69 pages 2-hour read

Dead Med

Fiction | Novel | Adult | Published in 2024

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Part 3Chapter Summaries & Analyses

Content Warning: This section of the guide includes discussion of mental illness, death by suicide, substance use, graphic violence, sexual content, cursing, and death.

Part 3: “Rachel”

Part 3, Chapter 32 Summary: “The First Day”

Rachel Bingham begins her first year at DeWitt Medical School, sharing a dorm room with Heather McKinley, whom she finds intolerable. Heather arrives with excessive luggage and constantly discusses her boyfriend, Landon. When Rachel hangs posters with thumbtacks, Heather protests that it violates dorm rules. Rachel privately predicts Heather will marry, work briefly as a physician, then quit to become a stay-at-home mother.


Rachel finds anatomy uninteresting and fails three consecutive quizzes. Dr. Matt Conlon begins paying close attention to her in the lab, observing her mistakes. Mason Howard mocks her dissection skills and laughs when Rachel suggests that naming the cadavers is disrespectful. He snorts derisively when Rachel says she wants to go into surgery.


Dr. Conlon reads the slogan on Rachel’s T-shirt and compliments it. After the lab session, Dr. Conlon suggests Rachel would benefit from tutoring. Rachel notes the anatomy professor’s “dorky” appearance, his limp, and that his office light is always on. She concludes that his loneliness makes the situation perfect for her purposes.

Part 3, Chapter 33 Summary

Rachel recalls her junior year of high school, when she was failing trigonometry. Her teacher, Harvey Pritchett, an unattractive middle-aged man, left a note on her failed midterm asking to see her. Rachel, then an unpopular loner with acne and frumpy clothes, was terrified. After class, Mr. Pritchett told her he would have to fail her if she did not improve. Rachel began crying uncontrollably. As Mr. Pritchett tried to comfort her, a kiss occurred. This was Rachel’s first sexual experience. She found Mr. Pritchett physically repulsive but did what she felt necessary to avoid failing. She received an A on her next exam despite most of her answers being incorrect. Sleeping with teachers to obtain better grades became a pattern throughout high school and college. She concludes that Dr. Conlon will be her next target.

Part 3, Chapter 34 Summary

Rachel is certain she has failed her first anatomy exam. Heather is also distraught, believing she has failed as well. While Heather is in the shower, their classmate Abe Kaufman knocks on the door looking for her. Rachel notes Abe has a crush on Heather. She bluntly tells Abe that Heather has a boyfriend and that he would not have a chance with her anyway. Abe looks crushed and leaves. Rachel checks her email and finds a message from Dr. Conlon asking her to see him after class the next day.

Part 3, Chapter 35 Summary

Rachel goes to Dr. Conlon’s office wearing a short red skirt. She observes that despite his “dorky” bow tie, Dr. Conlon is good-looking and in his late thirties, unlike her usual targets. Dr. Conlon expresses concern about her poor exam performance. Rachel fakes tears and tells him she feels lonely and is struggling. As he comforts her, she takes his hand. Instead of making a move, Dr. Conlon suggests she see Dr. Patrice Winters, the class psychologist.


When Dr. Conlon accidentally knocks his pen holder onto the floor, they both bend down to pick up pens. She sees his eyes flick to her cleavage. Seizing the opportunity, Rachel initiates a kiss. Though stunned, Dr. Conlon responds eagerly. Their sexual encounter is unlike anything Rachel has experienced before. Afterward, Dr. Conlon tells her she can call him Matt in his office.

Part 3, Chapter 36 Summary

The next day, after an anatomy lecture, Rachel goes to Matt’s office and sits on his lap. He kisses her, and she brings up her bad grade. Instead of offering to change it, Matt offers to tutor her personally. When Rachel threatens to tell the dean about their relationship, Matt reveals he already knows about her past: Dr. Hirsch, a professor she blackmailed in college, called DeWitt faculty to warn them about her. Matt points out that the faculty would be unlikely to take action against its only “disabled” staff member. Furious that he knew her plan all along, Rachel tries to leave. Matt stops her, reminding her she is still failing anatomy. He tells her he is holding special tutoring sessions for struggling students and that she must attend.

Part 3, Chapter 37 Summary

Rachel attends the first remedial anatomy session, which she finds humiliating. The other attendees are Victor Pereira and Marissa Dunne, both of whom Rachel dislikes. Despite her initial feelings, Rachel finds the session helpful, admiring Matt’s patience and excellent teaching.

