that she is actually a patient at the hospital and not a real doctor. He runs off, and she chases him down, explaining that she was a medical student that had a mental breakdown from the expectations she and others had for her. Paige tells Victor she loves him and he leaves not being able to deal with it.
Later, Victor is arrested by two cops on the deluded testimony of some of the women at the hospital. They also believe that Paige killed Ida but cannot find her since she was a voluntary patient and checked herself out.
The film ends with Victor on a plane, narrating that he now realizes that he has a choice on how he acts (meaning through his own will he can stop his sexual addiction). He occupies a bathroom and gets naked, thinking of Paige. A woman enters and starts to kiss him passionately. It is Paige, and it is inferred they have decided to start a new life to work out their problems together.