Content Warning: Both the source text and this guide discuss mental health conditions, violence, child neglect, child abuse, serial murder, kidnapping, and suicide.

Keep It in the Family opens with an italicized prologue set 39 years before the primary plotline and is written from the first-person perspective of an unidentified narrator who creeps along a darkened staircase in a house they know well. Fearing detection by unseen antagonists, the narrator makes their way to the attic and uses a peephole in the attic door to spy on a young boy who is suspended by a rope attached to a ceiling hook.

The narrator observes the boy without speaking to him; instead, they reflect on the unnamed couple who are implied to have abducted the boy. The narrator observes that the couple has a pattern of kidnapping and torturing children, and this boy—like the many others who came before him—will soon die. The narrator listens as the little boy dies and then slips away from the attic door, retreating to their bedroom until an unidentified woman tells them to come out. As the narrator pretends to read a book, they observe that the little boy’s disappearance will make headlines for a brief time until he is forgotten by the wider world.