Part 3, Chapter 38 Summary

The tutoring sessions help Rachel’s performance in anatomy. In the lab, Matt quizzes her, and she correctly answers, surprising Mason. Rachel reflects on how Matt acts as if nothing ever happened between them, treating her like any other student. She completes an extra-credit assignment early and takes it to his office. She arrives to find Dr. Winters there, having brought Matt homemade cookies. Rachel immediately assumes they are hooking up and feels a sharp jab of jealousy. Matt welcomes Rachel, and Dr. Winters glares at her before leaving abruptly, slamming the door. Instead of discussing the assignment, Rachel confronts Matt, asking if he is sleeping with Dr. Winters. A flustered Matt vehemently denies it.

Part 3, Chapter 39 Summary

Rachel attends a Friday night tutoring session. Victor and Marissa are both absent, leaving her alone with Matt. When she asks if he has slept with other students, he denies it, stating their encounter was out of character for him. They begin the lesson, but Rachel is distracted by the intimate setting and his presence, admitting she enjoyed their sexual encounter. Matt reminds her that he will not change her grade. He kisses her, then pulls back, saying it is a bad idea. Rachel agrees, but he kisses her again.

Part 3, Chapter 40 Summary

Matt sets ground rules for his renewed relationship with Rachel: They will maintain a purely academic relationship on campus and primarily meet at his house to avoid being caught. Rachel realizes she is infatuated with Matt and wonders if he feels the same. Matt is 38 and expresses discomfort with their 16-year age gap, saying he feels like “a creep.” Rachel reassures him, saying she has never related to people her own age.

Part 3, Chapter 41 Summary

Matt gives Rachel another pep talk about her potential. Revealing that he is a medical school dropout, he parts his hair to show a long scar running through his skull. Matt reveals he was shot in the head during his first year of medical school by his roommate, Kurt Morton, who was flunking out. One night, Kurt woke him at two o’clock in the morning, holding a gun. After shooting Matt in the head, Kurt died by suicide. Matt says he woke two weeks later, unable to move half his body. Rachel correctly intuits that his inability to continue medical school was not entirely his choice. Matt claims he is happier now as a professor than he would be as a surgeon, but Rachel is unconvinced.

Part 3, Chapter 42 Summary

Rachel is nervous about the second midterm, knowing Matt will not change her grade. During a study session at his house, Matt reveals his sensory and motor deficits on his right side. He expresses insecurity, saying he does not know why Rachel wants to be with him. They study late into the night using a game where Matt feeds Rachel a grape for every three consecutive correct answers.


The next morning, Rachel feels terrified about the exam, especially because she does not want to disappoint Matt. Heather points out that Mason looks terrible, leading Rachel to speculate that he might be on drugs. Heather shares gossip that Mason and Sasha Zaleski, another student from Rachel’s lab group, are hooking up. When Heather asks where Rachel was the previous night, Rachel lies, saying she was studying at school. In the lab, Rachel’s anxiety peaks. She sees Matt, who mouths that she will be fine, which calms her. The practical exam begins.

Part 3, Chapter 43 Summary

That evening, Matt cooks Rachel a celebratory dinner. When Rachel arrives, he tells her she got honors on the exam. Overjoyed, she embraces him, and they kiss passionately. While in his bathroom, Rachel notices the medicine cabinet is ajar. She snoops and finds many prescription pill bottles, including Vicodin and oxycodone, powerful painkillers. She briefly wonders if Matt is dealing drugs to students. However, the medication labels indicate that all have been prescribed to Matt by a physician. Finding a bottle of Zoloft, an antidepressant, she feels guilty and closes the cabinet.


Back at the dinner table, Matt burns his right hand on candle wax. As Rachel tends to his injured hand, he explains he is overdue for Botox injections, which relieve his hand spasms. He quizzes her on the muscles of finger flexion, and she answers correctly. They abandon the now-cold dinner for intimacy. During this encounter, Rachel realizes she is in love with Matt.

Part 3, Chapter 44 Summary

Rachel finds it hard to stick to the rule of keeping her relationship with Matt off campus. She goes to his office and eavesdrops, hearing an agitated Victor inside, upset about failing the second exam. Victor storms out, sees Rachel, and sneers at her. Inside the office, Matt asks Rachel whether Victor seemed high, noting his dilated pupils. As Rachel leaves Matt’s office, she runs into her classmate, Danielle Stern. When Danielle stares at her chest, Rachel realizes her shirt is buttoned incorrectly. Danielle shakes her head in disgust and walks away. Rachel decides not to tell Matt.

