The four-paragraph version: Meghan is an ICU nurse treating a patient, Caitlin, who is in a coma after jumping off a bridge, and there’s indications she may have been pushed. Meghan also recently divorced from her ex-husband Ben and has a teenage daughter, Sienna. There’s also been a string of attacks in the city with an intruder assaulting women in their homes.
Meghan is reunited with a friend from high school, Nat, who is trying to leave her abusive husband. Meghan invites Nat into her home and tells her a secret, that Sienna was the product of a one-night stand and that Ben doesn’t know he is not really her father. Soon, Nat disappears, and Meghan is gets a call from someone saying that’ve kidnapped Sienna and she needs to wire $10,000 to an account to get her back. Meghan pays, but it turns out is was a ploy, and Sienna was fine all along. The police determine that some woman paid someone to set up an account in their name. Meghan also learns that the Nat she knew in high school died 19 years ago and that “Nat” is a fake.
Meghan tracks down fake Nat and confronts her, leading to an altercation on a pedestrian bridge where fake Nat threatens to reveal Meghan’s secret, and Meghan shoves her off the bridge onto the tracks below. (So, it’s revealed that the first part of the book is told in two interweaved timelines, that fake Nat is actually Caitlin, and Megan was the one who pushed her.)
In present day, Caitlin (fake Nat) begins to awake, so Meghan kills her by overdosing her with insulin. It’s also revealed that the perpetrator of the attacks in the city is Luke, one of Meghan’s co-workers. Meghan is placed on probation but gets away with killing Caitlin. It turns out Caitlin was Ben’s new girlfriend. Ben doesn’t indicate that he knew anything about Caitlin’s scheme or Meghan’s involvement in anything. The book ends with Meghan thinking to herself that she’ll never really know how much Ben knows about everything that happened with Caitlin.
The Prologue opens with Meghan Michaels getting a call, telling her that her daughter has been kidnapped.
In Part I, Meghan is an ICU nurse in Chicago caring for a patient, Caitlin Beckett, who has attempted suicide by jumping off a pedestrian bridge onto the train tracks below. Meghan has a teenaged daughter, Sienna, and has been divorced for a year from her ex-husband and high school sweetheart, Ben. Meanwhile, there have been a series of attacks lately in Chicago with an intruder attacking and raping women in their homes.
Caitlin’s parents, Mr. and Mrs. Beckett, frequent the hospital, hoping for Caitlin to emerge from her coma. A witness to the fall soon comes forward, saying that Caitlin had an altercation with a man shortly before and suggests she may have been pushed, as opposed to being suicidal. When Meghan notices a strange man in Caitlin’s room, Police show her some photos and Meghan identifies the man, who turns out to be Milo Finch, an ex-con that Caitlin knew from when she was living in California before. Meghan soon recieves a strange note in a red envelope with the word BITCH scrawled on it.
At a divorcee support group, Meghan runs into Nat Cohen, who she knew from high school. Nat has a bruise on her face, and Meghan suspects that Nat’s ex, Declan Roche, is physically abusive towards Nat. Meghan and Nat soon meet for coffee. When Nat gets beaten up again, she finally tells Meghan about her husband’s abuse, saying she’s afraid to divorce him. He also controls their finances.
Nat can’t afford to pay for a place to stay, so Meghan invites her to stay with her instead. As the two women bond, Meghan confides in Nat that Ben doesn’t know that he isn’t Sienna’s father. She was the result of a hookup after they’d had a bad fight. Meanwhile, Meghan worries that Nat is on the verge of going back to Declan. She comes home a day later and sees that Nat is gone.
The next morning, Meghan gets a phone call soon after Sienna leaves for school. The voice on the other end says they’ve kidnapped Sienna, and they want Meghan to send $10,000 in the next five minutes or else. Meghan is unable to contact Sienna, so she sends the money and then contacts the police. They find out that Sienna was just in another class re-taking a test and was never kidnapped, so the whole thing was a ploy.
