Writers: Vivian Mayhew and Valerie Mayhew
Director: Kim Manners
When Dr. Lloyd, a plastic surgeon at the Greenwood Memorial Hospital's Aesthetic Surgery Unit in Chicago goes crazy during a liposuction procedure and kills his patient he claims it is a case of demonic possession. Mulder and Scully are called in to investigate and interview Dr. Lloyd, Scully believes that Dr. Lloyd's sleeping pill addiction cause a psychotic episode. However when Mulder discovers evidence of a pentagram, an occult symbol of protection, on the floor of the operating room he realises that someone is trying to protect the patients. When a second surgeon kills a patient and the pentagram symbol is discovered once more, the investigation narrows in on Nurse Waite.
Dr. Franklin informs Mulder and Scully that Nurse Waite was working at the hospital ten years before when there was a spate of similar murders. Mulder and Scully go to interview Nurse Waite at her house, they discover that her house is full of symbols and objects from the occult, but Nurse Waite is not at home. Mulder and Scully are called to Dr. Franklin's house when it appears that Nurse Waite has attacked him with a knife, but before she can explain to them she begins to regurgitate thousands of needles and dies.
Leading to the conclusion that she is responsible for the deaths at the hospital. But Mulder believes that she was just trying to protect the patients. And his suspicions fall on Dr. Franklin who was also present at the hospital ten years earlier when the first series of deaths took place.
The producers of The X-Files got an enormous amount of angry letters and emails from supporters of Wicca and ritual magic in response to this episode.
The words written in blood on Dr. Franklin's mirror are "vanitas vanitatum" or "vanity of the vanities".
When Mulder and Scully are discussing the nurse's ingestion and subsequent vomiting of pins. Scully mentions pica which is a condition that makes people eat non-nutritious and non-edible things, such as rocks, glass, metal etc. Mulder then goes on to describe allotriophagy, which he suggests is a condition, possibly even a spell, that causes people to vomit things they never ingested in the first place. This is completely untrue. Allotriophagy is similar to pica in that it is defined as a depraved appetite or desire for improper food.
(In the operating room, Dr Lloyd is violently stabbing liposuction tool into unconscious patient, who at this point we see has lines drawn on his balding head. Fat being sucked through tube turns bright red.)
Nurse Waite: Doctor Lloyd!!
Dr. Lloyd: (pulling down his mask) I think this patient is finished.
Scully: So this man committed these murders in order to make himself beautiful?
Mulder: Everybody wants to be beautiful, Scully.
Scully: Well, he started taking the drug 5 years ago and he went through . . . ooh, he took a lot of it. 19 100-tablet refills.
Mulder: (checking out a passing nurse) Wow.
Scully: (thinking he's commenting at pill numbers) Yeah.
Season Number: 4
First Aired: Sunday November 10, 1996
Production Code: 4X06