A heavily coated man walks through the alleyways and buys flowers from a man. When he turns his back, the man takes out a scalpel and cuts the man's throat. As witnesses gather, the man runs off but is blocked by a gate. He uses the scalpel to cut through the gate and make his escape.
After hearing the report, Jack checks the manifest for a scalpel and finds who it was sold to, a James Morgan. Jack checks on Morgan while Micki discovers a note saying the scalpel belonging to Jack the Ripper. Micki and Ryan end up waiting for Jack at a knife store, and he's discovered Morgan was a thug who used a blade and now owns the store. They ask Morgan about the scalpel and trick him into admitting he sold it and Jack blackmails him with some negatives he'll turn over to Morgan's parole officer. Morgan comes around and admits he sold the scalpel to a Dr. Vincent Howell. Jack knows of Howell, who is famed as a miracle worker who cures hopeless cases for big bucks.
Howell is giving a lecture to his fellow doctors over a patient's operation at the Ravenbrook Clinic. Afterward the head of staff, Dr. Price, welcomes him on board as their new doctor. Howell accepts and implies it's his reputation that will help the hospital's "tarnished reputation." en route, Jack explains that the hospital has to have Howell on board to improve their reputation. The chief of staff, who was also Howell's professor n college, is surprised that he's now so competent. After he leaves her, a woman sneaks through the hospital and tapes a picture of a young girl to Howell's door. He sees it and leaves, and the woman prepares to shoot him. Ryan and the others arrive and stop her just at time, and as she's taken away Jack goes through her purse and finds clippings of the dead girl and other murders.
Micki follows Howell while the woman, Jean Flappen, is strapped down. She admits the girl in the picture is her daughter and she admired Howell, who carved her up. She's been following him ever since and saw him commit other murders. Jack tries to get her confidence but she's clearly mentally unbalanced over her daughter's death.
In his office, Howell examines the scalpel as Micki comes in and pretends to be a member of the staff. She sees the scalpel and hurriedly slips out to meet Ryan. Ryan watches Howell and sends her to tell Jack. Ryan follows Howell as he goes out through the hospital and down to a closed-off area. Jack and Micki go to Howell's office and search it but find the scalpel missing. They check his surgery book and find he has a coming surgery scheduled. They realize Howell has to kill someone to cure another person, and Ryan is his next target.
Ryan is in the basement area and spies on Howell going to a locker to get his clothing he wears to kill. Ryan accidentally knocks over some crates and makes a run for it, while Jack and Micki hear him up above and go to investigate. Ryan hides in a morgue drawer and Howell comes in and stabs one of the corpses, but it's the wrong one. Micki and Jack interrupt the doctor and Jack chases after him while Micki gets Ryan out. Jack struggles with Howell but falls into an empty elevator shaft. Howell cuts the elevator cable that Jack is dangling from and sends him plunging to a near-fatal fall.
Jack is taken into examination and Dr. Price tells Micki and Ryan that he's in serious condition and only Dr. Howell can save him. Dr. Price tells Howell that he'll have to operate as he's the only one who can save Jack. Howell hasn't "charged" the scalpel yet but Price insists he do the surgery to redeem the hospital's reputation, and the press want to see him in action. Howell has no choice but to agree and heads out to find another victim.
Jean Flappen appeals to an orderly to loosen her straps then knocks him out and frees herself. Dr. Price tells Micki that Howell will have to operate and Micki realizes what that will entail.
Howell stalks a skater but the boy's friends show up and Howell is forced to find another victim. Jean sneaks into the patient storage area and gets her gun. Howell finds a prostitute and approaches her with the scalpel but he's interrupted by an emergency call and she escapes. He has no choice but to return and prepare for surgery, but when he sets the scalpel down, Ryan (disguised as an orderly) steals it and meets with Micki. She reveals that Howell is the only one who can save Jack and Ryan is forced to bring the scalpel back.
Jack goes into surgery and Howell does the operation without the magical enhancement, while Jean looks on from the gallery and Ryan and Micki consider Jack's life and his influence on them. When the covering is removed from Jack's face, Howell realizes who he is operating on but has no choice but to continue with the press looking on. Hours later he finally concludes the operation and orders that he'll tend to Jack personally. Price gives Micki and Ryan the good news and mentions that Howell will be visiting Jack.
Howell prepares to kill Jack with the scalpel when Jean holds him at gunpoint but he gets close enough to slice her gun in half. He cuts her arm but Ryan and Mick burst in and Howell runs off. The two chase him into the abandoned section again and Howell ambushes them. They manage to fend him off but are forced to run. They take refuge in a boiler room but it's a dead end and Howell starts slicing through the door. He comes in but Jean knocks him over the head and they run down the hall into another dead end. But they find an electric resuscitation machine and Ryan comes at him with a crutch. Micki activates the old machine and uses the paddles on the scalpel, electrocuting the good doctor as he falls on the scalpel.
Back at the store, Jack is recovering in a wheelchair and they point out at least he won't have to pay his bill.