Reese and Charlie roast a whole pig over a fire, joined by Cindy, Annie, and Termite. Reese has a fun time and thinks he isn’t all that different from Annie: “Maybe my inner emotions still had expression, still made it to the surface and bubbled out. Maybe I wasn’t dead after all” (220). They all take a jet ski ride and come back to eat the cooked pig. 

Reese thinks back to when he and Emma kissed for the first time: It differed from “the way you […] kiss your mom goodbye before school; I mean Emma spoke to me. Her lips were wet and soft, and her hands trembled slightly” (234).

Reese then finds Cindy and Annie sunbathing on his beach. While they make themselves at home, he goes into his workshop to work on a table that he’s been crafting for them as a surprise. Annie comes in and tells him that during her last surgery, she woke up, paralyzed, because the anesthesia wasn’t strong enough. She asks if she should let Dr. Royer perform a test (the one Reese ordered), which requires her to be anesthetized again. Reese says she should, although he understands her hesitation. 

Reese leaves Royer a voicemail telling him that he will attend Annie’s next appointment, with conditions: He asks Royer to perform Annie’s procedure on the children’s floor so that it will be less intimidating, and he asks that Royer avoid working with nurses or support staff who knew him previously. Royer agrees to his terms, and Reese drives Cindy and Annie to the appointment.

Reese likes being back in the hospital setting because he sees it as a place where hope lives: Hope “creeps along the corridors, hangs from every corner of every room, and speeds down every gurney in search of a soul in need” (246). Annie says that she hopes that Royer’s old partner will perform her surgery. 

Royer explains the results of Annie’s test: Annie’s enlarged heart does not work efficiently. Cindy hangs out with Annie while she recovers, and Reese runs errands for them, filled with wonder by how:

[…] a lifeless, unbeating, and cold heart that had not been inside a human chest for almost four hours could be removed from ice water, placed inside another’s chest, and, when filled with blood, beat as though it had never quit (257).

Cindy asks Royer to contact Dr. Mitchell one more time, and he says he already did. Reese realizes he must decide whether to perform Annie’s surgery. He takes Annie and Cindy to lunch at The Well and then takes them home. When they discover a burst pipe has flooded their house, he invites them to stay at his house.

Reese shows Cindy the table he made for her and Annie, which they love. Then, Charlie watches Annie while Reese takes Cindy rowing. When they get home, she takes a bath in his huge bathtub. That night, Reese finally reads Emma’s third letter to him. She says, “Remember, I am not the only one […] do this for the others like me who cry like the cardinal on our windowsill” (270).

Moved by Emma’s letter, Reese takes Cindy to his office and tells her the truth about his identity. He explains that he is Dr. Jonathon Mitchell, and he tells her why he changed his identity. At first upset and confused, Cindy then asks if he will perform Annie’s surgery; he says “yes.”

Later, Reese confesses to Charlie that, at the time Emma died, he had been using prescription stimulants to keep himself awake over long hours of back-to-back surgeries. Emma had tried desperately to wake him, but he had fallen into a deep sleep after crashing from the drugs. Reese says, “Charlie, if she’d been able to wake me […] we wouldn’t be having this conversation” (273). Charlie says he doesn’t blame Reese for Emma’s death or his blindness, and tells Reese to stop blaming himself. 

Reese tells Annie the truth about his identity. She asks if he will be her doctor, and he agrees.

Reese, Cindy, and Annie wait for the phone call that says the hospital has found a heart. In the meantime, “we ate several times at The Well, where Davis created a new menu item called the Annie Special” (279). 

At 2 a.m., they receive a call: A heart may be available for Annie. Reese says, “I held the phone and realized that I had just had the conversation I had waited my whole life to have. Mixed emotion—joy and sadness—fell on me in equal parts” (283). 

A Life Flight helicopter rushes Annie to the hospital. While in the helicopter, Annie asks Reese to explain how the heart will come to her. He explains that Dr. Royer is on his way to a hospital in Texas. “Once there, he’ll open up the donor, inject a solution into her heart to make it stop, and the doctors across from him will declare a time of death” (287). 

At the hospital, after Annie is prepped for surgery. Royer calls to say that the donor heart is diseased. They return to Reese’s, where Annie’s condition visibly deteriorates.

It’s now September, and a violent storm thunders across the lake. Cindy, Annie, and Reese take shelter in his workshop. The storm destroys almost all of Reese’s property; in the meantime, Annie is “ashen, her lips blue, her eyes falling back behind her lids, and her body […] a twitching combination of limpness and lockjaw rigidity” (299).

Seeing Annie experiencing the same heart failure that Emma had, Reese decides to perform the same procedure, even though he doesn’t have the proper tools. He uses his own blood to replenish Annie’s; this time, the surgery is successful.

Annie is again rushed to the hospital, where the medical team works to stabilize her while Royer goes to Nashville to investigate another potential donor heart. Faint from blood loss, Reese drinks soda and tries to recuperate. Once Royer returns with the heart, they begin Annie’s transplant, which goes well at first, but when things start to go wrong, Reese drops his emotional connection to Annie and focuses on his technique: “I noticed one anastomosis that did not hold the way I thought it should” (319).

Reese makes some last-minute adjustments, but when he’s finished, the heart does not beat. Fearing that Annie has died, Reese starts falling into a waking nightmare. He snaps out of it when he hears Emma whispering to him. After he speaks the Bible verse etched on the necklace Emma had given him, Annie’s heart miraculously starts to beat.

Six weeks after Annie’s surgery, Reese stands on his property “with my home destroyed and the life I had come to lead changed forever” (323). Reese hires Termite to help him rebuild, along with Charlie; meanwhile, he camps outside in a sleeping bag, in a cave-like area of his property. Cindy and Annie rent a place near Reese, and Cindy visits him daily.

Annie tells Reese that she saw a sailboat in a dream; the sail was made from a letter Emma had written to Reese. Later, Charlie reveals that Emma did him a letter to give to Reese when the time was right; the letter says that she wants Reese to love again one day.