From the title of the book, through the opening story of the origami surgeon and his creation of Merced de Papel, to the last scene where Federico de la Fe and Little Merced walk off the page, paper is the unifying motif of the novel, helping to develop themes such as the blurring of fiction and reality, metafictional intertextuality, and loss and sadness.

The Prologue tells the story of the origami surgeon, a heretical Catholic monk named Antonio who makes human organs by folding paper. Despite the impossibility of such origami organs in real life, in the book, the paper kidneys, hearts, and limbs are described in vivid and concrete detail. Paper serves here as a vehicle for the magical reality of the novel. Likewise, when there is no longer a call for paper organs because medical science has advanced, the monk turns first to more traditional and realistic origami, creating birds and animals from paper before moving on to creating an entire woman of paper.

Paper also overtly contributes to the intertextuality of the Prologue. Plascencia uses the moment Antonio “splits the spines of books, spilling leaves of Austen and Cervantes, sheets from Leviticus and Judges, all mixing with the pages of The Book of Incandescent Light” (15), to allude to an important metafictional moment from Gabriel García Marquez’s One Hundred Years of Solitude.