Dead Med

The narrator of Part 4, Mason Howard, exemplifies The Destructive Power of Academic Pressure on Identity. A round and dynamic character, he is initially defined by his fierce ambition and arrogance. He enters DeWitt with the singular goal of securing a top-tier plastic surgery residency, a path encouraged by his surgeon father, who told him, “Plastics, son. That’s where the money is” (272). This drive makes him relentlessly competitive and often dismissive of his peers. His confidence borders on hubris as he performs dissections with an air of effortless superiority, reinforcing his role as the class’s top student.

Beneath his arrogance, Mason possesses a keen, inquisitive mind. He is the first to question the remarkably healthy state of their cadaver, finding it strange that there is no obvious cause of death. This initial curiosity metastasizes into a full-blown obsession, leading him to believe he has uncovered a conspiracy involving Dr. Conlon. While his investigation is increasingly distorted by paranoia, his perceptive nature allows him to identify inconsistencies that other characters overlook. This fixation on solving the mystery of Frank’s death accelerates his psychological descent, as the search for an external truth mirrors his loss of internal stability.

Ultimately, Sasha’s secret drugging of Mason culminates in his psychosis, rendering him an unreliable narrator. His chapters document an alarming decline into paranoia, insomnia, and auditory hallucinations. Mason’s delusion that Dr. Conlon is involved in a drug ring and has murdered Frank to conceal a crime drives him to confront and kill both Dr. Matt Conlon and Dr. Patrice Winters, believing he is acting justifiably. His tragic arc exemplifies how the intense pressure of medical school, combined with malicious interference, transforms a brilliant student into a murderer destined to spend the rest of his life in prison.

As a deuteragonist and narrator of two sections of the novel, Abe Kaufman serves as a moral compass struggling to remain true in a corrupt environment. His narrative arc is defined by his relationships and the compromises he makes to survive. Abe is introduced as an exceptionally kind and protective figure. Despite his imposing physical size, which initially intimidates Heather, his nature is gentle and supportive. He becomes Heather’s staunchest ally, offering academic help and emotional comfort, and she comes to view him as her “guardian angel” (54). His actions are motivated by a deep and sincere affection for Heather, which he harbors long before she reciprocates his feelings. His steadfast loyalty and inherent decency provide a stark contrast to the ruthless competitiveness of peers such as Mason and Sasha.

However, Abe’s working-class background and the resulting financial desperation make him vulnerable. Unlike his more affluent classmates, he must juggle his studies with a part-time job at Dr. Stanley Kovak’s clinic. Initially naive to the clinic’s true nature, he is gradually drawn into its criminal operations. His need for the high-paying job, coupled with Dr. Kovak’s subtle threats, traps him in a situation that compromises his values. This external pressure forces Abe to become an unwilling participant in the illicit drug trade, illustrating how economic hardship can catalyze moral decay.

Abe’s character highlights The Corrupting Influence of Secrets and Deception as he becomes increasingly morally compromised. His complicity in the clinic’s activities escalates dramatically when he kills an intruder and then helps Dr. Kovak dispose of the body. Hiding the truth from Heather causes a significant rift in their relationship when she discovers his bloodstained scrubs. Abe’s attempt to explain away the blood, claiming that a clinical procedure “got a little messy” (82), echoes his “messy” entanglement in a web of secrets. His decision to confront Patrice with a gun creates a parallel with Mason’s character, emphasizing that when placed under enough pressure, both have the capacity for violence. However, in the Epilogue, Keira’s description of Abe as the kindest surgical resident suggests a return to his former good-natured self.

Rachel Bingham is introduced as Heather’s cynical roommate and serves as a foil to her naive optimism. Her narration in Part 3 reveals the complex psychology behind her hardened exterior, establishing her as a dynamic character who evolves through her relationship with Dr. Conlon. Initially, Rachel embodies a deeply cynical worldview, stating on the first day, “We won’t all be doctors” (10). She views medical school as a cutthroat game and has a history of using seduction as a tool for academic survival, manipulating professors to secure better grades. She plans to employ this same strategy with Dr. Conlon, whom she initially dismisses as a dork she can easily control. This manipulative tendency is her primary coping mechanism in a system she believes is rigged against her.

