It is a concept album that tells the story of a victim of a car crash who, upon awakening from a coma, finds himself in the mysterious town of Mercy Falls, a fictional world he has dreamed up in his comatose state.

The band announced on their website that the first 1000 copies to be sold would be limited edition copies, with an alternative cover and a bonus DVD containing video footage from the recording sessions as well as interviews with all band members about the new album and private photos from the entire recording process.

Within the man's mind, he dreams of a woman who lives in Mercy Falls, who constantly stays locked inside "the tall house", an empty mansion that the children fear to approach.

At the album's emotional climax, "One Last Goodbye", they turn off his life-support machines and assure him that his memory will live on.

He passes from Mercy Falls into the afterlife, and as he is dying, he has a flashback which reveals a conversation he had with his wife several years ago in the car.

Not only did she cause the accident in the first place by telling the man that the son he thought he had was not his, but the attempts to bring him out of his coma also failed because of her infidelities.