Part 3, Chapter 45 Summary

Matt calls Rachel and invites her over to study. She arrives at Matt’s house, and they are immediately intimate. Afterward, they order a pizza, and Matt takes a shower while Rachel waits. The doorbell rings. Rachel, wearing one of Matt’s T-shirts, opens the door expecting the pizza delivery. Instead, it is Dr. Winters. Dr. Winters is shocked to see Rachel there, dressed in Matt’s shirt. Matt emerges from the hallway, still damp from his shower. Dr. Winters reveals she thought Matt was sick and brought him soup. She confronts Matt, yelling at him for his indiscretion. Matt tells Rachel she should leave. While getting dressed, Rachel overhears Dr. Winters telling Matt that Rachel is playing him.

Part 3, Chapter 46 Summary

Rachel cries all the way back toward campus, convinced Patrice is in love with Matt and will either expose them or force Matt to break up with her. She sobs in her car outside the dorm, not wanting Heather to see her. Matt calls. He tells her Dr. Winters is gone and will not tell anyone about them. However, he says Dr. Winters made good points and asks Rachel if their relationship is worth the risk. Rachel insists it is, and Matt relents.

Part 3, Chapter 47 Summary

Despite the close call with Dr. Winters, Rachel practically moves in with Matt. Rachel confesses to herself that she may not be suited to be a surgeon. She tells Matt that she did not want to be like her mother, a stay-at-home mom, and saw being a surgeon as the furthest thing from that. Rachel tells Matt she loves him, and he confirms that he loves her too.

Part 3, Chapter 48 Summary

Rachel discovers an unsigned note stuffed under her locker door. The note threatens to expose her affair with Matt unless she leaves the answers to the final exam under the door of Locker 282.

Part 3, Chapter 49 Summary

The next morning, Rachel goes to see Matt’s secretary, Anita, to try to find out who is assigned to Locker 282. Anita refuses to help, stating that locker assignments are confidential. Rachel accidentally refers to Dr. Conlon as Matt. Anita realizes her suspicions about them are correct and confronts Rachel, accusing her of exploiting a lonely man.

Part 3, Chapter 50 Summary

Rachel decides she cannot tell Matt about the blackmail note, fearing his strict ethics would lead him to refuse to cooperate and lose his job. She decides to investigate on her own to identify the blackmailer. Her primary suspect is Danielle, who saw her leave Matt’s office with her shirt buttoned incorrectly. Rachel follows Danielle to the lockers, but she opens Locker 284, not 282.

Part 3, Chapter 51 Summary

Rachel arrives at the anatomy lab to find Frank’s limbs have been desecrated. She interprets this as a warning message from the blackmailer. Sasha reports the incident to Matt, who delivers an angry lecture to the class about competitiveness. Later, Matt leaves Rachel alone in his office when he goes to the bathroom. On his computer, Rachel finds the file for the final exam. She prints the exam and snatches the papers from the slow printer just as Matt returns. Rachel hides the exam in her jacket pocket.

Part 3, Chapter 52 Summary

Rachel locks herself in her bathroom to examine the stolen exam. She considers using it to cheat, but realizes that she cannot betray Matt’s trust. She reflects that Matt’s belief in her has motivated her to become a better person. However, she resolves to give the exam to the blackmailer to protect Matt and their future together.

Part 3, Chapter 53 Summary

The next morning, Rachel puts the exam in an envelope and slides it under the door of Locker 282. She then goes to Matt’s office. Matt confronts her with the exam paper’s final page, which she accidentally left behind on the printer. Matt tells Rachel that he was a fool for not heeding everyone’s warnings about her. He says he will rewrite the final exam and let her keep her honors grade on the midterm if they forget the whole thing happened. Rachel wants to tell him about the blackmailer, but knows he will not believe her. She insists that her feelings for him are genuine and tells him that she loves him. Looking deeply hurt, Matt tells her to get out.

Part 3, Chapter 54 Summary

In the days following the breakup, Rachel is miserable and cries constantly. She stops attending class and studies in the library. On the Saturday night before the final, she sees Sasha in the library and sits with her. Rachel confides in Sasha about her recent breakup, saying she did something unforgivable. In the conversation, Rachel has an epiphany: Her motives for stealing the exam were honorable, and Matt deserves to know the truth. She asks Sasha to watch her things and runs to Matt’s office.


