52 pages • 1-hour read
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Content Warning: This section of the guide contains discussion of illness or death, pregnancy loss or termination, bullying, emotional abuse, child abuse, substance use, and addiction.
Late at night in the ICU, Angel wakes with chest pain. A nurse, Sarah, adjusts his monitor but refuses his request for more medication. He arranges an autographed photo for her daughter, his thoughts turning to his own child, Lina.
Angel drifts into a memory of his youthful relationship with Madelaine. At carnival, Angel wins a pair of red earrings for a teenaged Madelaine. She says she isn’t able to accept them as her strict father forbids jewelry and goes through her belongings. They bury the earrings under a tree with a promise to return. Angel then remembers when Madelaine told him that she was pregnant, and how scared he was. After that, he was unable to contact Madelaine and realized that her father must have found out about the pregnancy. Soon after, Madelaine’s father, Alex Hillyard, offered Angel $10,000 to leave town, telling him that Madelaine would terminate her pregnancy. Angel took the money.
Back in the present, the alarms on his cardiac monitor sound as Angel’s heart fails again. Madelaine rushes in and urges him to hold on as he loses consciousness.
At a men’s session in Oregon, Father Francis DeMarco leads a counseling circle. Listening to the men speak about fatherhood, he realizes his true place is with Madelaine, Lina, and his brother. The clarity feels like a calling, and he ends the session early to drive back to Seattle.
He calls Madelaine, who is keeping vigil by Angel’s bed, and tells her he is coming home to bring their family together. A storm intensifies as he drives up a mountain highway. Slowing for an accident, his car hits standing water and spins out of control. He feels his spirit lift from his body as a policeman kneels to check for a pulse. His last thought is of Madelaine.
Madelaine waits for Francis at home when the power goes out. At 2:45 am, an Oregon State Police officer calls to tell her about Francis’s accident and directs her to a hospital in Portland. Madelaine wakes Lina, and they take the first flight out. On the plane, she shares small memories of Francis to comfort them both.
In Portland, a neurologist explains that Francis has a catastrophic brain injury and has suffered total brain death, meaning that he is completely dependent on life support and without hope of recovery. Madelaine conveys the finality of the diagnosis to Lina, who refuses to see the body. Devastated, Lina tells her mother that she wishes she had understood that Francis was the real father figure in her life.
Hours later, Madelaine stands by Francis’s bedside as life support machines keep his body functioning. She is Francis’s executor and legal next-of-kin, responsible for making end-of-life decisions. Dr. Nusbaum informs her that Francis is a perfect heart donor match for a critical patient in Seattle and she immediately knows that the recipient is Angel. She authorizes the donation but firmly requests that the donor’s identity remain confidential. She then tells Lina what is happening and secures her assent.
In Seattle, the surgical team prepares Angel. He is nervous and asks for Madelaine. As anesthesia takes hold, he has a vision of Francis. Madelaine arrives just before he goes under, hearing him murmur that he loves her and his brother. She watches from the operating gallery as Dr. Allenford transplants Francis’s heart into Angel’s chest. The donated heart is still for a moment, then begins to beat.
In the days following the transplant, Madelaine finds a grieving Lina on the porch swing and comforts her. At the hospital, Angel wakes disoriented and hypersensitive to the new heart in his chest. He hallucinates a double heartbeat and tells Madelaine they should have let him die, rejecting food and snapping at the staff.
Back at school, Lina isolates herself from her friends. Madelaine finds her at the football field and suggests she attend the upcoming Christmas dance to feel some normalcy. The idea of a family occasion without Francis enrages Lina, and she runs off, unable to accept life moving forward.
Within a week, Angel is moved to an isolation room, and Madelaine formally removes herself as his cardiologist to avoid a conflict of interest, insisting that donor anonymity be maintained by the new doctor. She and Lina attend Francis’s funeral in Portland. Afterward, Madelaine takes Lina to a private spot to grieve and says she spoke to Lina’s father, but he is too sick to see her. Believing she has been rejected, Lina lashes out.
Madelaine visits Angel and tells him Francis died in a car accident, lying that the death was instant. Angel is devastated, blaming himself for not making peace sooner. Alone, Madelaine goes to Francis’s empty home to pack his belongings. Surrounded by his things, the weight of her loss and her actions overwhelms her, and she collapses on his bed, sobbing.
