Suitable Flesh Ending, Explained: Does Elizabeth Die?

In the 2023 horror film ‘Suitable Flesh,’ psychiatrist Elizabeth Derby comes across a disturbing case of supernatural body swap when a patient named Asa Waite seeks her help. Initially skeptical of his claims of possession and identity theft, the doctor dismisses the boy’s concerns as the words of a person with paranoid schizophrenia who is afraid that his father, Ephraim, wants to take over his body. However, when a similar experience occurs to Elizabeth, she has to race against time to prevent permanently losing control of her body. To make matters worse, the entity pursuing her now resides within Asa, to whom she is strangely drawn.

As the narrative progresses, Elizabeth finds herself without allies as she battles the mysterious foe looking to possess her. Her work colleague, Dr. Daniella Upton, takes no notice of the psychiatrist’s rapidly degenerating psyche as she reminds the doctor to take responsibility for her actions. Meanwhile, Elizabeth’s husband, Edward, is confused by her changing personality as she loses agency over her behavior. As the film concludes, a riveting climax unfolds in which everyone’s identity gets muddled, leaving the fate of the central characters in doubt! SPOILERS AHEAD.

Suitable Flesh Plot Synopsis

In Arkham, Massachusetts, a victim of a murder is brought into the autopsy room of the Miskatonic Medical School. Psychiatrist Dr. Daniella Upton observes the body of the deceased before heading toward the psych ward, where the murderer, Dr. Elizabeth Derby, is held. Elizabeth and Daniella are colleagues and friends who work side-by-side at the medical school. It turns out that the former has killed one of her patients, Asa Waite, a boy Daniella purports to have met before. Upon questioning, Elizabeth reveals that Asa’s supposed corpse is not dead yet, and they need to kill it before it comes back to haunt the woman. When Daniella shows no signs of believing Elizabeth, the latter starts recounting her story leading up to Asa’s murder.

A few days ago, Elizabeth held personal counseling sessions for some of her patients when Asa knocked on her door, looking desperate for attention. As she started his therapy, she learned that he was having several out-of-body experiences, claiming that they were all related to his dying father, Ephraim Waite. Asa was of the opinion that Ephraim wanted to take over his body, stating that if he did it three times, he would permanently possess it. Swiftly after their discussion, Elizabeth witnessed Asa undergo a seizure and a complete personality makeover, almost as if someone else had taken over his faculties. Although the woman found it mysterious, she did not suspect foul play, citing it as a severe case of paranoid schizophrenia.

Following their initial meeting, Elizabeth felt drawn toward the altered Asa she had seen in her office. One day, she made a house call and met his grumpy father, Ephraim, who seemed absorbed in an occult book. Asa contacted Elizabeth, saying that his father was dying. She visited his house late at night but was unable to save Ephraim despite getting him his much-needed pills. The seemingly dead Ephraim reanimated briefly and switched bodies with Asa, who got stuck in his dead father’s corpse. Ephraim, now in Asa’s body, seduced Elizabeth, who was confused by the events of the night. The two had sex before changing bodies during the act. Upon returning to her body, the doctor witnessed Asa sever Ephraim’s head as the house caught on fire.

It soon became clear that Ephraim was possessing Asa. The boy pursued Elizabeth, who started seeing sexual dreams of Asa, almost as if she could not stay away from him. He eventually called her and said the incantation to trigger consciousness transference between them. Elizabeth woke up in Asa’s body and was handcuffed to a pipe in the Waite household. With no way to escape her confinement, she phoned Daniella, pleading for help. The woman conversed with her but vehemently refused to believe what she was trying to say. Soon after, Ephraim returned to his body while Elizabeth woke up in hers. Knowing that switching places three times would mean the change was permanent, the woman started racing against the clock to save herself from a disturbing case of supernatural identity theft.  

Suitable Flesh Ending: What Does the Demonic Spirit Want?

When Ephraim took over Asa’s body, the real spirit that had been residing within the boy was not of the Waite family patriarch. It was, in fact, a much older entity that had been swapping bodies for several centuries. When she was cornered by it in her office, Elizabeth learned that the demon no longer remembered what gender it was born because of how long it had been alive. The spirit also admitted that it was somewhat worn down after transferring consciousness in an endless cycle for many generations. However, after gaining a taste of possessing Elizabeth, the spirit professed an interest in taking over her life next. It was primarily intrigued by possessing a female body as it expressed that “the future is female,” and it would satisfy its intentions to dominate, something the spirit was born with.

Soon after hypnotizing the spirit, Elizabeth stabbed it with a knife. In the ensuing scuffle, the woman managed to direct Asa toward the window of her room, pushing him through the narrow opening. Even after plummeting down several stories, the spirit did not die. Elizabeth swiftly headed downstairs and entered her car. She ran Asa over with her vehicle, trying to stop him to the best of her abilities. When he still displayed signs of life, Elizabeth started stabbing and slicing him furiously with her knife, distressed that he refused to die no matter what she did. Her actions were halted when a police car pulled up behind her back, and the patrolling officers extricated her from the mutilated body that should have been extinguished under normal circumstances.      

