Grotesque

Patrick is Lisa's adopted brother who was born with severe facial deformities. The Krugers kept him hidden in a soundproof nursery within the house because they feared he might hurt someone. Orville and his wife raised Patrick in isolation, keeping him concealed from the outside world to protect both their son and others from his unpredictable nature.

Earlier, Lisa asks about "Patrick" during conversation, and Orville's special effects prank creates an eerie tone that foreshadows the hidden horror within the house.

Patrick is shot and killed by police when he confronts Scratch and Shelley outside the Krugers' home. After saving Lisa from a gang member at dawn, Patrick encounters the two surviving criminals, attempts to kill them, but is shot dead by authorities who arrive on the scene.

The gang discovers the hidden nursery decorated like a room for someone who has been kept isolated, hinting at Patrick's violent potential.

The entire movie is revealed to be a test screening of a feature film. None of the violent events actually happened, they were just a movie being shown to an audience. The Frankenstein Monster and the Wolfman then burst into the screening room, frightening the audience, adding a meta-textual layer to the story.

The meta twist is set up by Orville's special effects work and the theatrical tone of some scenes, which blur the line between reality and performance.

Rod kidnaps Scratch and Shelley because they are about to be released by police despite being the sole survivors of the gang that murdered his brother Orville, sister-in-law, and caused Lisa's death. With Lisa dead and the only witness gone, the criminals would walk free. Rod takes justice into his own hands, using his surgical skills to punish them for their crimes.

Rod's background as a plastic surgeon and his decision to rent surgical tables and procure a shotgun after Lisa's death foreshadow his violent revenge.

Rod reveals that he also has a facial deformity, hidden behind a prosthetic mask created by his brother Orville. Like Patrick, Rod was born with facial deformities that required the Krugers to keep him hidden from society. He removes this mask in the makeshift operating room, showing his true face to the terrified criminals before mutilating them.

Lisa's conversation about Patrick and the revelation that Orville was a special effects artist hint at the family's hidden secrets about physical appearance.

Lisa does not survive. After being found unconscious in the woods, she is hospitalized with a blood clot but dies during an emergency operation. With Lisa as the only witness to the gang's crimes dead, Scratch and Shelley are freed by police, leading Rod to take his brutal revenge.

The earlier escape scene shows Lisa running into the dark woods, setting up her eventual capture and fatal fate.

Scratch and Shelley are freed because Lisa, the only surviving witness to the crimes, dies from a blood clot before she can testify. They claim to have been innocent victims of Patrick, and without the key witness, the police have no evidence to hold them. This injustice motivates Rod to take matters into his own hands.

After Lisa is found unconscious, Scratch and Shelley already begin their false narrative of being victims, setting up their eventual freedom.

The punk gang, led by Scratch, invades the Krugers' home at night while the family is sleeping. They hold the family hostage, demanding valuables. When Orville says they have none, the gang beats him to death with a log and kills Lisa's mother. They attempt to rape Kathy, but a female gang member stabs her to death. Lisa escapes through a window while the gang is distracted.

Earlier on the road, the gang harasses Lisa and Kathy and explicitly discusses robbing the Krugers' home, establishing their violent intentions.

Patrick is Lisa's adopted brother. Both Patrick and Rod were adopted by the Krugers family as children. Patrick was abandoned as an infant due to his severe deformities and was raised by the Krugers in secret within the house. Lisa knows about Patrick and asks about him upon arrival, indicating she is aware of her brother's existence.

Lisa's casual question about "Patrick" to her mother reveals she has knowledge of the hidden family member.

The Krugers kept Patrick in a soundproof nursery because his deformities and unpredictable behavior made him potentially dangerous. The room was designed to contain him safely while also providing a controlled environment. Rod later locks Scratch and Shelley inside this same nursery after mutilating them, using the space as a final prison for the criminals.

The nursery is discovered by the gang during their ransacking of the house, decorated with childish items that hint at someone kept imprisoned long-term.