Beneath this manipulative facade, Rachel is profoundly lonely and insecure. Her cynicism is a defense mechanism designed to keep others at a distance. Her transactional relationship with Dr. Conlon unexpectedly evolves when she experiences a genuine emotional connection and sexual satisfaction for the first time. This relationship exposes Rachel’s deep-seated vulnerability and her longing for a meaningful connection, challenging her cynical beliefs about herself and others. Her love for Matt becomes the catalyst for her transformation, forcing her to confront the emptiness of her past manipulations.

The evolution of Rachel’s character is most evident in her capacity for love and loyalty. When she is blackmailed, she steals the final exam paper to protect Matt’s career, an act of sacrifice that starkly contrasts with her earlier selfishness. This decision signifies a fundamental shift in her priorities from self-preservation to protecting someone she loves.

Rachel’s appearance in the Epilogue as a licensed physician training to become a psychiatrist suggests a further evolution. Despite her devastation at Matt’s murder, she has continued her medical training and succeeded without male assistance. The revelation that she is drugging her coworker, Sasha Zaleski, indicates her ongoing vendetta against the woman who set Matt’s murder into motion.

As the narrator of Part 5, Sasha Zaleski is a quiet yet formidable antagonist whose actions serve as a primary catalyst for the novel’s tragic climax. Her character is driven by ambition rooted in personal loss as she seeks to honor the memory of her late father, whose dream it was for her to become a doctor. Sasha’s defining trait is her intense desire to be “at the very top of my class” (355), a goal she pursues with single-minded determination. She perceives the competitive environment of medical school as fundamentally unfair, believing that good-looking and privileged students like Mason Howard have an unearned advantage. This perception fuels her decision to take extreme measures to “level the playing field” (394), making her a compelling example of how noble motivations can become corrupted.

Sasha’s trajectory illustrates the theme of Ambition as a Catalyst for Moral Decay. To achieve her goal, she employs deceit and manipulation, operating from behind a facade of quiet diligence. Her most significant act of manipulation is the systematic drugging of Mason with her late father’s dopamine medication. She does this coolly and methodically, hoping to disrupt his ability to study and thereby eliminate her chief competition. This act precipitates Mason’s psychological breakdown. Sasha further demonstrates her ruthless nature by blackmailing Rachel to obtain the final exam answers. These actions reveal a character who is willing to abandon all ethical principles in the pursuit of her ambition.

Despite her ruthlessness, Sasha is not entirely without a conscience. She experiences flashes of guilt, particularly after her brief physical relationship with Mason complicates her view of him as mere competition. Sasha experiences remorse when she realizes that cheating on the final exam would bring shame rather than honor to her father’s memory. Her decision to destroy the stolen exam marks a crucial turning point. However, the epiphany comes too late to avert the catastrophic events she has already set in motion.

Dr. Matt Conlon is the central mentor figure in the novel, as well as a love interest for Rachel and the ultimate victim of Mason’s paranoia. As the narrator of Part 6, he offers insight into his past trauma, establishing him as a round but largely static character. Matt is first and foremost a passionate and dedicated educator. He is beloved by his students for his “dorky” but effective teaching style and his genuine investment in their success. His life revolves around his work, a path he embraced after a traumatic event forced him to abandon his own medical studies. After being shot by his roommate, he is left with permanent physical disabilities. His role as a professor is thus both a career and a way of remaining in a world from which he was violently ejected.

Although professionally fulfilled, Matt is personally isolated and lonely. This vulnerability allows Rachel Bingham to initially succeed in her seduction attempt. What begins as a moment of weakness for him develops into a genuine emotional connection, the first he has experienced in years. His relationship with Rachel brings him a sense of happiness that has long been absent from his life. Matt adheres to a strong ethical code in his teaching, refusing to alter Rachel’s grades despite their affair. However, by engaging in a relationship with his student, he compromises his professional integrity. His loyalty ultimately shifts from his professional duties to Rachel herself. He keeps Dr. Winters’s secret to protect Rachel’s future career, and in his final moments, his sole focus is on ensuring her survival. By silently instructing her to stay hidden from Mason, he knowingly sacrifices his own life to save hers, a final act of love that solidifies his tragic role in the narrative.