Dead Med

Dead Med (2024) is a psychological thriller by Freida McFadden set in the high-pressure world of medical education. The novel follows five first-year medical students as they navigate the grueling pressure of DeWitt Medical School, an institution nicknamed “Dead Med” due to a history of student drug overdoses. As they struggle with their classes and relationships, the students become entangled in a web of secrets that culminates in a night of shocking violence. The novel explores themes of The Destructive Power of Academic Pressure on Identity, The Corrupting Influence of Secrets and Deception, and Ambition as a Catalyst for Moral Decay.

McFadden is a practicing physician specializing in brain injury. She is a number one New York Times best-selling author, known for psychological thrillers such as The Housemaid and The Inmate. Dead Med is a revised edition of her 2014 novel, Suicide Med, and became a New York Times and USA Today bestseller upon its release.

This guide refers to the 2024 Freida McFadden e-book edition.

Content Warning: The source material and guide feature depictions of mental illness, death by suicide, suicidal ideation, substance use, graphic violence, sexual content, cursing, and illness or death.

Plot Summary

The night before the anatomy final exam, first-year medical student Danielle Stern is studying in the cadaver lab. Danielle hears two gunshots, and a male classmate, whose identity is not revealed, enters the lab. His scrubs are splattered with blood, and he points a gun at Danielle, telling her to do exactly as he says.

The narrative shifts to the beginning of the school year from Heather McKinley's perspective. On her first day at DeWitt Medical School, she meets her cynical roommate, Rachel Bingham. Rachel tells Heather the school’s nickname is “Dead Med” because of a history of student drug overdoses and suggests a professor might be the supplier.

During orientation, Heather is introduced to the anatomy professor, Dr. Matt Conlon, and the school’s wellness counselor, Dr. Patrice Winters. In the cafeteria, she meets Abe Kaufman, a large, kind classmate. Later, in a women’s restroom, Heather sees a large crack in a sink, caused by the head of Darcie Peterson, a student who died there from an overdose the previous year.

In her first anatomy lab, Heather is grouped with Abe, Rachel, and two other students: the handsome and arrogant Mason Howard and the quiet, intelligent Sasha Zaleski. Mason nicknames their cadaver “Frank,” which Rachel finds disrespectful.

As the weeks pass, Heather struggles academically, and her long-distance relationship with her boyfriend, Landon, deteriorates. She begins studying with Abe, and they become friends. After the first major anatomy exam, Heather is convinced she has failed. She visits Dr. Conlon, who reassures her that she passed and reveals he is a medical school dropout. Elated, Heather calls Landon to share the news, but he ends the relationship.

Devastated, Heather goes to Abe and Mason’s dorm room, intending to seek a rebound with Mason. Instead, she finds Abe, who confesses his feelings and kisses her. They begin a relationship, and with Abe’s help, Heather’s grades improve. She passes the second exam but is puzzled by Abe’s indifference to his own honors-level grade.

After Thanksgiving break, Heather goes to Abe’s dorm to surprise him. She finds Mason looking disheveled and possibly high. Intending to join Abe in the shower, Heather enters the bathroom and finds his scrubs on the floor, soaked in blood. Abe screams at her to leave. He later claims the blood was from a messy procedure at the off-campus clinic where he works, but Heather knows he is lying. Worried, she confides in Dr. Winters but feels dismissed. The night before the final exam, Heather enters Abe and Mason’s dorm room. On Mason’s desk, she discovers papers about dead police officers and a bullet.

The perspective shifts to Abe’s first day at medical school, where he is immediately smitten with Heather. To afford tuition, Abe takes a job at a rundown clinic run by Dr. Stanley Kovak. He soon suspects Dr. Kovak is selling drugs to students and believes a professor, likely Dr. Conlon, is sending students to the clinic. After Heather’s breakup, Abe seizes his chance and begins a relationship with her.

Abe reports his suspicions about the clinic to Dr. Winters, who promises a discreet investigation. One night, a man named Hooper breaks into the clinic, holds Dr. Kovak at knifepoint, and demands drugs. Abe grabs Dr. Kovak’s gun and, in self-defense, shoots and kills Hooper. Dr. Kovak convinces Abe they must dispose of the body to avoid a police investigation that would expose the clinic. Abe helps dump the body in a lake, returning to his dorm covered in blood, which leads to his confrontation with Heather.

