69 pages • 2-hour read
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Content Warning: This section of the guide includes discussion of substance use, graphic violence, and death.
At medical school orientation, Abe Kaufman sees a female student and instantly believes he will marry her someday. At lunch, he steps on her toes and learns her name is Heather McKinley and that she has a boyfriend.
Needing money to manage his student loan debt, Abe searches for part-time work during his first week. He finds an ad on the anatomy lab bulletin board for a position at a medical clinic. The clinic, run by Dr. Stanley Kovak, is located in a dangerous neighborhood and is extremely rundown. Despite the poor conditions, the pay is excellent.
Dr. Kovak hires Abe on the spot to check in patients, take vital signs, and schedule appointments. Though suspicious, Abe accepts the job and agrees to start the following day.
Abe finds himself falling for Heather as they become study partners. When Heather, exhausted, rests her head on his shoulder, his heart pounds. She then leaves to call her boyfriend, Landon.
Abe’s roommate, Mason Howard, arrives and teases Abe about his crush, advising him to be more confident. He predicts Heather and Landon will break up within two weeks. Exactly two weeks later, a distraught Heather arrives at Abe’s dorm asking for Mason. When Abe says Mason isn't there, she sobs that Landon has broken up with her.
Realizing Heather came seeking a rebound hookup with Mason, Abe decides to be more assertive. He kisses her, and to his surprise, she kisses him back, beginning their relationship.
Abe attends his mandatory counseling session with Dr. Patrice Winters, the school’s wellness counselor. Assuming the session is merely a check-in related to a rampant drug problem at the school, Abe insists he does not use drugs and asks to leave early. Dr. Winters makes a note on her pad before dismissing him, and Abe resolves never to return.
Abe’s suspicions about Dr. Kovak’s clinic deepen. Many patients, especially students, use the phrase, “I’ve got a cough that won’t go away” (110). His classmate Victor Pereira arrives, uses the code phrase, winks at Abe, and leaves after a brief appointment, paying cash. When Abe tentatively questions his boss about Victor’s visit, Dr. Kovak dismisses his concern with a wink. He reminds Abe of his high pay and that he is valued at the clinic. Thinking of the loaded gun in Dr. Kovak’s desk, Abe feels intimidated and agrees to continue working.
Abe concludes that Dr. Kovak is dealing drugs to students, finally understanding the source of the school’s notorious drug problem. He suspects Dr. Matt Conlon is sending students to the clinic, since the job ad was posted outside the anatomy lab.
While waiting for Heather to arrive for movie night, Abe worries about the clinic. He is certain Dr. Kovak is selling drugs and fears he is trapped because he knows too much. When Heather arrives and senses Abe is upset, he admits he does not want to watch the romantic movie she brought, but is willing to because he wants to spend time with her. Touched, Heather suggests they see a zombie apocalypse movie instead. Her gesture reinforces Abe’s love for her, making him wish he had never taken the job at the clinic.
After anatomy lab, Dr. Conlon stops Abe and criticizes him for not properly spraying down the cadaver. When Abe mentions he has an appointment with Dr. Winters, the school counselor, Dr. Conlon appears displeased, strengthening Abe’s suspicion that the professor is involved with the clinic.
Abe goes to Dr. Winters’s office and reports his belief that the clinic where he works is distributing drugs to students. She promises a discreet investigation.
At the end of a shift at the clinic, Dr. Kovak counts the cash and gives Abe a bonus. A man named Hooper bangs on the door, demanding entry. Dr. Kovak retrieves the gun from his desk, but Hooper bursts through the door with a knife. He disarms Dr. Kovak and holds him at knifepoint, demanding money and drugs.
As Hooper presses the knife to Dr. Kovak’s throat, Abe picks up the fallen gun. Hooper charges at Abe, who shoots Hooper in the chest, killing him instantly. Horrified, Abe believes his life is over, but Dr. Kovak remains calm. Dr. Kovak convinces Abe that a police investigation would expose the drug operation and ruin both their lives, especially since Abe already reported his suspicions to Dr. Winters. Abe reluctantly agrees to help dispose of the body in a lake.
Abe arrives home covered in Hooper’s blood. He goes to shower, leaving his bloody scrubs on the bathroom floor. Heather unexpectedly enters the bathroom naked and sees the scrubs. Panicked, Abe screams at her to leave.
After showering, Abe hides the scrubs under his mattress. When Heather confronts him, Abe claims the blood was from a messy medical procedure. Heather notices dried blood under his fingernails and asks follow up questions. Abe can tell that she knows he is lying.
Abe throws the bloody scrubs in a dumpster. When he arrives at Heather’s door with a bouquet of lilies, her roommate Rachel Bingham answers, telling Abe that Heather is upset and does not want to see him.
Abe quits his job at the clinic by not showing up and ignoring Kovak’s calls. He goes to the library, where he runs into Sasha Zaleski, who asks him to tell Mason that she wants to see him. Abe recalls previously catching Sasha and Mason together and believes they have been hooking up.
Dr. Kovak calls repeatedly until Abe answers. Dr. Kovak reveals he has security camera footage of Abe shooting Hooper and blackmails him into returning to work. Trapped, Abe agrees.
Abe now views Dr. Winters as a problem because he confided in her about the clinic. In the parking lot, he sees Mason mumbling to himself, possibly on drugs, but decides not to approach him.
