“While I finished my drink, she watched me with neither impatience nor worry. Somehow I knew, despite the mountain of money at my feet, that even if I never gave her a penny, she’d pour that lemonade until I either turned yellow or floated off. Problem was, I had longer than she did. Annie’s hope might lie in that bottle, and I had a feeling that her faith in God could move Mount Everest and stop the sun, but absent a new heart, she’d be dead before she hit puberty.” 

This moment reveals some of Annie’s and Reese’s key characteristics: Annie, despite being terminally sick, remains hopeful because of her faith in God. Reese is pragmatic: Although Annie has hope because of faith, he knows that her future depends on receiving a new heart.

“No makeup. Strong back, long lines. Rigid and stern, but also graceful. Cold but quietly beautiful. Complicated and busy, but also in need. More like an onion that a banana. Her eyes looked like the green that sits just beneath the peel of an avocado, and her lips like the red part of the peach that sits up next to the seed.” 

The novel’s first physical description of Cindy also highlights Reese’s observant nature. He has only met her a couple times, but from her physical appearance alone he’s able to discern her internal complexity. During this initial observation, Reese acknowledges her beauty, demonstrating least a flicker of attraction, which he pushes away because of his guilt over Emma’s death.

“Rowing is a sport unlike any other. On the surface, it’s the only one where you don’t constantly look ahead. More often than not, where you’ve been—your hindsight—tells you where you’re going. In track and field, sprinters and hurdlers look like locomotives at full speed—their arms and legs pounding the track and air like rods and pistons. In football, players spin about like battering rams or bumper cars. And soccer is an anthill of players caught between a ballet and a bullfight. But in rowing, the man in the scull is something of a spring.” 

Reese believes that rowing is unique because the rower doesn’t look ahead. In the same way, Reese, unable to see a future for himself without Emma, stays focused on what is behind rather than what’s ahead. Rowing not only mirrors his mental state but also highlights his self-sacrificial nature. He took on most of the rowing for Emma, who was incapacitated, and steers for Charlie, who can no longer see.

“If buildings and vehicles were interesting, even fascinating, then the human body was an all-encompassing obsession. The walls of my room were covered in posters and diagrams demonstrating everything from bone structure and muscular growth to organ systems and the electronic neural pathways of the brain. Because my hands played a large role in educating my mind, by the age of seven I had already dissected and sewn back together two giant frogs, one fish, a neighbor’s cat, an armadillo, and a long black snake—all of which were dead, or quickly dying, before I got ahold of them.” 

This moment demonstrates Reese’s natural aptitude for surgery, even as a boy. Now one of the top heart surgeons in the world, Reese has always been obsessed with putting things back together. Discovering Emma’s condition made him focus his attention on working with the heart.

“Every night it is the same, and just before the dying man takes his last gasp of air, I wake up, drenched, cramped, suffering from muscle spasms in my hands and arms, thirsty beyond belief, my ears ringing with his screams and wrapped in the fear that he is dying from something very simple. Something everyone should have seen by now, but no one else has. Something I can’t see, because I too am blind.” 

Since Emma’s death, Reese has had a recurring nightmare that prevents him from getting a good night’s sleep. In the dream, a stranger is dying, and the only way Reese can try to save him is by pouring water onto him from a leaky but always replenished pitcher. Once he stops pouring, the man starts dying again. This dream represents the panic and despair that Reese still feels over failing to save Emma’s life and shows that the trauma’s effects are ongoing.

“What Emma knew filtered from her head down into her heart and informed who she was—what I have since come to call the Infinite Migration. If my wonderings about life were scientific, bent toward examination and physical discovery, Emma’s all leaned toward matters of the heart. While I could understand and explain the physics behind a rainbow, Emma saw the colors. When it came to life, I saw each piece and how they all fit together, and Emma saw the image on the face of the puzzle. And every now and then, she’d walk me through the door to her world and show it to me.” 

This moment explains the fundamental yet complementary differences between Emma and Reese. Throughout their relationship, Reese focused on saving Emma’s heart while she wanted to open his. In the end, Reese regrets that he spent so much time away from her, trying to save other peoples’ hearts instead of spending what little time she had by her side.

“They built a dam and began flooding the surrounding land on December 22, 1919. The 80-some-odd homeowners, whose homes had just been flooded, hopped into their canoes and runabouts and watched the lake rise up beneath them. When the lake topped out, the tips of the 60-foot-tall pines were some 30 to 40 feet below the surface of the water, which was as clear as the green ice. In a sense, Burton became a flowing cemetery—a lot had been buried up there.” 

