54 pages • 1-hour read
The Clinic
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Symbols & Motifs
Content Warning: This section of the guide includes discussion of death by suicide, death, addiction, and substance use.
Poker
Poker appears as a motif related to the theme of The Lasting Effects of Trauma. Meg’s boss at a luxury casino describes her as “the best poker player [he’s] ever seen” (24), and poker is essential to her understanding of the world and her interactions with others. For instance, Meg attempts to understand her fellow patients by imagining them as poker players. When she first meets Sierra, she pegs her as someone who “has a bad hand” and “got hustled into playing” (102, 104). She describes Dex as someone who “tried out at the wrong league and lived to regret it” and says that Tom has the look of someone who has started “betting big right after a big loss” (104). Meg’s assessment of the other patients through the lens of poker suggests that poker is essential to her worldview.
Poker also informs how Meg acts with the others. She repeatedly uses the poker slang “tilt” to describe her emotional unavailability. She defines tilt as “a poker term meaning you’re out of control of your emotions” and unable to play effectively (23). Meg claims that “at the poker table, all emotions are tilt” and therefore dangerous (32). Meg applies this same philosophy to her relationships, telling Max that she aims for “zero tilt” in her life. Meg’s repeated use of this word suggests that poker is the defining metaphor for her life.
Meg’s association of poker with cool rationality proves ironic, as it eventually emerges that her earliest experiences of the game were highly emotionally charged. At the beginning of the book, Meg does not remember when she learned to play poker. While at the Clinic, however, she uncovers memories of learning to play on the day that her mother attempted to die by suicide. The fact that Meg devotes her life to poker suggests that the trauma of that day had a profound, lasting effect on her.
Celebrity
With the exception of Meg and “Jade,” all of the patients at the Clinic are celebrities. As a motif, celebrity proves to be a double-edged sword that can both protect and endanger individuals. This is evident in the depiction of the Clinic itself. Its defining feature is its privacy, which is enforced by an advanced security system surrounding and inside the property. Lutz claims to be “careful to use the very best [security] on account of [the Clinic’s] famous guests” (21), who don’t want their treatment to be “disturbed or publicized” (54). However, the fact that the novel ends with the patients trapped in the Clinic with a murderous Lutz suggests that this isolation and secrecy also allow the Clinic to function as a kind of prison (which the building itself was in a prior incarnation).
This is equally true of celebrity itself. The patients’ fame makes it difficult for Meg to form meaningful relationships with them. Meg sees Dex simply as the “famous front man of an infamous rock band” (93). She describes Sierra as a “famous girl band singer” and dismisses Madeline as a “former supermodel” (105). Meg struggles to see past the public personas of these celebrities that she knows from television, suggesting that celebrity can make it difficult for famous people to form real connections. This also hints at the theme of The Difficulty of Discerning Character; more than even the average person, celebrities cultivate a public image that may be starkly at odds with their true selves.
Ships and the Ocean
The Clinic takes place in the Pacific Northwest, and ships and the ocean appear as recurring motifs reflecting Meg’s relationship with her sobriety. Meg repeatedly refers to her time in the Clinic as a “journey,” and Cate Quinn uses similar language in the novel’s supplemental materials. The Clinic’s aesthetics reflect the metaphor of sobriety as a journey through nautical architecture. Cara’s reception desk is described as “a huge polished-wood structure like an upturned boat” (11). The hallways of the Clinic are marked by “fat beams of curved oak” (148), and when Meg arrives at the clinic, she feels as if she’s “walking beneath the skeletal keel of a half-built Nordic long boat” (148). The dormitories are styled to resemble the “below-decks in a luxury yacht” (41). Cara attributes this nautical style to the Clinic’s history as a prison, whose inmates were “brought by tall ship” (26). The recurring motif of ships and nautical design reflects Meg’s sense of her time at the Clinic as a transformative journey, while the association with imprisonment hints that the journey could be dangerous.
The wild Pacific Ocean also appears as a motif reflecting Meg’s emotional journey. As her detox causes emotional turmoil, Meg refers repeatedly to the Pacific with descriptors that mirror her experience: “wild,” “squalling,” and “stormy.” Similarly, the sound of the “ocean crashing” interrupts her phone calls with Harry, reflecting her lack of certainty about their relationship.
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