Matt is angry and tells Rachel he has been rewriting the exam all night. Rachel tearfully tells him about the blackmail note and Locker 282. Matt believes her, and they reconcile, exchanging declarations of love. A male student knocks on the office door. Matt asks Rachel to hide, and she crawls under his desk.

Part 3, Chapter 55 Summary

From under the desk, Rachel hears the student accuse Matt of killing someone. She prepares to emerge, but Matt’s hand appears under the desk, gesturing for her to stay hidden. She hears Matt say he is sorry, followed by a gunshot. Rachel hears the intruder leave, and a second gunshot is fired from outside the office. She crawls out from under the desk and finds Matt dead from a gunshot wound to the head. Hearing Matt’s voice in her head, urging her to escape, she flees the office.

Part 3 Analysis

In Rachel’s narrative, her character evolves from a cynical worldview to one defined by emotional vulnerability. Initially, her identity is constructed around a transactional understanding of relationships, a defense mechanism forged in her exploitative experience with her high school teacher, Mr. Pritchett. She views seduction as a tool for academic survival, a strategy she deploys with precision. When her carefully planned seduction of Dr. Conlon results in an unexpectedly powerful connection, her established coping mechanisms fail. This loss of control marks the beginning of an identity crisis. Her relationship with Matt forces her to confront the emptiness of her transactional existence, challenging the cynical persona she has cultivated. Rachel’s journey from seeing Matt as a lonely, exploitable target to loving him reveals a capacity for connection she had suppressed, demonstrating how a cynical identity can be dismantled by genuine intimacy.


The novel’s narrative structure, which limits these chapters exclusively to Rachel’s perspective, generates dramatic irony and underscores the theme of The Corrupting Influence of Secrets and Deception. Confined to Rachel’s point of view, the reader witnesses her misinterpretation of crucial events, creating a tension between her perception and the truth. She interprets the desecration of her group’s cadaver as a threat from the blackmailer, an assumption that steers her further from the truth. Similarly, she confides in her classmate Sasha about her relationship troubles, viewing her as a sympathetic friend while remaining oblivious to the potential dangers posed by those around her. This sustained use of dramatic irony highlights how Rachel’s own secrets render her incapable of recognizing others' deceptions.


Rachel’s isolation results from the compounding layers of deceit that propel her story. The initial deception—seducing Matt for a grade—necessitates a larger one: their secret affair. This primary secret becomes a breeding ground for further falsehoods. Rachel’s decision not to tell Matt about the blackmail note stems from a misguided desire to protect him, which ironically destroys his trust. Matt’s pained accusation that he “fell for [her] bullshit act” (255) reveals how deceit taints their mutual love. The physical act of hiding under Matt’s desk during the novel’s climax serves as a metaphor for Rachel’s position throughout the affair: concealed, silent, and ultimately powerless as a witness to catastrophic events she has inadvertently helped set in motion.


Rachel’s perspective on Matt’s physical disabilities highlights her character’s development. Initially, she perceives his limp as an external marker of his vulnerability, a sign that he is an easy target. However, as her feelings deepen, these attributes are reframed. The scar on his skull from a gunshot wound becomes an indicator of his profound trauma and resilience. Rachel recognizes Matt’s decision to show her the scar, which is usually hidden by his hair, as a moment of profound trust and intimacy. The motif of drugs and pills further illustrates Rachel’s shifting viewpoint. On seeing several bottles of strong painkillers, she initially wonders if he is dealing drugs—a sign of her ingrained cynicism. However, Rachel quickly realizes that the medication is a testament to Matt’s heroism, revealing the chronic pain he so cheerfully conceals. The sadness Rachel feels on noticing antidepressants in the cabinet is a further sign of this growing empathy. Rather than seeing weaknesses to be exploited, Rachel views the pills as a valuable insight into her lover’s complex humanity.


While Rachel’s story begins as a clear illustration of Ambition as a Catalyst for Moral Decay, the novel ultimately complicates this theme by redefining the object of her ambition. Her established pattern of trading sex for grades is a direct result of academic pressure and a desire for control. Yet her relationship with Matt shifts her ambition from academic success to preserving their bond. Her decision to steal the final exam is a desperate attempt to protect Matt’s career and their future rather than an act of self-advancement. This internal transformation is crystallized when she resolves not to use the exam paper to cheat because betraying Matt’s trust “feels worse than anything” (252). This pivotal moment demonstrates that love and desire have superseded her ambition. Through Rachel, the narrative presents morality as a quality that is continually reshaped by human connection.

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