Home Again

First published in 1996, Home Again is a contemporary romance by Kristin Hannah, a former lawyer who became a #1 New York Times bestselling author. Hannah writes in the historical and women’s fiction genre, and is known for the international bestsellers The Nightingale (2015), The Great Alone (2017), and The Four Winds (2021). Unusually in Hannah’s oeuvre, Home Again uses a contemporaneous setting, drawing on the social context of 1990s medical advancements in heart transplantation, and the rise of invasive tabloid media culture. Its narrative explores themes such as The Power of Forgiveness and Second Chances, Traditional Family and Home as the Location of Personal Fulfilment, and The Tension Between Public Persona and Private Identity.

The novel’s plot was inspired by a real-life account of a man who received a heart transplant from his own daughter. It centers on Angel DeMarco, a self-destructive movie star who returns to his hometown of Seattle for a life-saving heart transplant. There, he must confront his first love, Dr. Madelaine Hillyard—now the brilliant cardiologist in charge of his case—and their estranged daughter, Lina, whom he never knew existed. Angel’s medical crisis forces a reckoning with his past, stripping away the celebrity facade he has used to mask his deep-seated insecurities. His journey of medical recovery is intertwined with his attempt to build a relationship with his daughter and seek forgiveness from Madelaine. The story blends medical drama with complex family dynamics, examining whether a second chance at life can also provide a second chance at love and redemption.

This guide is based on the 2025 Ballantine Books Trade Paperback Edition.

Content Warning: The source text and this guide contain depictions of illness or death, pregnancy loss or termination, bullying, emotional abuse, child abuse, substance use, addiction, sexual content, and cursing.

Plot Summary

At a wrap party for his latest film, world-famous movie star Angel DeMarco suffers a massive heart attack. At a local Oregon hospital, his doctor informs him that he has end-stage cardiomyopathy (heart disease) and will die within the year without a heart transplant. Angel demands a transfer to a top facility and is sent to St. Joseph’s Hospital in Seattle, the hometown he left suddenly 17 years earlier. A flashback reveals his departure as a teenager after a painful goodbye with his brother, Francis, and a confrontation with their mother, who was addicted to alcohol.

The narrative shifts to Dr. Madelaine Hillyard. Madelaine is the leading cardiologist at St. Joseph’s and a lone parent who juggles work and family responsibilities. She has a difficult meeting with a guidance counselor, Vicki Owen, about her teenaged Lina, who is skipping classes and acting rebelliously. Lina feels resentment at her mother’s work commitments and that she has never known her father. She resolves to find her father after some in her social group mock her for not knowing his identity. On Lina’s 16th birthday, she confronts Madelaine and Madelaine’s best friend, Father Francis DeMarco—Angel’s estranged brother—demanding that they tell her of her father’s identity as her birthday gift. An argument follows, with Lina accusing her mother of driving her father away and storming out of the house. 

Meanwhile, Angel arrives at St. Joseph’s, where the head of the transplant team, Dr. Chris Allenford, assigns Dr. Madelaine Hillyard as Angel’s cardiologist. Angel is shocked to learn that the doctor in charge of his case is the woman who was his first love. Madelaine’s reunion with Angel is tense. She is cold and professional, while he is hostile and resentful of his medical dependency on her. She warns him that he will not be approved for a heart unless he commits to changing his lifestyle to reduce drinking, smoking, and drug use. Angel’s agent, Val Lightner, visits to discuss how to keep the transplant a secret from the media. When Madelaine tells Angel that his brother, Francis, will want to visit, Angel forbids her from telling Francis he is in Seattle.

Madelaine promises Lina she will contact her father, admitting that he does not know Lina exists. When a crisis at work delays her, an angry Lina acts out and is arrested for shoplifting. Madelaine grounds Lina and revokes her privileges, leading to more conflict between them.

Angel calls Francis, who visits him at the hospital. Their reunion is fraught with old rivalries and complicated by Angel’s jealousy over Francis’s close relationship with Madelaine since he left. Francis tells Angel that he is a priest and that he helped Madelaine—who was pregnant by Angel—after Angel left her. They argue and part in anger. 

Francis leads a couples’ retreat in Oregon. While driving home from this during a storm, he is severely injured in a car accident. When Madelaine and Lina receive the news, they fly to Portland and learn Francis has suffered total brain death and is reliant on medical life support. In Seattle, Angel goes into cardiac arrest, making the search for a suitable donor increasingly critical. Dr. Nusbaum in Portland informs Madelaine that Francis is a perfect organ donor match for a critical patient in Seattle. Madelaine realizes this patient is Angel. As the executor of Francis’s estate, Madeleine is obliged to make the decision on whether to remove life support and donate his organs. She authorizes the transplant of his heart into Angel but requests that Angel not be told the identity of his donor. Angel does not know that Francis has died, as distressing him might be fatal.

Madelaine flies to Seattle with Francis’s heart and is present for Angel’s transplant surgery. As the anesthesia takes hold, Angel asks her to tell Francis he loves him. The surgery is successful, but when Angel wakes, he is horrified by the sensation of a stranger’s heart beating in his chest, telling Madelaine she should have let him die. Angel’s physical recovery progresses well, but he is distressed, hostile to the staff, and plagued by vivid dreams of Francis. He is told of Francis’s death but not of his identity as donor. He also begins experiencing changes in taste and a new appreciation for music like The Beatles, which he previously disliked.

To give him a sense of purpose, Madelaine tells Angel he has a daughter. He reacts first with anger at her for keeping the secret, then with fear, refusing to meet Lina because he believes he will only hurt her. After a dream in which Francis tells him to “Be her friend” (261), Angel changes his mind. Madelaine arranges the meeting, and Lina is stunned to discover her father is the movie star Angel DeMarco and, more shockingly, Francis’s brother. They form an immediate but tentative bond.

As media speculation about his health intensifies, Angel holds a press conference to control the narrative. He confirms he had cardiac surgery but denies it was a transplant and announces he is quitting his acting career to live a regular life. 

Madelaine takes Angel to visit Francis’s grave to help him grieve. There, fearing the media will soon uncover the connection, she tells him the truth: He has Francis’s heart. Angel reacts with shock, fury, and betrayal, accusing Madelaine of lying to him and letting them “cut Franco’s heart out” before running off into the cemetery (309). After a while, Angel returns to the bench at Francis’s grave, and he and Madelaine talk through their pain and grief. He comes to understand her decision and begins to see Francis’s heart as a gift. 

Angel and Madelaine visit her abandoned childhood home, the site of Angel’s original betrayal. They have sex and he tells her he is falling back in love with her. When they return to Madelaine’s house, a hurt and excluded Lina confronts them. Angel, acting as a father for the first time, disciplines her for her disrespect. Lina storms out but soon returns, and the three reconcile. They celebrate Thanksgiving together, creating a new family tradition and honoring Francis’s memory. Angel arranges a memorial mass for Francis, giving a moving eulogy and playing a rock-and-roll song from their childhood. This helps him process his grief. On the night of Lina’s first school dance with her new boyfriend, Zach, Angel decorates Madelaine’s living room as a mini prom hall and proposes to her. She accepts. 

In the epilogue, Francis’s spirit watches over his family as they decorate for Christmas. Seeing them happy, he has a vision of their future: Madelaine and Angel will have a son they will name Francis but call Frank, “Because there’s already been a Francis” (393), Francis’s spirit finds peace, his heart still beating in his brother’s chest.