In the anatomy lab, Abe accidentally glances at Rachel’s chest while she is dissecting Frank. Rachel notices and snaps at him. Dr. Conlon approaches and looks at Abe in a threatening manner. Abe leaves the lab and goes to Dr. Winters’s office. She claims that the school investigated the clinic but found nothing wrong. Abe shares his suspicion that Dr. Conlon is involved in drug distribution. Dr. Winters agrees; she also has concerns about Dr. Conlon and promises to watch him. Abe leaves feeling validated but worried about what a deeper investigation might uncover.
Abe is suffering from insomnia and stops attending the anatomy lab to avoid Heather. He has become physically destructive, having punched a hole in the wall in his sleep. When his mother calls, telling him how proud she and his father are of him for getting into medical school, Abe feels immense guilt.
Arriving early at the clinic, Abe overhears Dr. Kovak telling a woman that this is what he is paying her for. When the door opens, Abe is shocked to discover the woman is Dr. Winters. He realizes she is working with Dr. Kovak, sending vulnerable students to the clinic for drugs. Dr. Winters and Dr. Kovak pretend her visit was part of her official investigation, but Abe angrily shrugs off her touch when she tries to reassure him.
After Dr. Winters leaves, Dr. Kovak offers Abe a significant raise to ensure his silence. Abe refuses the money, saying he just wants to quit, but a patient’s arrival interrupts their conversation.
At two o’clock in the morning, Mason wakes Abe, begging for sleeping pills and accusing him of being a drug dealer because he works at Dr. Kovak’s clinic. Abe furiously denies the accusation. When Mason becomes aggressive, Abe gets out of bed, ready to fight. Mason apologizes and leaves.
Unable to sleep, Abe goes to the empty anatomy lab and uncovers their cadaver, Frank, noting the a tattoo on his arm: “To serve and protect” (153). Taking a scalpel, he begins dissecting Frank’s limbs. Soon, his actions turn violent as he vents his rage and frustration by mutilating the cadaver. Exhausted, he cleans up and sits in a bathroom stall for nearly an hour.
The night before the anatomy final, Abe attempts to study in the library. When he goes to fill his water bottle, Victor asks Abe for drugs to help him pass the exam, referencing his position at Dr. Kovak’s clinic. Enraged, Abe threatens Victor, who runs away. Abe abandons his books and drives to the clinic, determined to end his involvement with Dr. Kovak.
Finding the clinic’s waiting room empty, Abe unlocks Dr. Kovak’s desk drawer, and takes the gun. After Kovak’s patient leaves, Abe confronts Kovak alone, pulling the gun and demanding the security camera footage of him shooting Hooper. Dr. Kovak retrieves a flash drive from a cabinet, and Abe takes it, warning Dr. Kovak that he will kill him if any other copies exist. He leaves with both the flash drive and the gun. Abe heads toward Dr. Winters’s office, where he plans to confront her and extract the full truth.
These chapters trace Abe’s moral erosion, as his identity as an earnest student disintegrates under financial and emotional strain. His perception of himself as a “nice guy who’s never done a bad thing in my whole life” (106) creates a baseline against which his subsequent actions are measured. Abe is portrayed as both a victim of circumstance and an agent of his own downfall. His transformation involves a series of compromises, each rationalized as the only solution to his problems at the time. Taking a job is a pragmatic choice driven by economic necessity. However, his decision not to look “a gift horse in the mouth” (101) and accept the lucrative position at Dr. Kovac’s clinic is a moral compromise that ignores his intuitive sense that the business is corrupt. The shooting of Hooper and Abe’s coerced decision to help dispose of the body serves as a point of no return, marking his transition from observer to participant. Abe exemplifies the theme of Ambition as a Catalyst for Moral Decay, as each corrupt act is committed to preserve the future he believes he deserves: a career as a doctor and a life with Heather. His mutilation of the cadaver, Frank, symbolizes this moral descent in a shocking act of desecration.
The narrative arc is shaped by The Corrupting Influence of Secrets and Deception. Abe’s secrets become a barrier between him and Heather, represented by the bloody scrubs he attempts to explain away. His lie about the source of the blood is the first significant deception in their relationship, and Heather’s recognition of his dishonesty damages the trust between them. The secret isolates Abe, precipitating a psychological breakdown evident in his insomnia and destructive behavior. Dr. Kovak’s blackmail transforms this secrecy from a personal burden into an inescapable trap. The narrative demonstrates how one secret begets another, creating a web of lies that erodes Abe’s relationships and sense of self.
The theme of The Destructive Power of Academic Pressure on Identity informs Abe’s behavior throughout these chapters. The financial burden of medical school prompts Abe to seek employment, making him vulnerable to Dr. Kovak’s offer. Furthermore, Abe’s ambition to become a doctor is central to his identity, and the fear of losing that future makes him susceptible to manipulation. Dr. Kovak’s extortion is effective because it threatens Abe’s future. However, Abe’s complicity ultimately reshapes how others perceive him. When Victor approaches him to buy drugs, asserting, “‘Everyone knows” (157), he confirms that Abe’s attempts to secure his future have destroyed his reputation. His journey illustrates how the intense environment of elite academia can compel individuals to compromise the morality their chosen profession is meant to uphold.
The focus on Abe’s perspective in Part 2 utilizes his first-person narration to create a claustrophobic atmosphere. Confined to Abe’s consciousness, the reader experiences his mounting panic, guilt, and flawed rationalizations firsthand. Abe’s limited viewpoint encourages readers to share his misinterpretation of events, such as his suspicion that Dr. Conlon is behind the drug distribution, heightening narrative disorientation.



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