Ward D is a novel written by physician Frieda MacFadden. Published in 2023 by Amazon Kindle Direct, the novel follows medical student Amy Brenner’s first overnight shift on the hospital’s locked psychiatric floor, Ward D. As a practicing physician, MacFadden lends her knowledge to Amy’s story as she navigates her complicated past and medical school as a whole.

This guide uses the 2023 Kindle ebook version of the novel.

Content Warning: Ward D engages with stigmatizing tropes that connect mental health conditions to criminal behavior. It also depicts drug misuse and child abuse and neglect.

Plot Summary

Medical student Amy Brenner is on her psychiatry rotation and is about to spend the night in the locked psychiatric ward, Ward D, for the first time. She feels nervous, as the last time she visited Ward D, she was 16 and visiting her best friend since kindergarten, Jade Carpenter, who’d just had a mental health crisis. The memory of this visit haunts her, due to guilt for not having intervened sooner. Amy’s roommate Gabby drops her off at the hospital, and Amy makes her way to the ninth floor where she finds Cameron Berger, her ex-boyfriend, waiting outside the locked doors to Ward D. Cameron tells her that he switched shifts with another student who needed the night off. She is unhappy to see him because he broke up with her so he could study for the board exam. He tries to speak, but they are interrupted when a nurse, Ramona, lets them into the ward.

Amy and Cameron are introduced to the physician on call, Dr. Richard Beck. Amy finds the young doctor attractive and sends a text to Gabby saying so, but discovers cell reception on the floor is limited to one spot near the window in the staff lounge. Dr. Beck shows Amy and Cameron around, pointing out the seclusion rooms and mentioning there is a patient in Seclusion One named Damon Sawyer, who is violent but will be removed in the morning. They are warned to stay away from the room. Amy becomes aware of the watchful patient in Room 905, and realizes it is her former friend, Jade Carpenter.

Dr. Beck tells Amy and Cameron to read the chart of a patient and interview them. Cameron, who has used every chance to flatter and pander to Dr. Beck, quickly chooses a patient named Dan Ludwig, a man with schizophrenia who believes he is Spider-Man—nicknamed Spider-Dan by the staff. Amy chooses another man with schizophrenia named William “Will” Schoenfeld. Her interview with Will begins promisingly as they connect over their shared affection for John Irving books. However, Will becomes standoffish. Amy returns to the nurse’s desk to find Cameron writing a detailed note about his interview with Spider-Dan. She considers reading Jade’s chart but decides not to. She leaves and runs into Jade, who appears both excited and angry to see her. Jade feels Amy abandoned her to the mental health system when they were 16, and mentions Amy skipping her mother’s funeral a few years ago.

Amy meets more patients, including Mary, an elderly woman who is constantly knitting. In the patient lounge, Cameron attempts to talk to Amy, hinting at a desire to reconcile, but she brushes him off. As the evening wears on, Amy’s nervousness increases as she remembers an incident from eight years ago: Jade broke into their math teacher’s house, tied him up, and threatened to kill him to protect her and Amy from getting in trouble for stealing a copy of a trigonometry test. Suddenly, Cameron disappears.

Miguel, another patient, becomes frantic after causing a brief power outage by urinating on a light switch and is placed in Seclusion Two. Soon after, Amy believes she hears a choking sound inside the room and sees blood under the door. However, when she informs Dr. Beck, the blood is gone. Patient Will pulls her aside and says he saw the blood, which the nurse Ramona allegedly cleaned up, but Amy is uncertain she can trust Will because he is not taking his medication. He claims he is a reporter who faked his symptoms to be placed in Ward D to investigate allegations of neglect, but Amy is still uncertain because he is diagnosed with paranoid schizophrenia.

Patient Mary becomes frantic, and Amy watches as Dr. Beck and Ramona sedate her. Worried the dose of Ativan might be too much for Mary, she goes to check on her and finds her missing. Will tells her that they must stick together until morning since the power outage reset the doors, locking them from the inside. Amy agrees, but then Dr. Beck and Ramona confront Will, accusing him of hurting Mary and sedating him. Amy goes to the staff lounge and gets cell reception long enough to receive a text from Gabby—which reveals Dr. Beck is an elderly man. She realizes “Dr. Beck” is Damon Sawyer, the patient in Seclusion One. Afraid, she pours water on a light switch to trigger a power outage, hoping it will unlock the doors. However, Amy looks inside Seclusion One and discovers four dead bodies, including that of Cameron.

Jade and Damon confess to a plot to burn down the ward and fake their deaths. They attempt to sedate Amy before starting the fire, but Spider-Dan comes to her rescue and she is able to fight Jade off. The morning shift arrives, and Amy is rescued. A year later, Amy is dating Will, who is writing a book about the incident. However, unbeknownst to anyone, she is having hallucinations in the form of a young girl—a girl she saw eight years ago—who tells her to kill Will.