In 1987, New York City investment banker Patrick Bateman leads a double life, meticulously maintaining a polished social façade while harboring violent impulses. By day, he dines at trendy restaurants, obsesses over his physical appearance, and navigates a shallow circle of wealthy associates he secretly despises, all while engaged to Evelyn Williams. During a business meeting, he and his colleagues flaunt their business cards, fixating on their designs while missing the misspelled "Aquisitions" on each. Bateman is enraged by the perceived superiority of colleague Paul Allen's card. Later, he encounters a homeless man and his dog in an alley; initially offering help, Bateman instead insults and brutally kills them. Bateman's envy intensifies over Allen's affluent lifestyle and ability to secure reservations at the exclusive Dorsia, a restaurant Bateman cannot access. At a Christmas party, he arranges dinner with Allen, who mistakes him for another co-worker, Marcus Halberstram. During the dinner, Allen's condescending attitude fuels Bateman's resentment. Bateman lures him to his apartment, gets him drunk, and murders him with an axe. He disposes of the body and uses Allen's keys to access his apartment, leaving a message on Allen's answering machine claiming he has gone to London. When private investigator Donald Kimball questions Bateman about Allen's disappearance, mentioning sightings of Allen in London, Bateman deflects suspicion. Bateman hires prostitutes Christie and Sabrina, engaging in sadistic acts before paying them to leave. His violence nearly turns on colleague Luis Carruthers when he attempts to strangle him in a restaurant restroom, but Carruthers misinterprets the act as a sexual advance, horrifying Bateman, who flees. Kimball's second interview heightens Bateman's paranoia, but he continues his spree, seducing a model and later toying with killing his secretary, Jean. At his apartment, Jean narrowly escapes harm after Bateman warns her he might lose control, unaware of the model's severed head in his refrigerator. Kimball later informs Bateman that a colleague claims to have dined with Allen on the night of his disappearance, solidifying Bateman's alibi. Kimball dismisses the idea of Allen's murder as implausible, leaving Bateman relieved yet unnerved. Bateman rehires Christie and invites acquaintance Elizabeth for a drug-fueled encounter that turns deadly. Christie discovers corpses in his apartment while fleeing, only to be killed when Bateman drops a chainsaw on her in a stairwell. Bateman unravels after breaking off his engagement with Evelyn. An ATM bizarrely displays "Feed me a stray cat", prompting him to nearly shoot a cat, but he kills a woman who intervenes instead. Fleeing from police, he shoots an officer, inexplicably blows up a patrol car, and kills more innocents before hiding in his office building. In a frantic voicemail to his lawyer, Harold Carnes, Bateman confesses to around 40 murders, including Allen, Christie, Elizabeth, and others. The next day, Bateman visits Allen's apartment, now vacant and for sale. A realtor, suspicious of his dust mask, denies the apartment's connection to Allen and urges him to leave. Jean, alarmed by Bateman's disturbed state, finds his journal filled with graphic sketches of murder. At lunch, Carnes mistakes Bateman for someone else, laughs off the confession, and claims he recently dined with Allen in London, undermining Bateman's reality. As his friends discuss dinner reservations and muse about Ronald Reagan's persona, Bateman, uncertain if his crimes were real or imagined, narrates his unrelenting pain and desire to inflict it on others. Recognizing that his punishment and liberation from a hollow existence will never come, he declares his confession meaningless. On a door behind him, a sign reads "THIS IS NOT AN EXIT".
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