The narrative structure of these chapters continues to employ shifting perspectives and parallel timelines, which are now developing commonalities to create a sense of fateful convergence. The cross-cutting between Francis’s hopeful drive to reunite his family, Madelaine’s anxious vigil at Angel’s bedside, and Angel’s descent into heart failure imbues the subsequent tragedy with thematic weight. When Francis experiences his epiphany about his family, the reader is already aware of Angel’s critical state, creating a tension between Francis’s vision and the impending disaster. This juxtaposition transforms his death figuratively from a random accident into a sacrificial, almost predestined act. His desire to bring his family together is tragically fulfilled by his death and the subsequent donation of his heart. The violent storm that serves as the backdrop to his final drive functions as a pathetic fallacy, reflecting the characters’ emotional turmoil and underscoring the collision of their separate trajectories. This structure elevates the plot, framing the events within a larger exploration of sacrifice and destiny.
The symbolism of the heart is central to this middle section, which depicts the transplant itself. This supports the theme of The Power of Forgiveness and Second Chances. Angel’s end-stage cardiomyopathy is the corporeal manifestation of his emotional and moral decay. This connection is forged in a flashback where the memory of betraying Madelaine is described as an event “emblazoned on the ragged organ that was his heart” (167). His heart has failed him just as he failed those he loved. Consequently, the transplant of Francis’s heart becomes more than a medical procedure; it is a symbolic transfer of grace. Francis, who served as the spiritual and emotional heart of the family, literally gives his heart to Angel, the brother whose own heart has failed. Angel’s initial horrified reaction upon waking—his feeling of being invaded and his declaration, “You should have let me die” (220)—is a psychological rejection of a second chance he feels he does not deserve. It is a physical manifestation of his deep-seated self-loathing. The novel thus uses its central symbol to make the abstract concept of redemption tangible, forcing the protagonist to physically embody the goodness of the brother he wronged.
The account of the transplant combines visceral sensory detail with spiritual undertones to invest the medical event with symbolic meaning. The text does not shy away from the clinical reality of the surgery, describing the buzz of an electric saw and Angel’s chest as a “gaping hole.” This medical realism is then layered with moments of spiritual suggestion. As he is anesthetized, Angel has a vision of Francis, and after the new heart begins to beat, Madelaine believes she hears Francis’s voice. This blend of the corporeal and the transcendent transforms the transplant from a prosaic plot device into a sacral exchange of life-force. The clinical details ground the event in a tangible reality, making the spiritual implications more powerful through juxtaposition.
The catastrophic events of these chapters deconstruct the characters’ protective personas, stripping away their public-facing identities. This process is crucial to the exploration of The Tension Between Public Persona and Private Identity. Angel’s memory of the carnival dismantles the façade of the confident movie star, exposing the scared 17-year-old who chose escape over responsibility. His subsequent physical helplessness completes this process towards vulnerability. Similarly, Madelaine’s identity as the composed Dr. Hillyard shatters under the weight of personal tragedy. In the Portland hospital, she is no longer a cardiologist in control but Francis’s next of kin, forced to make an impossible emotional decision. Her collapse in his empty rectory signifies the complete disintegration of her professional mask, revealing the profound grief she has suppressed. For Lina, the crisis exposes her rebellious anger as a defense mechanism. Her anguished realization that Francis was an available father figure—“You should have told me he was right there all along” (199)—pinpoints the true source of her pain. This necessary stripping away of established identities is a prerequisite for the characters to begin forging a new, more authentic family structure.
Angel’s vivid flashbacks, triggered by his brush with death, are a painful excavation of his own regrets, representing the first step toward accountability. However, this moment of truth is immediately contrasted with Madelaine’s construction of a new web of deceit. Her decision to conceal the donor’s identity from Angel and her lie to Lina that her father is too ill to see her, while born of a protective instinct, postpones the development of a family built on honesty. This juxtaposition is thematically significant: just as one foundational truth is being faced, another set of foundational lies is established. In doing so, Madelaine isolates both Angel and Lina in their grief, preventing them from bonding over their shared loss of Francis. This complicates the theme of Traditional Family and Home as the Location of Personal Fulfilment, suggesting that building a new life on a foundation of secrecy is a perilous endeavor.



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