When Samuel Wilson is nineteen, he sees a fortune teller who reads palms. This is a formative experience for Sam. The fortune-teller, Imogen, uses her slender hands to reiterate and discuss everything during their conversation. Sam feels thrilled as she does this. This is unexpected to Sam. The fortune reader tells Sam about the importance of hands and fate. They sleep together. She sucks his fingers. Sam realizes if he ever finds a lover, they will need hands as beautiful as Imogen’s.

Sam then grows up, dates, and has occasional affairs. However, Sam knows why he can not find love. It is his lustful passion for hands. The women in his life attempt to help him with his love life, but it is to no avail. Sam never reveals his fetish to anyone, afraid that his female relations will make fun of him for it.

However, at thirty-two, Sam decides he can no longer ignore his own desires. He calls the number of Beth Hurt, a medical illustrator, that he finds on her website. He explains that he needs a drawing for his work in advertising, which is a white lie. He works in advertising but wants the hand drawing for himself. Sam explains that he is looking for a drawing of beautiful hands.

He goes to meet Beth to pick up the finished drawing. He goes inside her building after being let up by a woman over an intercom. There are paintings on the wall and various surgical instruments strewn about. When Beth enters the room, Sam is drawn to her, though she does not have beautiful hands. She goes to get coffee and mentions someone named Kate. Sam wonders who Kate is.

When she returns, they talk about her medical illustrations and drawings of body parts. She describes the bones in the hand. She tells him about the mnemonics she uses for remembering body parts.

Though there is sexual tension between the two, Sam does not want to sleep with her because her hands are not ideal. The drawing of hands that she gave him, however, is perfect. Beth confesses that the drawing was not exactly based on Sam's instructions, and instead, she used her sister Kate as the hand model.

Beth soon introduces Kate and Sam. Kate’s hands are perfect, but he is more attracted to Beth than to Kate. Beth goes to get them coffee.

Later, Sam is in Beth’s bed naked, thinking about her mnemonics. Driven by desire, he amputates both the hands of Kate and Beth, sewing Kate’s hands onto Beth. He undresses Beth, who is still alive, and brings her to bed where he rapes her.