44 pages • 1 hour read
Freida McFaddenWard D
Fiction | Novel | Adult | Published in 2023A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Chapters 37-48Chapter Summaries & Analyses
Chapter 37 Summary
The narrative flashes back to eight years ago. Amy’s mother asks about Jade, concerned because she knows Jade’s mother has bipolar disorder; she worries Jade inherited the mental health condition. Amy goes outside for fresh air, and Jade drives up in her mother’s car. She convinces Amy to join her.
Chapter 38 Summary
Amy goes to the patient lounge and lies down on the couch. She hears footsteps but can’t see anyone. She quickly falls asleep.
Chapter 39 Summary
Amy has four hours left of her shift. Spider-Dan is standing over her when she wakes. He claims Damon Sawyer wants to kill her, and that he will protect her. Someone screams—Mary.
Chapter 40 Summary
Mary is in the hallway, screaming about Damon Sawyer. Dr. Beck and Ramona drag her to her room and sedate her with Ativan. Amy sees Jade with her hand on Will’s shoulder. She thinks Will might be Jade’s boyfriend.
Chapter 41 Summary
The narrative flashes back to eight years ago. Jade drives recklessly, taking Amy to a house in a distant part of town. They go inside, and Amy drops her peach iced tea when she sees what Jade has done.
Chapter 42 Summary
Dr. Beck and Ramona leave Mary’s room. Amy worries about Mary and wants to check on her, but Ramona says to leave her alone. She then asks Ramona if Jade and Will are dating, and Ramona says they are.
Chapter 43 Summary
Amy goes to Jade’s room and confronts her over Will. She says Will’s diagnosis could make him dangerous, but Jade dismisses her.
Chapter 44 Summary
Amy has three hours left of her shift. She asks Ramona about Mary again, aware that too much Ativan can cause a patient to stop breathing. Ramona reiterates to leave Mary alone. Amy sneaks into Mary’s room and discovers she’s not in her bed. She checks the bathroom, and as she exits, she finds Will in the doorway.
Chapter 45 Summary
Amy accuses Will of hurting Mary. She also says she knows he’s Jade’s boyfriend. He denies these claims and reveals he’s a reporter who faked his symptoms to investigate Ward D’s allegations of neglect. Amy is still uncertain, but decides to trust him for the time being.
Chapter 46 Summary
Amy and Will go to his room and briefly talk about their love of reading. Amy asks about Damon Sawyer, and Will thinks he escaped Seclusion One during the power outage. He believes they will stay safe while together.
Chapter 47 Summary
The narrative flashes back to eight years ago. Jade broke into Mr. Riordan’s house, tied him up, and beat him. Now, she wants to kill him. She claims she and Amy can make the murder look like a robbery, solving their disciplinary problem. When Amy argues against it, Jade says she knows Amy sees a young girl. The girl shows up and tells Amy that she has no choice but to kill Mr. Riordan. Jade gives her a knife.
Chapter 48 Summary
Amy reflects on Jade’s attack on Mr. Riordan, remembering how she ran away, got a ride home, and told her mother everything except for the young girl. Jade was taken to the hospital and diagnosed with Bipolar I. Amy visited her in Ward D, and Jade threatened to kill her for ruining her life.
Amy and Will read for a while, and then Jade knocks on the door. Amy steps out to speak to her and finds Ramona with her. Jade claims Will is always lying, that he pretends to have different professions, including a reporter, but he drives an Uber. Ramona takes Amy to Mary’s room and shows her blood-soaked sheets. She claims Will is responsible, and that they need to take care of him so he doesn’t hurt anyone else.
Chapters 37-48 Analysis
Mary’s panic takes place while Amy is napping, so she doesn’t know what caused it: All Amy sees is Dr. Beck and Ramona sedate Mary. Mary resists, and Amy seems to be the only personnel concerned about her wellbeing. This concern is based on the amount of Ativan administered to Mary, as Ativan can cause a patient to stop breathing, foreshadowing a future instance of this problem. When Amy discovers Mary is missing, she doesn’t alert anyone. Instead, she reads with Will, a decision that seems not only counterintuitive, but callous. Speaking of Will, he appears to be the only other person in Ward D who understands something strange is happening. However, Amy continues to question his credibility because of his diagnosis, reinforcing the theme of Mental Health Diagnoses and Their Impact on Patients. Yet, instead of investigating, they lock themselves in Will’s room and read. Again, their inaction seems to play into the idea that the threat isn’t real, or that they’ve decided there is no reason to fight the threat.
Amy read Jade’s chart and knows she was admitted with her boyfriend, so when she sees her and Will standing together, she jumps to conclusions. These conclusions are based on several factors, such as Amy believing she saw Will go to Jade’s room earlier, with Ramona confirming it. However, Amy also read Will’s chart and knows he was alone when admitted to Ward D. Yet in her exhaustion, she doesn’t note this discrepancy or that with the main door’s alarm (or lack thereof). Later, Ramona shows Amy blood-stained sheets in Mary’s room, accusing Will of hurting Mary. This undermines what little trust Amy has in Will and exacerbates her fear that his untreated paranoid schizophrenia might be causing him to commit crimes. While her own paranoia is understandable, it proves she never truly trusted him in the first place.
As Amy struggles to parse the present, she recalls Jade’s past torture of their math teacher, Mr. Riordan. Jade’s penchant for violence is established with this incident, showing what she was capable of and will be capable of without proper treatment. Likewise, Amy is framed as just as capable of violence when she takes a knife from Jade during Mr. Riordan’s capture; in the present, she wields a steel knitting needle. Despite being encouraged by both Jade and the young girl, she again resists manipulation. However, this moment does briefly call Amy’s mental state into question.
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By Freida McFadden