Although the spirit mainly changed bodies to survive, it had grown bored over the years and transferred consciousness whenever it felt intrigued by something or someone. That someone happened to be Elizabeth this time. Despite Asa’s body being young, healthy, and suiting the spirit’s survival needs, it was mainly excited by the prospect of taking over the psychiatrist, who it deemed an untapped well for new exploration. When it possessed Elizabeth’s body for the second time, it used the opportunity to have sex with her husband, Edward, familiarizing itself with the body’s raw sex appeal as a way to dominate the minds of those around it. As the spirit showcased no signs of empathy for its victims, it had no issues with exerting control over others to serve its own needs. Thus, it was akin to a parasite. 

Does Elizabeth Survive?

The end of ‘Suitable Flesh’ recycles back to the film’s opening sequence when Elizabeth is locked in the psych ward while Asa’s mutilated body lies in the medical school’s autopsy room. After completing her retelling, Elizabeth pleads with Dr. Daniella Upton to believe her story. However, the skeptical psychiatrist tells Elizabeth to reflect upon her actions and question whether she is showing signs of mental illness herself. Their conversation is cut short when Asa’s corpse opens its eyes and is rocked by a seizure. The same happens to Elizabeth, whose body is taken over for the third time, signifying that the alteration has become permanent. Although she manages to survive in Asa’s destroyed body, she is ultimately killed and set free by Daniella, who takes over Elizabeth’s body herself in the film’s final battle.

Before Elizabeth passes away, she manages to crawl through the autopsy room and enter the hallway despite the several injuries covering her host body. She tries to warn the panicking hospital staff and Daniella that she is in Asa’s body and the real spirit now resides within hers. However, given the extent of the bodily harm Asa has been subjected to, it is a miserable existence for Elizabeth, who has been thrown out of her body and is trapped within the incapacitated physique of someone else. Therefore, when Daniella shoots her through the head, it is an act of mercy to put her out of her new horrifying reality. Additionally, Elizabeth manages to warn her friend about the presence of the spirit, thereby allowing Daniella to put up some level of resistance against the malignant parasite.  

Tragically, however, Elizabeth ends up succumbing to a dreadful scenario before Daniella ultimately euthanizes her. Even if Asa’s body manages to recover from the terrible scars inflicted upon it, there is only a meager chance that Elizabeth will be able to live as someone else without the swap causing tremendous distress to her psyche. The thought of her identity being ripped away may have haunted her forever. Although Daniella’s actions may seem drastic, it is the only way to free the woman from a torturous future where she lives as a stranger while knowing that someone else with ulterior motives has taken over her life. Furthermore, it will only cause greater anguish when no one will believe her when she tells them the truth about what happened.  

Who is in Daniella’s Body?        

Despite being unconvinced throughout the narrative, Dr. Daniella Upton realizes the truth behind the body swapping at the film’s end. After witnessing Asa’s reanimated corpse crawling through the medical school’s hallway and the enigmatic personality shift in Elizabeth, Daniella connects the dots and deduces the identity of the spirit residing within her friend’s body. The two engage in a fight before slipping out of the psych ward cell, where it is revealed that the spirit has taken over Daniella’s body while she is in Elizabeth’s. Although it seems as if Daniella holds the upper hand in the engagement initially, the film’s conclusion divulges a disturbing detail concerning the psychiatrist. She gets trapped in Elizabeth’s body and is held in the asylum, while the spirit possesses her body and lives in freedom.

In the penultimate altercation, Daniella corners the spirit by threatening it with the gun belonging to Mace, the security guard. However, she fails to kill the spirit before it latches back into Elizabeth’s body while she returns to hers. Subsequently, armed with the gun, the spirit shoots Mace through the head and is attacked by Daniella with a scalpel. With victory close to attainment, the psychiatrist tries to stab Elizabeth’s body but fails to do so in time before the spirit recites the incantation to swap bodies again. Right before the orderlies arrive to stop the fight, the two women switch places. Daniella, in Elizabeth’s body, is put in a straitjacket and locked in a containment cell within the facility. Meanwhile, the spirit in Daniella’s body consoles Edward Derby, who is distressed by his wife’s perceived mental illness.

After jumping bodies across several people — Ephraim, Asa, Elizabeth, and Daniella — in a short period, the spirit manages to escape the clutches of those whose lives it took over. All of its victims, save Daniella, have died trying to recover their lost identity. Although the film only depicts Daniella switching bodies with the spirit twice, it is likely that the parasite completes its permanent switch to her body as it only requires one more try. Ultimately, the psychiatrist suffers the most out of all the victims. She is trapped in the psych ward of the Miskatonic while living with full knowledge that someone else is navigating her body. Her end is vastly more cruel than her compatriots, who only suffered for a brief period before their lives were extinguished, which is not the case for her.

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