Content Warning: This section of the guide includes depictions of medical procedures and trauma, self-harm, sexual assault, suicide, disordered eating, outdated and offensive mental health beliefs and terminology, police brutality, and the death of a child.

“It was a plea for mercy in black and white, until you read between the lines: here was the first time I lied, and said that I wished you’d never been born.”

Under Piper’s advice, Charlotte signs a DNR for Willow. She confirms that she does not in fact wish that Willow hadn’t been born, an assertion that other characters will question throughout the novel. This quote is ironic because nothing about Willow’s existence is “black and white,” and her life will force all of the characters to consider murky ethical matters.

“You were, in general, full of information no one else knew or cared about, because you read all the time, or surfed the Net, or listened to shows on the History Channel that put me to sleep. It freaked people out, to come across a five-year-old who knew that toilets flush in the key of E-flat or that the oldest word in the English language is town, but Mom said that lots of kids with OI were early readers with advanced verbal skills. I figured it was like a muscle; your brain got used more than the rest of your body, which was always breaking down; no wonder you sounded like a little Einstein.”

This quote introduces one of the central symbols in the novel, Willow’s trivia. Additionally, it highlights the theme of Visible and Invisible Illnesses and Disabilities. People assume Willow will behave less maturely than she does because of her OI and rarely can look past the physical manifestation of her disability. Amelia uses hyperbole to highlight how frequently Willow breaks bones by comparing her to Einstein, a very intelligent scientist.

“Everything that had ever been good and kind in me, everything people imagined me to be, had been poisoned by the part of me that had wished, in the darkest crack of the night, that I could have a different family. The real me was a disgusting person who imagined a life where you had never been born.”

Amelia thinks this before she purges for the first time, implying that her family dynamics are the root of her mental health conditions and that she feels guilty for wanting a different family. However, like her bulimia, she will keep these thoughts a secret, because she feels shame about her true feelings. By suggesting the “good and kind” parts of her have been poisoned, Amelia implies that she knows, deep down, she is a good person who has been affected by external factors.