With Mulder trapped in a car by a seemingly deranged man, Scully races to determine if the man is suffering from a deadly illness - and if Mulder is in danger of becoming the next victim.

Via a live news report, a high-speed car chase comes to an end in the Nevada desert. Assuming it to be a kidnapping, the female passenger is pulled from the vehicle and placed into the protective custody of a police vehicle. The driver, Patrick Crump, is pushed to the asphalt and handcuffed. The woman in the police car begins violently banging her head against the car window. As the news chopper catches all of this on film, the woman's head explodes, sending a spray of blood across the window.

The agents get wind of this bizarre car chase as they're doing scut work in Idaho. Mulder coerces Scully into taking a detour by Elko, Nevada on a hunch that this may be an X-File. Once there, however, Mulder manages to get himself kidnapped by Crump, who has escaped from the police.

Mulder realizes that Crump is in a considerable amount of pain and that the only way to ease the pain is to drive west. Scully investigates the Crumps home and discovers that an antenna array emitting ELF waves stretches beneath their property. She deduces that an abnormal surge in these waves somehow caused a rising pressure in the inner ear of the nearby inhabitants. Westward motion seems to be the only thing to help the ease the pain of the increasing pressure.

Mulder explains to Crump that Scully will meet them at the end of the highway. There she will insert a needle into Crump's inner ear, hopefully relieving the pressure. But when Mulder arrives, it is too late. Crump has already died.