Content Warning: This section features graphic depictions of medical trauma, infant death, and death by suicide.

In June 1919, eight months after James brought Kathleen back from New York, she is writhing in pain during a difficult delivery. She is having twins: a boy has already been born, but the second baby is breech. Materia, who is supervising the delivery, understands she must make a choice, to dismember the second baby to save the mother, or deliver the child and doom the mother. She opts to deliver the child, knowing that Kathleen will not survive. In the moments before Kathleen succumbs, she glimpses the grotesque figure of the demon Pete above her bloody bed, “his no-face tucked beneath his arm” (133). Later Materia is wracked by guilt. She did the right thing for the wrong reason. Three days after Kathleen’s death, Materia dies by suicide, sticking her head in the gas stove in the kitchen.

At Materia’s funeral, six-year-old Frances struggles to understand what has happened to her family. “What a week” (136)—three deaths in just a few days: her sister Kathleen, one of the twins (she does not share the circumstances), and then her mother. Frances has also learned how to keep a secret.