Lenore takes Sam to a nearby diner. Sam notes that the server is hostile to Lenore, who is a trans woman. She asks Lenore why she stays in “this backward place” (348), and Lenore replies that Pikeville is her home. Sam asks Lenore to tell her about Gamma, whom Lenore knew before Sam and Charlie were born. Before Lenore’s transition, she dated Gamma before introducing her to Rusty, Lenore says Gamma felt isolated in her male-dominated field and wanted a more traditional family life. Sam tells Lenore that Kelly may be pregnant. The father could be Adam Humphrey, a boy Kelly mentioned, or Frank Alexander, Lucy’s father. Frank being Lucy’s father could be a motive for Kelly shooting her. Sam also considers the possibility that the pregnancy could be from coerced or non-consensual sex as vulnerable young women like Kelly are often the target of abuse.

Sam travels to the hospital. On the way she puzzles over the briefly glimpsed content of Zach’s letters to Rusty, saying “YOU OWE ME” (351). Rusty is happy to see Sam. Rusty tells Sam that his investigator, Jimmy Jack, has learned Kelly underwent an abortion in middle school. Sam tells him about a possible pregnancy.