44 pages • 1 hour read
Freida McFaddenA modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Content Warning: This section of the guide discusses drug misuse, child abuse and neglect, and stigmatizing tropes that connect mental health conditions to criminal behavior, which Ward D portrays.
Amy Brenner is currently doing her psychiatry rotation for medical school. She is assigned to a sleep lab where she interviews a woman experiencing insomnia, but after their conversation, the woman realizes the insomnia is linked to the death of her cat and solves her issue by getting a kitten. Amy makes a report to Dr. Silver. The doctor asks if she is nervous about her next assignment, an overnight shift in Ward D, a locked psychiatric unit; Amy admits she is. Dr. Silver assures her it will be safe and allows her to go home early to rest. As she leaves, she reflects on her visit to Ward D eight years ago to visit her best friend.
Amy’s roommate, Gabby, drives her to the hospital for her overnight shift. Gabby already completed her rotation at Ward D and reassures Amy. Amy receives a text from Cameron Berger, her ex-boyfriend. She ignores it, still hurt that he broke up with her to study for the board exam. When the roommates arrive at the hospital, Gabby promises to return for Amy in the morning. Amy promises to text, but Gabby says there is no cell reception in Ward D except for a small space beside the window in the staff lounge. This adds to Amy’s nervousness. She fears someone will mistake her for a patient, and Gabby laughs.
The narrative flashes back to eight years ago. Amy is in Ricardo’s at the mall, trying on a sweater. She’d like to buy it, but it’s expensive. Her best friend since kindergarten, Jade Carpenter, encourages her to buy it, but Amy thinks not. Amy sees a young girl who tells her to steal the sweater, but she refuses. Jade suddenly grabs her arm and tells her that they need to go. As they leave the store, alarms go off. Jade starts to run, and Amy runs after her. After they evade a security guard, Jade shows Amy a shirt she stole. Amy expresses outrage, telling Jade that the young girl in the store told her to do the same thing, but she refused. Jade is confused because she didn’t see the girl.
Amy has 13 hours left of her shift. She receives a phone call from her mother as she rides the elevator to the ninth floor of the hospital. She lies to her mother about where she’s going because she doesn’t want to worry her. Her mother asks about her psychiatry rotation and Jade. She comments on seeing Jade at her mother’s funeral two years ago, and this makes Amy feel guilty because she skipped the funeral. On the ninth floor, Amy arrives outside of Ward D and finds ex-boyfriend Cameron waiting. He says he switched with the medical student who was supposed to accompany Amy on the shift. He tries to make small talk, but she voices her annoyance. The door to Ward D opens.
The narrative flashes back to eight years ago. Amy, drinking peach iced tea, is annoyed because she is supposed to study with Jade, but can’t find her. As she waits, she sees the same girl she saw at Ricardo’s over the weekend. She is concerned the girl is lost, but before she can approach, Jade arrives. When Amy turns back, the girl is gone. Jade suggests they hang out behind the school rather than study, but Amy refuses. Jade becomes annoyed and leaves Amy to hang out with other children.
Amy and Cameron are let into Ward D by a nurse named Ramona. She directs them to Dr. Beck, the physician on call. Amy is surprised to see that Dr. Beck is a young man. Dr. Beck shows Amy and Cameron around, showing them how to use the keypad on the main door so they can leave at any time. Amy memorizes the code, but also writes it on her cellphone. Dr. Beck explains that whenever the correct code is inputted, an alarm sounds. Whenever the wrong code is inputted, a quieter sound is made. As they talk, a patient, Miguel, announces he is supposed to go home. Dr. Beck sends Miguel to his room and explains he is diagnosed with schizophrenia and believes God is his father.
Dr. Beck shows Amy and Cameron the staff lounge and gives them a minute to put away their dinner. Amy sticks her cheese sandwich in the refrigerator, appalled by how dirty the refrigerator is. Cameron comments on the lack of cell reception, prompting Amy to try Gabby’s theory that there is service near the window. She gets a single bar, so she sends a text to Gabby about how attractive Dr. Beck is. She and Cameron go to the nurse’s station, and Dr. Beck explains the computers are down for maintenance, so they have to use paper charts for the night. He encourages them to choose one patient to interview and follow for the night. As they walk around, Amy hears a clicking noise and Dr. Beck explains that Mary, an elderly patient, likes to knit, her needles being child-safe. Dr. Beck points out the seclusion rooms, explaining that Seclusion One is occupied by a patient named Damon Sawyer, a violent patient who will be transferred to a more secure facility in the morning. He tells Cameron and Amy not to open the door.
