The film, based on Ralston's autobiography Between a Rock and a Hard Place, was written by Boyle and Simon Beaufoy and produced by Christian Colson and John Smithson (both Beaufoy and Colson had previously worked with Boyle on Slumdog Millionaire). The music was scored by A. R. Rahman who had also previously worked with Boyle on Slumdog Millionaire. The film was well-received by critics and was nominated for six Academy Awards including Best Picture and Best Actor (James Franco).
On April 25, 2003, Aron Ralston (James Franco) prepares for a day of canyoneering in Utah's Canyonlands National Park as he drives to the trailhead at night. The next morning, he bikes through the park, aiming to cut 45 minutes off the guide book's estimate for the time needed to reach his destination. He is on foot, running along a bare rock formation when he sees two hikers, Kristi (Kate Mara) and Megan (Amber Tamblyn), apparently lost. Ralston convinces the pair that he's a trail guide and offers to show them a much more interesting route than the one they had been trying to find. He leads them through narrow canyons, including a blind jump into an underground pool, where the three film themselves repeating the plunge using Ralston's video camera. As they part company, Kristi and Megan invite Ralston to a party they're holding the next night, and he promises to attend. However, they doubt he will show.
Ralston continues into Blue John Canyon, through a narrow passage where boulders are suspended, wedged between the walls of rock. As he descends, one boulder is jarred loose, falling after Ralston to the bottom of the canyon and pinning his arm against the canyon wall, trapping him. He initially yells for help, but nobody is within earshot. As he resigns himself to the fact that he is on his own, he begins recording a video diary on his camera and using his pocket multi-tool to attempt to chip away at the boulder. He also begins rationing his water and food.
As he realizes his efforts to chip away at the boulder are futile, he begins to attempt to cut into his arm, but finds his knife too dull to break his skin. He then stabs his arm, but realizes he will not be able to cut through the bone. He finds himself out of water and is forced to drink his own urine. His video logs become more and more desperate as he feels himself dying. He begins dreaming about relationships and past experiences, including a former lover (Clémence Poésy), family (Lizzy Caplan, Treat Williams, Kate Burton), and the two hikers he met before his accident. After reflecting upon his life, he comes to the realization that everything he has done has led him to this ordeal, and that he was destined to die alone in the canyon.
After five days, Ralston sees his unborn son through a premonition. He gathers the will to apply enough force to his forearm to break it and severs his arm with the dull knife, fashioning a crude tourniquet out of the insulation for his CamelBak tube and using a carabiner to tighten it. He wraps the stump of his arm and takes a picture of the severed portion he is leaving behind. He then makes his way out of the canyon, where he is forced to rappel down a 65-foot rock face and hike several miles before, exhausted and covered in blood, he finally runs into a family on a day hike. The family sends for help and Ralston is evacuated by helicopter.
The film ends with shots of the real Aron Ralston from his life after his ordeal — including several of Ralston's further adventures in climbing and mountaineering, which he continued following the accident — and of Ralston with his wife, whom he met years later, and their son, Leo. A title card that appears before the closing credits says that Ralston makes a point to contact his family whenever he goes anywhere alone.
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