Ten years have passed: It’s April 1999, and Sam has moved to San José, Costa Rica, with a medical outreach organization called Orbis. Mickie lives in Sam’s home in California. Sam returns home periodically to spend time with his mother and father. Max has regained some speaking function, and the family enjoys taking wheelchair accessible trips to national parks and other tourist destinations. Though Sam finds his work fulfilling, he still carries guilt about Trina’s death. However, he’s also rediscovered some sense of spirituality, one different from his mother’s:

I didn’t consider my work as ‘God’s work,’ largely because I didn’t believe in my mother’s God. If anything, I’d classify myself as a Buddhist. I believed that every living thing came from the earth and was to be respected. I meditated and I chanted and I found that it helped me sleep—as did the exhausting schedule I purposefully kept. [… I]n some way, this was not my way of helping others as much as it was my penance for the death of Trina Crouch (379).

Back in Costa Rica, a villager brings a six-year-old orphaned boy named Fernando to the clinic. He has ocular albinism, and the people in his village refer to him as “the son of the devil” (381).