69 pages 2-hour read

Dead Med

Fiction | Novel | Adult | Published in 2024

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Symbols & Motifs

Content Warning: This section of the guide includes discussion of mental illness, substance use, illness, and death.

Drugs and Pills

The recurring presence of drugs and pills is a central motif that embodies the desperation, corruption, and dangerous shortcuts endemic to the DeWitt environment, giving rise to its nickname, “Dead Med.” This motif illustrates how characters respond to the theme of The Destructive Power of Academic Pressure. The pills represent a perilous solution to an overwhelming problem, a way to artificially enhance performance or escape from stress. From the seemingly benign caffeine tablets Phil offers Heather to the amphetamines that caused Darcie Peterson’s fatal overdose, the motif highlights a spectrum of desperation. Heather herself contemplates turning to pills when she feels she is failing, showing how quickly the pressure can push a student toward a dangerous path.


The constant discussion of past overdoses creates an atmosphere of lurking danger, suggesting that failure at DeWitt is potentially fatal. Rachel Bingham underscores this systemic issue when she observes, “Three students in three years got their hands on enough pills that they accidentally died. Someone is giving them those pills” (18). Her comment frames the drug problem as a symptom of a corrupt system with a hidden source. The revelation that this source is Dr. Patrice Winters, the wellness counselor, underscores the institution’s deep hypocrisy, connecting the motif to The Corrupting Influence of Secrets and Deception.


McFadden further develops this motif through the characters’ use of prescribed medication. Sasha Zaleski’s secret drugging of Mason Howard with her late father’s medication exemplifies the theme of Ambition as a Catalyst for Moral Decay. While Sasha attempts to justify her actions, reflecting the effects on Mason’s cognitive functioning will be minor, her recollection of her father’s horrific hallucinations highlights her knowledge that the drugs can cause serious harm. The novel emphasizes Sasha’s warped moral compass as she utilizes the pills that were an essential part of her father’s care as a weapon to sabotage a rival. Drugs are also employed to illustrate character in the portrayal of Dr. Matt Conlon. Rachel’s discovery of powerful prescribed painkillers and antidepressants in Matt’s medicine cabinet indicates the lasting effects of the shooting he survived in medical school. While Matt maintains a cheerful façade, his medication reveals the chronic physical and psychological pain he continues to experience.

Frank

The cadaver, “Frank,” is a symbol of the dehumanization that occurs under intense academic pressure and the dangerous nature of unchecked ambition. Initially, Mason’s act of naming the body is a way to cope with the reality of dissection, personalizing the impersonal. However, Frank quickly becomes a set of systems to be mastered for an exam. This dehumanizing process echoes how the anatomy students feel their identities being stripped away and reduced to their academic performance.


Mason’s observation that “I have probably spent more time with Frank than any other person in my life” (292) underscores the cadaver’s constant presence as a silent, central figure in the anatomy lab. Frank physically embodies the death-haunted environment that tests the students’ limits. For Mason, the cadaver transforms from an academic subject into a personal obsession, becoming a canvas onto which he projects his paranoia and ambition. When he examines Frank’s heart and declares it “perfect,” it marks the beginning of a fixation that spirals into a delusion that Frank was murdered. This obsession with uncovering a secret conspiracy is a manifestation of Mason’s fear of losing his top-student status. He cannot accept that Frank died of natural causes because his world feels rife with hidden threats. Ultimately, Mason loses his own humanity, killing an innocent man, in his obsessive quest to solve the mystery of Frank’s death.

The Crack in the Sink

The crack in the bathroom sink is a symbol of the unaddressed trauma and institutional negligence at DeWitt. Located in the women’s restroom near the anatomy labs, this structural flaw is the damage left from a previous student’s fatal overdose. Illuminating the theme of The Destructive Power of Academic Pressure on Identity, the scar in the porcelain is a tangible reminder of the real-world consequences of the school’s high-pressure environment. The unrepaired defect symbolizes the administration’s willful disregard for the human cost of its academic demands. The crack’s lingering presence is a testament to a culture that normalizes student suffering and death.


When Rachel first points out the crack to Heather McKinley, she frames it as a core part of the school’s identity, stating, “You can still see the crack in the sink where her head smacked against it before she hit the floor—they never fixed it” (13). Heather automatically focuses on the crack whenever she uses the bathroom, and it becomes a recurring memento mori during her moments of greatest stress. Before her first lab and after her disastrous first exam, she perceives the sink as a harbinger of doom, reminding her of the potentially fatal consequences of academic pressure. However, as her narrative progresses, Heather’s feelings toward the crack change. She reflects, “as the term has gone on, it has reminded me to be strong. Yes, med school is hard but […] I could be dead” (89-90). For Heather, the crack’s symbolic shift in meaning from a sinister omen to a fate she has successfully avoided indicates her growing resilience.

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