Beneath Lake Burton, which is behind Reese’s house, lies the remnants of Burton, a town that once flourished. When the state built the dam and flooded the town, the people happily accepted the money and left. The awareness of an entire town—all the buildings, trees, memories, and graves—swallowed by water feels strange to Reese. Like Lake Burton, Reese has a placid exterior, with many secrets lurking beneath the surface.

“There’s a gold mine in salvageable wood draped in kudzu, pine needles, and acorns if someone is willing to peel back the vines and plane the wood. It’s a slow process, and you’re bound to uncover a few snakes, but maybe life is like that—you never know when something that’s been hidden is going to rise up and bite you, or glow with a golden hue.” 

Reese loves to take old things, whether they be old wood or boats, and restore them to their former glory. Although Reese is talking about the surprises—both good and bad—that can go along with refinishing wood, he also references his own life. Like a worn and weathered piece of old wood, Reese is reclaimed when Annie and Cindy peel back the layers, revealing the beauty of his abandoned self.

“People marvel at the genius of Mozart because he supposedly wrote ‘Twinkle, Twinkle, Little Star’ at the age of three and composed his first symphony at the age of twelve. And yes, of course, he was a genius, but another way to look at it is that he just discovered early what it was God made him to do.” 

As one of the top heart surgeons in the world, Reese doesn’t think that he is necessarily special; he believes that he knew from a very young age what God had created him to do—not only to perform heart surgeries but also to love Emma.

“To science, the heart was just something to be dissected, labeled, and put on a shelf in a pickle jar where a kid with glasses and a mouthful of braces could say, ‘Ooh’ and ‘Ahh.’ The scientific approach was cold, unfeeling, and even the way they talked about it was sterile. As if the heart were nothing more than cells linked together by other cells.” 

Reese spent much of his childhood and young life researching the human heart, but science could only explain it in sterile language. He knew this kind of pragmatic approach didn’t do the heart justice, viewing the organ as too complex to be explained only in scientific terms.

“Reese, your books might not tell you this, so I will. Every heart has two parts, the part that pumps and the part that loves. If you’re going to spend your life fixing broken hearts, then learn about both. You can’t just fix the one with no concern for the other.” 

Emma verbalized the complexities of the heart that Reese had always known but couldn’t articulate. He knew that textbooks couldn’t fully describe the heart, and although Reese knew the biological and anatomical details of the heart, he had yet to learn about the loving part—the part Emma knew the best.

“Bottom line, Davis is not interested in the people who aren’t attracted to the promise of big bosoms, cold beer, and the possibility of having both. And for that reason he’s targeting the folks who think they can’t live without them.” 

Davis, also known as “the Monk,” is the owner of The Well. He started the bar with the sole purpose of evangelizing to the lost. He decorates the bar with Bible quotes and holds a weekly Bible study that he invites bar patrons to attend. He intentionally seeks those he views as lost, giving them a map to Christian redemption. 

“You can buy that lie if you want, but if you’re working for a bank, you don’t study the counterfeit to know the real thing. You study the real thing to know the counterfeit.” 

At the docks, Reese runs into Termite, who’s looking at a porn magazine. Reese tells him that the girl in the photo is someone’s daughter, but Termite gets mad that he’s trying to ruin the images for him; he also says that he wants to “test-drive a few cars” before he buys one. Reese tells Termite that sleeping with multiple women will never help him understand love. From Reese’s perspective, the only way a man can know love is through experiencing it with one woman. 

“That afternoon many of the pieces fell into place, and it struck me that doctors can help people get well, even prolong their lives, but they cannot heal them or make them whole. That’s something else.” 

When Reese and Emma were in high school, she had given him a necklace inscribed with a Bible verse: “Above all else, guard your heart […] for it is the wellspring of life” (114). Although Reese has learned the intricacies of the human body from a scientific and medical perspective, he realizes that making a person well isn’t the same as healing, distinguishing between physical healing and the spiritual/emotional healing he experiences first with Emma, and then with Cindy.

“The human heart is remarkable in that it is designed to pump continuously for 120 years without ever needing to be reminded what it was meant to do. It just does it. In all my reading and study, I have come to know one thing without any shadow of doubt: if anything in this universe reflects the fingerprint of God, it is the human heart.” 

