In her author’s note, Brittney Arena reveals that Vasalie’s chronic pain is inspired by her own mid-twenties diagnoses of several complex illnesses, including postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), Ehlers-Danlos syndromes (EDS), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and dysautonomia. These conditions manifest in a wide range of debilitating symptoms. POTS is a blood circulation disorder characterized by a rapid increase in heart rate upon standing, leading to dizziness, brain fog, and severe fatigue. MCAS is an immune condition causing symptoms like hives, trouble breathing, and stomach issues. EDS is a group of inherited disorders affecting connective tissues, resulting in joint hypermobility, fragile skin, and chronic pain. ME/CFS causes extreme exhaustion that worsens with physical or mental activity and isn’t improved by rest.

Arena channels the physical limitations and unseen struggles of these conditions into Vasalie. After her imprisonment, Vasalie’s physician diagnoses her with muscle and nerve damage and an unidentifiable heart syndrome with unpredictable triggers. Her body, once a source of strength, becomes a site of constant pain, mirroring the author’s own experience. Arena’s motivation to portray a heroine dealing with chronic pain arose from a single question: “We often read about powerful heroines wielding mighty swords, but where were the ones who struggled to function, let alone fight?” (xi). In this context, Vasalie is shown to fight for survival while living with physical constraints. Even though the novel has supernatural elements, there is no magical “healing” for Vasalie, portraying an authentic representation of disability.