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Psychiatrist Sam Foster (Ewan McGregor) investigates his new patient, Henry Letham (Ryan Gosling), who claims to be suicidal, but as reality contradicts fact, Sam's mental state spirals into an unstable world where the boundaries between truth and fantasy blur. In trying to stop Henry from killing himself, Sam searches for clues, meets Henry's mother and a woman he claims to love, Athena, played by Naomi Watts, and uncovers a connection to a tragic artist who died on the Brooklyn Bridge, leading him to confront the possibility that his own reality is a dream.