How do the novel’s minor characters—Sage’s friends, the Willowbrook attendants, the waitress at the diner, and the couple visiting their son at the beginning of the novel—affect the themes, motifs, and characterization of the novel’s main characters?

Ellen Marie Wiseman has been praised for her historical accuracy. Research the history of Willowbrook and discuss how Wiseman’s inclusion of real events and characters enhances her novel.

Why does the novel feature several male antagonists in positions of authority? How do gender dynamics work in the novel’s social, medical, and historical context?