The morning after Jamie’s arrival, Nick makes brown-butter waffles while Rocky fries bacon. Willa lounges with the kitten, Angie, and Rocky’s father shuffles in, joking that he has survived the night because of a Valium and Chessmen cookies. Jamie enters, and the family settles for breakfast. Rocky sits out the first round, prompting her father’s concern. Willa explains to Jamie that Rocky is avoiding gluten due to a widespread rash. She also reveals Rocky has stopped drinking alcohol, disappointing Jamie, her favorite drinking companion. 

Rocky’s father becomes emotional over gooseberry jam his late wife made. When he asks Jamie about Dickens’s involvement in the train accident, Jamie confirms the work predates the incident. His face clouds when asked if Dickens also consults for the Federal Railroad Administration (FRA). Then, Jamie explains the FRA oversees railroad regulation and safety. When Willa questions the ethics of Dickens advising both the company and its regulator, Nick compares it to working with both Big Pharma and the FDA, which Dickens also does. Jamie admits he does not love this. Internally, Rocky questions whether they have mistaken Jamie’s good nature for actual goodness, feeling Miles’s death resembles the answer to an unholy math problem more than an accident.

Rocky collects a stool sample for ulcerative colitis testing, struggling with the logistics of transferring waste from a large bucket to a small jar. The cats demand bathroom access while she works. She disposes of the bucket and then rushes to her car to meet the lab deadline. She is intercepted, however, by a neighbor girl on a scooter talking about her upcoming dinosaur-themed sixth birthday. When the girl rides away, Rocky’s father emerges and asks about the bag. When she says it is actual feces, he brightens, joking about his own mail-away cancer screening traveling through the postal system. He becomes serious, asking if she is okay and if it is cancer. Rocky reassures him she is fine and does not need help. He says her mother should be there, but Rocky insists she does not need assistance. She suggests Willa make him a bagel, and he waves her off irritably.

On Halloween night, Rocky and Willa sit on their front step giving away Zotz candy. They discuss Rocky’s diet changes due to her rash. A doctor suspects sarcoidosis, which could explain her symptoms. Meanwhile, Rocky uses a meditation app and inspects her spreading rash daily.

Trick-or-treaters arrive in various costumes, and Rocky feels emotional about the teenagers’ wholesomeness and is nostalgic about Willa’s past costumes. During a lull, Willa mentions it is Miles Zapf’s birthday. They discuss Facebook posts, including his mother’s heartbreaking tribute. Rocky suggests Miles seemed lonely, but Willa accuses her of making a case for suicide to absolve Jamie. Rocky admits Willa might be right.

Willa explains how she focuses on Jamie’s net positive impact, mentioning his kindness and weekly volunteer work at a soup kitchen, which surprises Rocky. A teenage girl approaches, and Rocky embarrassingly treats her like a trick-or-treater before Willa introduces her as Ruby, her date. After the girls leave together, Nick joins Rocky on the step. When he asks if she is okay, she says she has no idea.

Rocky and Nick drive to Boston for her liver MRI. Fasting and lacking caffeine, she is in a dangerous mood. In an email, an editor demands she completely rewrite her chicken piece for turkey, which enrages her, but she needs the money and agrees. Then, Nick drops her to go for a run while she has her MRI.

In the hospital waiting room, she bonds with an old man in a wheelchair. Then, an intake person runs through safety questions about metal in her body. During the scan, Rocky struggles with breath-holding instructions and feels claustrophobic until she realizes her eyes are closed. She reflects on being pulled out to sea away from the healthy people on shore and thinks about her two pill organizers: one for prescriptions including methotrexate and immunosuppressants, another secret one filled with supplements like bovine colostrum that she lies to doctors about taking.

After the scan, Rocky finds the old man outside. They chat about soap operas and time continuing while they were in medical limbo. He reveals he has shrapnel in his remaining leg from war. As Nick arrives, the man tells Rocky to appreciate anything she can and calls her “lucky girl” (163).

At four o’clock in the morning, Rocky wakes and scrolls through her phone. She watches a recipe video and reads vitriolic comments, browses absurd Buy Nothing listings, and checks her children’s Instagram accounts. She investigates a man who posted photos of Jamie at a bar and accidentally likes his story.

She reopens her patient portal to reread her MRI results. While many findings are reassuring, one sentence haunts her: the beaded appearance of her bile ducts may represent primary sclerosing cholangitis (PSC). The radiologist’s comment indicates an intermediate probability. Her research reveals PSC is untreatable and ends in liver failure or transplant, with a median 10-year survival. Despite this, her ulcerative colitis test was negative, even though the diseases typically occur together.

She browses the r/railroaders subreddit, reading a post from a conductor’s mother whose son was involved in a fatal accident possibly caused by a sleep incident. Comments range from sympathetic to cruel, discussing management consulting’s role in understaffing and the Value of a Statistical Life used in risk calculations. Someone posts an accident photo, making Rocky think of Miles’s mother. She learns the train that hit Miles was carrying snowmelt for road safety. She remembers when Jamie smashed his baby teeth as a child.

Willa enters Rocky’s room in tears. Having done a Google search of methotrexate, she fears Rocky has cancer. When Rocky reassures her she does not, Willa notices her mother trimmed her bangs with nail clippers. They discuss Jo’s canceled plans due to a taint cyst and an emotional support pigeon named Cheese at Willa’s lab. Rocky reminds Willa to schedule her gynecology appointment.