As Amy looks through paper charts to choose a patient to follow for the night, Cameron expresses a desire to discuss their relationship, but she brushes him off. As she reads the charts, she is shocked to find Jade’s name, as she is the patient in Room 905.
The narrative flashes back to eight years ago. Amy visits Jade’s home and is shocked by its disrepair. Jade lives alone with her mother, who works long hours as a waitress. The friends settle on a couch, with Amy trying to avoid setting her backpack anywhere filthy. Before they can begin studying, Mrs. Carpenter comes home and accuses Jade of stealing her pills. When Jade denies it, Mrs. Carpenter throws an ashtray at the wall. Amy leaves and Jade follows, begging Amy not to tell anyone what she saw. Amy asks what pills Mrs. Carpenter was talking about, and Jade insists her mother takes high blood pressure pills.
Amy considers reading Jade’s chart but decides it would be wrong. A patient wearing a Spider-Man shirt comes to the nurse’s station. The nurse Ramona identifies him as Daniel Ludwig, and the personnel call him Spider-Dan because he believes he’s Spider-Man. Cameron grabs Spider-Dan’s chart. Amy decides to follow the patient in the room next to Jade’s, a young man named William “Will” Schoenfeld, who was diagnosed with paranoid schizophrenia after arriving at the emergency room claiming to hear voices that tell him to kill people.
On her way to Room 906, Amy stops by Mary’s room. Amy continues to Will’s room where she finds a young man close to her age reading a novel. She introduces herself and asks about the voices he claims to hear. Will seems unwilling to talk about his symptoms, but when Amy notices he is reading a John Irving book, he brightens to learn Irving is her favorite author. However, when she returns the conversation to his symptoms, Will becomes uncooperative.
Amy has 12 hours left of her shift. She passes Seclusion One and hears something that sounds like a person throwing their body against the door. She pauses and hears laughter behind her—Jade. She accuses Amy of ruining her life while achieving her own dreams. She suggests Amy engage in a romantic relationship with Will because he’s her type.
From the beginning of Ward D, Amy expresses fear of being locked in Ward D. This fear likely stems from her best friend Jade being admitted to Ward D when they were 16, but also Amy’s concern for her own mental health. This concern introduces the theme of Fear of Knowing Oneself. As a medical student, Amy is under a great deal of stress, so this is a potential reason why she might question her own mental health. However, as the novel progresses, it is revealed that she once experienced hallucinations, foreshadowing her later revelation that the young girl in Chapter 3 and Chapter 5 is an ongoing hallucination. As for Jade, Amy’s friendship with her ended eight years ago when Jade was admitted to Ward D. Amy expresses guilt over this and missing the funeral for Jade’s mother, but this guilt is wavering.
The introduction of fellow medical student Cameron further sheds light on Amy’s social life. She used to date Cameron, but never thought they would marry. At the same time, she is hurt and angry that he broke up with her so he could focus on studying for the board exam. His decision, albeit insensitive, shows his commitment to the medical school program, as does his pandering to Dr. Beck. However, Amy has yet to recognize her own lack of commitment to their relationship when they were dating and finds Cameron a distraction, as he wishes to reconcile during their shift together.
The patients and layout of Ward D are introduced in these early chapters. Amy’s focus on the seclusion rooms, especially after learning one of the rooms holds a dangerous patient, adds tension to the plot as it increases her fear. The patients themselves add to this tension by openly discussing Damon Sawyer of Seclusion One, implying he is homicidal. On the other hand, Amy will come to know and rely on patients such as Spider-Dan, who will play an important role in the climax. It is important to note these characters aren’t indicative of all people with their diagnoses or the diagnoses themselves. Schizophrenia and bipolar disorder vary in severity and symptoms and are not inherently linked to violence.
Amy’s reunion with Jade is initially framed as climactic, but turns into a petty argument between former friends, introducing the theme of Friendship Becoming Adversity. Jade clearly feels betrayed, holding on to old hurts associated with unknown events from her and Amy’s past. The flashbacks thus far frame her as an impulsive teenager, someone willing to steal and shirk responsibility. However, this behavior likely stems from her hostile household. By contrast, Amy’s reaction to Jade is mild compared to the expectation built up by their last meeting in Ward D. However, this reunion does foreshadow potential adversity as Amy’s shift wears on.
In the flashbacks, attention is also given to Amy’s obsession with peach iced tea. She has this drink in one form or another in almost all the flashbacks, implying its importance. She also repeatedly sees the same young girl in a dress. At first, the girl’s two appearances in different places seem like a benign coincidence, but it becomes clear that Amy is the only one who sees her. The girl preys on her doubts and encourages her to commit crimes, acting as her impulse. Amy resists listening at first, but this opens up the possibility of her doing so in the future.
By Freida McFadden