Kovak uses security footage of the shooting to blackmail Abe into continuing his work. Abe later discovers Dr. Winters is Dr. Kovak’s accomplice. Wracked with guilt, Abe mutilates Frank’s limbs in the anatomy lab. The night before the final, Abe goes to the clinic, steals Dr. Kovak’s gun, and forces Dr. Kovak to hand over the incriminating footage. He then heads to the hospital to confront Dr. Winters with a gun.

The story then moves to Rachel’s perspective, revealing her history of seducing professors for grades. She targets Dr. Matt Conlon, but after successfully seducing him, she is surprised to find herself genuinely attracted to him. When she tries to blackmail him, he reveals he was warned about her and forces her into remedial tutoring. Through these sessions, a real relationship develops, and they fall in love.

Rachel learns that Matt’s physical disabilities are the result of being shot in the head by his roommate during medical school, an event that ended his own surgical career. Their secret affair is discovered by a jealous Dr. Winters. Soon after, Rachel receives an anonymous note threatening to expose them unless she steals the final exam and leaves it in Locker 282. When Frank’s body is mutilated, she interprets it as a warning from the blackmailer. Rachel steals the exam from Matt’s computer, decides not to cheat, and leaves it in the designated locker. Matt discovers the theft when he finds the last page in his printer. Heartbroken, he ends their relationship.

The night before the final exam, Rachel goes to Matt’s office and tearfully explains the blackmail plot. He believes her, and they reconcile. Just then, a student knocks, and Matt hides Rachel under his desk. She overhears an argument, followed by a gunshot. After the visitor leaves and a second shot is fired in the hallway, Rachel emerges to find Matt dead.

A shift to Mason’s perspective reveals his ambition to become a top plastic surgeon. He excels in anatomy and begins a sexual relationship with Sasha. During dinner at his parents’ house, Mason has an auditory hallucination as a voice tells him to steal his father’s gun. His mental state rapidly deteriorates, and he begins suffering from insomnia and paranoia. Mason believes his auditory hallucinations are the voice of Frank, the cadaver his group has been dissecting. He becomes convinced that Dr. Conlon murdered Frank, a former cop. His grades plummet, and he fails the second exam, believing Dr. Conlon, Dr. Winters, and Abe are all part of a conspiracy.

The night before the final exam, Mason confronts Dr. Conlon with a loaded gun, accusing him of murdering Frank. When Dr. Conlon says, “I’m really sorry,” Mason interprets it as a confession and shoots him in the head. He then encounters Dr. Winters in the hall and, believing she is an accomplice, kills her before heading to the anatomy lab to eliminate other witnesses.

Sasha’s perspective shows her fierce competitiveness, driven by the memory of her father, a Russian immigrant, who died of Parkinson’s disease. Resenting Mason’s success and privilege, she secretly begins drugging his coffee with her father’s leftover dopamine medication, knowing it can cause hallucinations. As Mason’s mental health collapses, Sasha feels guilty but does nothing. She also anonymously blackmails Rachel into stealing the exam papers. The night before the final, Sasha retrieves the stolen exam from Locker 282 but is overcome with shame and destroys it. Moments later, a blood-soaked Rachel finds her and reveals that Mason shot Dr. Conlon.

In his final moments, Dr. Conlon reflects on his discovery that Dr. Winters was working with the school’s drug dealer and his intention to report her. As Mason points the gun at him, with Rachel hidden under the desk, his only goal is to save her. His last words, “I’m really sorry,” are meant for Rachel.

Seven years later, a medical student named Kiera recounts the distorted legend of “Dead Med”: Dr. Conlon, a drug dealer, was murdered by a student who discovered his affair with another student and blackmailed him. Abe and Heather are now married and are both successful doctors. Kiera’s attending physician is Dr. Sasha Zaleski, known for her terrible temper. A psychiatry resident, Dr. Rachel Bingham, helps Kiera get Sasha coffee. As Rachel prepares the drink, Kiera sees white particles dissolving into the black liquid but dismisses it as a hallucination from sleep deprivation.