At a grocery market in Virginia, Agent Frank Burst and a phalanx of sheriff's deputies arrest a man known only as Pusher. Pusher is shackled in leg irons and seated in the back of a cruiser, a heavy steel screen separating him from Burst and a deputy (who's at the wheel). As the deputy waits his turn to pull onto a busy highway, Pusher uses the sound of his voice to take control of the deputy's mind. Against his will, the deputy drives the cruiser directly into the path of an oncoming truck, and an enormous collision ensues.
     Burst survives the impact, but the sheriff's deputy is killed and Pusher escapes. Burst approaches Mulder and Scully for help with the bizarre case. He describes how, a month earlier, Pusher called him and confessed to a string of contract killings going back two years. The murders Pusher confessed to had all been ruled suicides by the coroner's office. But he possessed intimate details known only to police. Burst believes Pusher was bragging when he confessed to the crimes, as if he was playing a twisted game. Most disturbing is how Pusher somehow willed the sheriff's deputy to unlock his shackles.
     A clue finger-written on the wrecked police cruiser leads the agents to back issues of a magazine called "American Ronin" (a ronin is a samurai warrior without a master). After leafing through several issues, the agents find "hit for hire" ads they suspect were placed by Pusher. They trace a telephone number listed in the ad to a pay phone, which, in turn, leads them to a driving range where Pusher works. Heavily-armed federal agents surround the range. Pusher takes refuge inside a shed and is cornered by an agent. He wills the agent to pour gasoline over his own body and set himself on fire. Scully extinguishes the flames, and Pusher is taken into custody. But during a preliminary court hearing, Pusher (whose real name is Robert Modell) clouds the mind of the presiding judge and is released.
     Using his mental powers, Modell slips by FBI security and gains access to the agency's computer records. Skinner spots the intruder and attempts to intercede. But Modell overpowers an office cleric's mind and wills her to spray mace in Skinner's eyes. During the confusion, Modell escapes with the records.
     Skinner recovers, and later informs the agents that Modell fled with Mulder's computer file. Burst, Mulder, Scully and a team of SWAT officers storm Modell's apartment, but find it empty. What they do find is epilepsy medication. Scully theorizes that if a brain tumor triggered Modell's powers, he might be dying... and committing murders as one last big "hurrah." Modell phones the agents as they are sifting through his apartment. As Burst tries to keep him on the line until the call can be traced, Modell wills him to suffer a fatal heart attack.
     The FBI tracks Modell to a nearby hospital. Mulder fears that Modell might focus his powers on one of the armed agents, so he enters the building alone, unarmed and wired with high-tech video gear that allows Scully and the other agents to see what he sees.
     As Mulder walks through the building, shots ring out. He finds the dead bodies of an MRI technician and a security guard. He also finds a medical chart which confirms the tumor is fatal. Modell clouds Mulder's mind and forces him to play Russian roulette, first on himself, and then on Scully. Scully trips a fire alarm after realizing that Modell must concentrate all of his energy for his powers to work. This distracts Modell long enough for agents to rush him. Later, we see Modell in a hospital bed, weak and near death.