The narrative systematically details the targeted murder of Mollie Burkhart’s family to consolidate their subterranean headrights: Minnie dies of a mysterious wasting illness, Anna Brown is executed in a ravine with Ernest's assistance, their mother Lizzie Q is slowly poisoned, and Rita Smith is killed alongside her husband when their home is leveled by dynamite.
Simultaneously, local white physicians supply Ernest with tainted insulin under the guise of treating Mollie’s diabetes. Ernest dilutes and injects the poison himself, driving Mollie near death. Following the arrival of federal investigator Tom White, Hale eliminates pawns to conceal his trail. Ernest is arrested and initially stays loyal to Hale, but the death of his young daughter Anna from whooping cough motivates him to testify against his uncle in federal court.
After exposing Hale's scheme on the witness stand, Ernest meets Mollie in private. Mollie asks him what was in the medicine he repeatedly injected into her; Ernest maintains his lie, claiming it was "just insulin." Mollie walks out in silence, ending their marriage. The narrative concludes with a 1930s radio theater production of The Lucky Strike Hour, in which sound-effects artists dramatize the tragedy. Martin Scorsese appears to read Mollie’s 1937 obituary, noting that her public memorial made no mention of the murders that destroyed her family.