When Meghan sees Milo Finch again, he tells her that he hates Caitlin, but he didn’t push her. He says that Caitlin worked at his restaurant and stole from him, so he fired her. She then retaliated by breaking into his home, downloading child pornography on his computer and sending it to people. He was convicted, marked as a sex offender and sentenced to five years in prison.
Meanwhile, Meghan tries to reach out to Nat unsuccessfully. She soon finds out that the Natalie she knew in high school actually died in a car crash when she was 19, so the woman she met (“fake Nat”) was a fraud. She also realizes her jewelry (engagement and wedding ring) were stolen from her house. The police then tell her they’ve tracked down the account that Meghan was ordered to wire the $10,000 but it belongs to a drug addict who was paid to let some woman set up an account using his name.
Meghan happens to spot fake Nat on the street and confronts her. They end up on a pedestrian bridge. Fake Nat declines to explain herself. Instead, there’s an altercation, and fake Nat insults Meghan and threatens to reveal the truth about Sienna’s father. Meghan shoves fake Nat and she falls off the bridge onto the tracks below.
(Basically it’s revealed that Part I of the book has been told using two interweaved timelines. Fake Nat is Caitlin and Meghan is the one who pushed her. Everything at the hospital happens after that.)
In Part II, it has been two weeks since Meghan pushed Caitlin (aka Fake Nat) off the bridge. Caitlin begins to wake from her coma, amd Meghan realizes she needs to kill her. As Caitlin contines to improve, Meghan takes an insulin pen from another patient and injects Caitlin with a fatal overdose. Caitlin goes into cardiac arrest and dies.
Meghan is upset afterwards and tells Sienna to go stay at a friend’s house, claiming that she’s sick and doesn’t want to give it to Sienna. Ben soon shows up, saying that Sienna said she was acting strangely and wanted him to check up on her.
As Meghan and Ben talk, he mentions having recently concluded relationship with a woman named Caitlin, and Meghan wonders if Caitlin had been seeing Ben. Megan then texts Sienna and Sienna responds that she never asked Ben to check up on her. Megan asks Ben to leave, and he does.
Back at the hospital, Meghan is placed on administrative leave while they investigate what happened.
Meghan comes home to find Sienna’s phone and sees that Sienna was lying, that she actually did ask Ben to go over to check up on her. She also sees in Sienna’s texts with Ben that Sienna is calling her (Meghan) a liar and is very angry with her. She goes to talk to Sienna who is with a guy, Nico, and Meghan sees that they have a red envelope with a note with them that has the same handwriting as the BITCH note she got before.
Meghan confronts Sienna, who finally admits that she sent the note and that she’s angry because Fake Nat/Caitlin told her the truth about her father. Sienna also tells her that she didn’t tell Ben.
Meghan is upset afterwards and goes to have a drink with Luke. Afterwards, Meghan gets a call from Luke’s wife Penelope, who calls to warn her about Luke. She says that the police have determined that Luke is the perpetrator of the various attacks on women in the city. They’re now looking to apprehend him. She found Meghan’s contact info because she saw that Luke has a photo of her and her daughter and felt she needed to warn her. Meghen realizes that before Luke left, she told him about Sienna was at home alone.
Meghan rushes home to find Sienna, who isn’t there. Instead, Luke texts her to go to an address. Meghan goes, and sees that Luke has a gun on Sienna, and he says that they’re going to help get him out of there. Instead, the police show up, Luke is shot dead. Sienna goes to the hospital with a busted ankle from Luke abducting her.
Meghan and Sienna reconcile, and they agree not to tell Ben the truth. In the Epilogue, Ben tells Meghan her engagment ring ended up at his place somehow and he returns it to her (confirming that he was dating the same Caitlin who stole her ring). When he leaves, Meghan realizes she’ll never know how much Ben truly knows about what happened with her and Caitlin.
For more detail, see the full Chapter-by-Chapter Summary.
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