They discuss Ruby, and Willa confirms the relationship is going well. They met on Tinder, like Willa’s controlling ex-girlfriend Jack. Reminiscing, they recall how literal the kids were as children, misunderstanding common phrases like “Take a Penny, Leave a Penny” and “tourist trap” (175).

Willa says she wants to support Jamie but feels she is simply holding sadness on Jamie’s behalf. She asks if Jamie feels judged by her. She texts Nick to request Corn Chex nachos. When Nick arrives with food and joins them on the bed, they debate worldwide Corn Chex nacho consumption and plan the Thanksgiving menu. Willa comments on Rocky’s agreeability, and Rocky reveals her father gave her half a Valium for a migraine. Nick and Willa laugh as Rocky turns off the light and falls asleep.

On Thanksgiving morning, Rocky prepares food while her father complains about temperature and requests coffee as she stuffs the turkey. The conversation turns to how Rocky’s late mother made gravy, and her father expresses sorrow over her absence. Rocky reflects on missing her mother’s calming presence. Her father picks a fight over Rocky’s nickname, wishing she would use her real first name—Rachel, the name her mother chose. Stressed, Rocky asks him to stop, and he apologizes.

Willa enters, senses tension and starts washing cranberries. Nick returns from an errand Rocky had forgotten she sent him on. When Nick cleans a glass door poorly with wet newspaper, Rocky criticizes him sharply. Willa intervenes, and Rocky apologizes, blaming holiday tradition on her foul mood.

Jamie and Maya enter the kitchen discussing his favorite day-after-Thanksgiving bagel. While Rocky chops vegetables, Maya quietly pulls her aside, asking her to go easy on Jamie. Maya mentions that Jamie feels Rocky is mad at him, referencing a comment Rocky made linking Dickens to aggressive health insurance company tactics. Feeling defensive and like a stereotypical mother-in-law, Rocky rebuffs Maya’s offer to help with cooking.

Rocky asks Jamie to walk with her outside. She apologizes, but Jamie says he is sorry for disappointing her, feeling she wants him to feel worse than he does. Rocky realizes this might be true—she wants to absolve him while ensuring he understands his potential responsibility. Jamie says he already feels worse than she imagines, comparing his and Miles’s lives as interchangeable.

Jamie acknowledges Rocky hates his job at Dickens. Then, Rocky inwardly reflects on her old etiquette column, where the answer was always grace, realizing that mistaking difference for loss is how you lose everything. Jamie insists he has not “drunk the Kool-Aid” (194) and does not believe they have no moral responsibility. He explains that low probability does not mean bad outcomes will not happen. He mentions receiving a dismissive memo from Dickens’s CEO after the accident.

Rocky stops herself from asking if he is reconsidering his work, thinking instead about Christine Zapf’s last conversation with Miles. She tells Jamie she is grateful to be talking with him and loves him despite their differences. Jamie breaks the tension by joking that he likes money, which prompts Rocky to recall his childhood voice-operated safe. The chapter ends with a flash-forward to their happy Thanksgiving dinner and family walk afterward.

Rocky attends a contra dance held in memory of Miles Zapf. The caller dedicates the first dance to Miles and instructs everyone to wear masks to protect immunocompromised members. Rocky realizes this applies to her. Swept up in the joyful chaos of dancing—being twirled, spun, and paraded from person to person—she laughs uncontrollably. An older woman repeatedly corrects her, but everyone is welcoming. Overwhelmed, Rocky leaves between sets and steps into a surprise snowfall.

Walking home, she feels an ache beneath her ribs. In flashback, she recalls her appointment with a Boston hepatologist and a Harvard medical student. The doctor explained her case was discussed at a special meeting and that it is unlikely she has two unrelated rare diseases. While sarcoidosis could explain both her rash and liver findings, it is not a perfect fit. He admits how hard it is to diagnose sometimes. The medical student reassures her that her blood work is nearly normal. The hepatologist says they are sticking with the provisional diagnosis of primary sclerosing cholangitis, noting she is in very early stages. Promising medications are in development, and he notes that she will be screened for cancer every six months. He advises her to “visit with the fear, but don’t hire a van and move there” (203). In the present, Rocky walks home under snowy trees, feeling acutely alive as an owl hoots.

On New Year’s Day, Rocky and Nick participate in a polar plunge at a frozen reservoir with a large group. Rocky reflects that this communal experience is what she needs—the opposite of an isolating float tank. The group accepts her rash without judgment. The cold water is like baptism, quieting her catastrophic thoughts.

In flashback, an acupuncturist saw through Rocky’s symptoms to her fear of death. When a needle in Rocky’s abdomen hurt, the acupuncturist identified the point as the Gate of Hope, suggesting the sensation might be “the full, expansive possibility of being alive” (206) rather than pain. After treatment, Rocky slept deeply.

In another flashback, Rocky’s father announces he is moving back to his New York apartment. Though upset, Rocky understands he wants independence before becoming a “lumpy dependent” (208). They acknowledge he will return under less rosy circumstances and agree the one thing they know for certain is love. Later, at four o’clock in the morning, Jamie texts Rocky about a job offer from Rockefeller for philanthropic consulting—less money but interesting work.

In the freezing water, Rocky feels flooded with endorphins. She reflects on the uncertain future, concluding there is no telling what is ahead—only loving each other, living now, and feeling gratitude for still breathing.