60 pages • 2 hours read
Charles GraeberA modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
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Danny listens to Amy’s testimony and gets a good feeling about her. Amy returns home, thinking about the interview. Danny shared Charlie’s Pyxis printouts with her, and what Amy saw confirmed that Charlie was at fault. She drinks wine and tries to reconcile the Charlie she knows with what she saw on the Pyxis sheets, especially struggling with how much she trusted Charlie and the extent to which he betrayed that trust.
Tim and Danny drive to Amy’s house, discussing her and her reaction to the data. When they arrive, they tell her everything that they know and suspect and then ask her to look over the Pyxis printouts. Amy comments on how odd it is that Charlie has so many drug orders and provides context for his inappropriate use of digoxin. When the detectives share some of the hospital’s efforts to hide the truth, Amy tells them about Cerner, the patient data portal that also has vital information. Ultimately, the detectives ask her to go undercover, continuing a relationship with Charlie and keeping it a secret from the hospital. Their talk is interrupted by a call from Mary, during which she asks Amy to tell her if the detectives contact her. Amy lies to Mary and then helps the detectives with medical terminology.
Amy tries to get a more explicit understanding of what she would do as an “undercover agent” but puts off deciding in the moment. Later, she talks to her daughter about the situation and what the detectives want. Her daughter gives her consent for Amy to help the investigation.
Danny and Tim try to make sense of the case. Tim requests that the FBI be brought in to help, but his superior denies the request. Meanwhile, Amy calls Charlie on a recorded line. She’s sympathetic and warns him that people are asking questions about him at the hospital.
Detectives continue interviews at the hospital, intentionally asking incriminating questions about Amy to hide her cooperation from hospital administration. She continues to call Charlie while sorting through the medical documentation, focusing on Reverend Gall in hopes of building the strongest case. She discovers that Charlies often orders rare drugs in large quantities and cancels orders at a rate beyond traditional mistakes. One night, she mistakenly enters a drug code into the Pyxis at work and cancels it. However, as Charlie discovered, the drug is still dispensed. Amy shares this with the detectives. While it’s an important facet of the case, unfortunately, it’s circumstantial evidence that isn’t enough to convict Charlie.
Amy and Charlie talk one evening. He expresses his distress over his pregnant girlfriend, Cathy, and her supposed affair with a coworker. When Charlie expresses his feelings of sadness and thoughts of death by suicide, Amy tries to cheer him up. That night, Amy dreams first that she’s a murderer and then that Charlies is murdering her. Although the dream distresses her, she realizes that Charlie always helped the pharmacy drug runner so that he could access drugs before they were put away, giving him an unlimited supply of whatever he wanted.
Amy transforms from being a supporting figure to a central figure in the investigation against Charlie. This transition is powerful and difficult, underscoring the struggle Amy faces socially, emotionally, and morally as she grapples with her new role. Her personal affection for Charlie sharply contrasts with her horror that he’s capable of murder. This, in turn, is complicated by Amy’s own history of abuse. Her struggles represent a major theme: The Lingering Effects of Trauma. Her choice to befriend Charlie was rooted in navigating her traumatic past. She took Charlie into her confidence, which she rarely does with her cohorts. Her initial denial of his culpability links to this betrayal, as she struggles with the knowledge that she didn’t see Charlie for who he was. This is intensified by her own guilt because she didn’t recognize Charlie’s crimes and malicious behaviors in the moment. Amy goes through the stages of grief while coming to terms with Charlie’s actions, inviting reflection on what one’s own reaction might be if presented with similar information.
The detectives are slowly gathering the information they need to make a case against Charlie, an endeavor as exciting as it is frustrating. Each time they or Amy make a new discovery, they’re immediately set back because the evidence is circumstantial, which makes it infeasible for proving Charlie’s guilt. The tension increases as Charlie becomes increasingly despondent, worrying the police that he’ll find new employment and put more people at risk. His getting another job presents a “catch-22”: It would provide detectives with the opportunity to catch him in the act but endanger the lives of innocent people. The pull between two perspectives reveals no clear “best” option.
While Charlie has repeatedly abused technology over the course of his nursing career, the detectives and Amy are finally able to use technology for good. They navigate the Pyxis machine and the nursing logs to reverse-engineer Charlie’s actions. Amy’s surprise at his manipulation of these systems highlights one of the book’s main themes: Technology: as Moral as its User. The Pyxis machine itself isn’t a bad invention, just as the nursing logs aren’t inherently harmful. Their intentional manipulation is what ultimately puts others at risk and creates a distrust of the system itself.
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