"A Small, Good Thing" opens on a Saturday afternoon in a quiet American suburb. Ann Weiss, a devoted mother, visits a shopping center to order a chocolate cake for her son Scotty's birthday, which is just days away. The baker, seemingly unfriendly, assures her the cake will be ready by Monday morning.

An Unexpected Accident

Monday morning unfolds with Scotty walking to school alongside a friend. Suddenly, he is struck by a car after stepping off a curb. The driver halts momentarily but departs once Scotty appears unharmed. Yet, when Scotty arrives home, he collapses and slips into unconsciousness. Rushed to the hospital, he is diagnosed with a mild concussion and shock. Although deeply asleep, Dr. Francis, overseeing his care, reassures Ann and her husband Howard that Scotty isn’t in a coma.

Silent Calls

Howard returns home that evening to refresh himself. There, he receives an odd call from someone mentioning an unclaimed cake. Confused, Howard dismisses the call, only for the phone to ring again shortly after, with the caller remaining silent this time.

Lingering Worries

Back at the hospital in the early hours, Scotty's condition remains unchanged. Dr. Francis maintains that Scotty will recover soon. A nurse assures Ann and Howard that Scotty’s condition is stable. Yet, as hours pass, their anxiety deepens. Dr. Francis eventually acknowledges that Scotty has entered a coma, though he insists on optimistic signs.

Shared Moments of Concern

Seeking a brief respite, Ann returns home to attend to household duties. She encounters another family at the hospital waiting room, united by concern for their son Franklin, who was innocently injured in a brawl. Their shared experience of waiting and uncertainty draws her empathy.

A Troubling Call

At dawn, Ann receives another unsettling call at home, cryptically mentioning Scotty. Disturbed, she contacts the hospital, learning there’s been no change. Howard speculates the persistent caller might be the driver from the accident, possibly someone dangerous who found their number.

Unexpected Tragedy

By morning, Ann returns to the hospital, inquiring about Franklin, only to hear of his passing. In Scotty's room, Howard updates her on the doctors' plans for further tests and potential surgery. During this tense moment, Scotty briefly awakens, meets his parents' eyes, but then, in a distressing twist, stops breathing.

A Heartbreaking Reality

The doctors reveal Scotty's death was due to a rare, unforeseen complication. Dr. Francis, visibly moved, expresses his condolences and mentions an autopsy will follow. Devastated, Ann and Howard head home, overwhelmed by grief. Ann reaches out to family, while Howard seeks solace in the garage with Scotty's bicycle.

Unwanted Phone Calls

In the midst of their sorrow, another call interrupts, the same voice from before speaking of Scotty. In anger, Ann curses the caller before hanging up, collapsing in tears. Later, as the clock approaches midnight, the phone rings again, only to fall silent when answered. Both Ann and Howard realize it’s the same relentless caller.

A Midnight Realization

Suddenly, Ann recalls the cake order, deducing that the baker has been the source of these distressing calls. Determined to confront him, she and Howard drive to the bakery despite the late hour. Ann knocks, and the baker, recognizing her, mentions the unsold cake, now three days old, offering it at a discount.

Profound Connection

Upon learning of Scotty’s death, the baker’s demeanor shifts, offering sincere apologies. He invites Ann and Howard inside, offering them chairs, coffee, and fresh cinnamon rolls. As they share this simple meal, he speaks candidly about his own solitude and the stark reality of a life without children. The three talk deeply into the morning, bridging their pain with understanding and a small, good thing.