Miguel Chico sits at his desk in San Francisco beneath a wartime photograph of himself as a child walking hand in hand with his paternal grandmother, Encarnación Olmeca de Angel, known as Mama Chona—a title she insisted upon, never the diminutive “abuelita.” Called “Mickie” by his family to distinguish him from his father, Miguel Grande, Miguel Chico is a second-generation American.

Thirty years after the photograph and 12 years after leaving the desert, Miguel Chico lies in a university hospital near death, thinking of his family’s sinners: his deceased Uncle Felix, great-aunt Cuca, cousin Tony; the living pariah Aunt Mema; and his father, whose transgressions the family overlooks. Though he’s the first of his generation to attend a prestigious university, the family suspects he belongs among the sinners for remaining unmarried and visiting rarely. Mama Chona died before he earned his doctorate, but on her deathbed, she recognized him and whispered, “la familia.”

Miguel Chico’s health crisis began when medication for a bladder infection aggravated a dormant intestinal illness. On the operating table, weighing only 98 pounds, he hears the surgeon say his mother is outside. The doctors explain he will need a permanent ostomy appliance, assuring him this solution is preferable to death. Initially he wants to ask them to let him die, but the drugs subdue him. When he makes it through the surgery, the surgeon calls his survival miraculous, and Miguel Chico realizes Mama Chona had trained him to suffer and, if necessary, to die. In the recovery room, he reflects that, ironically, he’s achieved the bodiless consciousness his grandmother and the church idealized.

As a young child, he visited the cemetery with his family for three years before understanding its purpose. Mama Chona never attended. Instead she locked herself in her room on the Day of the Dead to pray. At age five, unable to cry with the mourning adults, Miguel Chico was more frightened by the toothless flower seller than by the dead themselves. A year later, his eight-year-old friend, Leonardo, hanged himself on his back porch. At the mortuary, Miguel Chico touched Leonardo’s cold, waxy face and heard his nursemaid Maria say he would not see Leonardo again until Judgment Day. He began to understand that the cemetery stones represented actual bodies, and he told his mother he was not afraid of the dead, but of what would happen tomorrow.

Maria was one of many undocumented Mexican women working as domestics on the American side of the border. Years later, carrying his own ostomy bag through New York, Miguel Chico sees Maria in every “bag lady” he encounters. His mother, Juanita, coached Maria weekly on what to tell immigration officials, though Miguel Grande’s police connections usually protected her. For six years, Maria took Miguel Chico to daily Mass and bought him paper dolls. Miguel Grande scolded her for this, not wanting his son raised like a girl. Once, his father caught them dancing while Miguel Chico wore a skirt Maria had made, and created a terrible scene, accusing Juanita of turning their son into a joto (a pejorative slur for gay men).

Several months after Leonardo’s death, Maria converted to Seventh-day Adventism. She stopped taking Miguel Chico to Mass and began secretly reading the Bible to him. He admired Satan’s rebelliousness but felt guilty for attending Adventist services behind his Catholic family’s back. During this period, his mother gave birth to his brother, Gabriel, which made Miguel Chico jealous. One day, hiding in his mother’s closet, he saw a bloody undergarment in the hamper. Later, Maria carried him to the kitchen window where they watched his mother tending the garden. Near a peach tree he had planted from a pit, Maria whispered that when the tree bore fruit, the world would end, and that he must always love his mother because one day, she will die. The image of the peach tree merged forever with the bloodstained undergarment, linking love and death in his mind.

Two years later, terrified that the world was ending, he betrayed Maria by telling his parents about the Adventist services. Miguel Grande initially fired her but eventually allowed her to return on the condition she never discuss religion. She grew distant, spending more time with Gabriel than with Miguel Chico. When she finally left, he refused to say goodbye, though he felt lonely that night.

Years after his operation, living alone in San Francisco, Miguel Chico receives a letter from his mother describing Maria’s recent visit to the desert. Now white-haired, Maria remembers everything from his childhood, including a white dress she had made for him. When she met Gabriel, now a priest, she asked when he would marry; Gabriel replied firmly that he had seen what marriage does to people. On Miguel Chico’s birthday, Maria herself writes him a letter, expressing gladness at his recovery and wishing him a long life so they might meet in paradise. He resolves to respond immediately, but delays. A month later, on the anniversary of his operation, Juanita calls to say Maria had been killed by a drunk driver leaving her church in Los Angeles. When Miguel Chico responds with a cynical remark, his mother calls him heartless. Juanita says she would have Gabriel celebrate a Mass for Maria, and Miguel Chico promises to look for peach trees in the park in her honor.

That Sunday, he does laundry at the local laundromat among other solitary people, then cooks his special spaghetti sauce using a chile from his godmother Nina’s annual Christmas wreath. He performs the weekly ritual of changing his ostomy appliance, reflecting bitterly on how he can no longer hold someone naked without plastic between them.

Trying to read, he keeps glancing at a photograph of himself with Mama Chona, realizing he has no picture of Maria. His near-death experience had not given him special insights, and he still sees people as books requiring editing. He recognizes that his tendency to rearrange stories comes from Mama Chona, who dressed unpleasant realities in comforting tales. He concludes he might have survived to tell these women’s stories and better understand himself—the family analyst, examining psychological motives from an earthly, rather than spiritual, perspective.

Walking into his fog-filled garden, he feels Maria’s presence and hears her whisper that humility is inherent to earthly existence, not a virtue purchased for heaven. He returns inside, changes his bag, and goes to bed.