Reese acknowledges that for all scientists and doctors know about the human heart, they have only scratched the surface. This push and pull between the heart being knowable, and at the same time completely mysterious, recurs throughout the novel. This moment also demonstrates Reese’s belief in and reverence for God. 

“She looked down, and the crickets fell quiet, making a low, almost inaudible chatter, as if they obeyed or observed something I knew nothing about. It was like a song you could hear only if you weren’t trying to listen, or a far-off star that you could see only when you weren’t focusing, and then only out of the corner of your eye.” 

Annie realizes that the crickets she raises and sells have to die for her to live, mirroring the fact that a heart donor will have to die to save Annie’s life. Annie tells Reese that the crickets are crying. He says he can’t hear them, but she says you can only “hear them with your heart” (128).

“The twelve of us who made up the surgical team at Mass General had been handpicked from the best schools around the world. We were called ‘the best’ because we were. Our record proved it. I justified the long hours away from Emma by telling myself that every hour spent in the hospital was one more hour in pursuit of perfecting my craft. One more hour credited toward her healing.” 

Reese deeply regrets spending most of his life away from Emma, thinking that by gaining more surgical experience, he’d have a better chance of saving her, In reality, he sacrificed many moments with her and ultimately, could not keep her alive. Although this regret haunts him, he leverages what he learned in those hours away from Emma to save Annie. He also comes to view surgery itself, not saving Emma, as his life’s ultimate purpose. 

“My whole life, everything about my existence, had led to one singular moment, but that moment had come and gone and left me alone. All my preparation had been in vain.” 

As soon as he met Emma as a young child and found out she had a sick heart, he decided to become a heart surgeon. After he’s unable to save her, he rejects his identity as a surgeon, thinking that his training and practice have all been pointless.

“Her chest incision had healed well. Staple holes dotted the side of her scar, which was red and raised somewhat. But for the most part, Annie had not scarred badly. Which was good. And the fact that she wasn’t afraid to let the world see it meant she hadn’t scarred too badly on the inside either. Both would make the next surgery less difficult for whoever did it—cutting her open and sewing her up would take less time, not to mention the fact that she’d be less conscious of it for the rest of her life.” 

Although she’d had heart surgery before and endured the trauma of waking up paralyzed during it, Annie feels hopeful about her next procedure. Reese acknowledges that this process can scar people and make them weary about things in the future, but Annie has remained hopeful despite constant setbacks. In this way, Annie reminds Reese of Emma.

“Hope is not the result of medicine or anything that science has to offer. It is a flower that sprouts and grows when others pour water upon it. I think sometimes that I spent so much time worrying about how to protect and strengthen the flower—even going so far as to graft in a new stem and root system—that I forgot to simply water it.” 

Reese realizes that his once greatest strength—his technical knowledge of the heart—is also his greatest downfall. Although he knew how to care for Emma’s physical heart and was obsessed with honing his craft in the hopes of saving her, he often neglected the emotional needs of her heart. 

“I loved this, the feeling of absolute and eternal optimism, the feeling that no matter how bad or no matter how dire the circumstances or predictions, that until death had been declared and the sheet rolled up over the patient’s eyes, that even beyond the flat-line, anything is possible. Beneath the undercurrent of even the direst predictions, hope lives there.” 

When working in the hospital, Reese loves being surrounded by hope. Hope’s palpable presence in the hospital reminded him of Emma: No matter how weak Emma became, she always remained optimistic. 

“The amazing thing about transplantation, aside from the fact that it worked, was that it allowed people to feel again. The thing I liked best about my previous life was the first smile when a patient woke up. Because with that smile, I knew that I hadn’t simply given that person a new pump, I had given him or her a new pump that allowed that person to live, to express emotion. It was the smile, even more than the first beat of the heart, that told me it had worked.” 

A heart transplant not only saves the life of the recipient but also gives them a chance to truly live. This second chance gratifies Reese and underscores his understanding of the heart as both an organ and a person’s emotional core. 

“I’d like my eyes back, Reese, but I’m not waiting around. I’m living. And that’s the thing. You’re not. I’m soaking it in, feeling every minute, and you’re the walking dead.” 

Charlie observes that Reese’s problem, ever since Emma died, is that when she left him, she took his heart with her. Instead of letting himself feel or experience the joy of the world around him, Reese closes himself off from everyone. Although Charlie lost his eyesight, he’s not trapped in anger or in an eternal desire to see again; instead, Charlie allows himself to feel alive in the present.