“But I was beginning to learn that your life is a story told about you, not one that you tell.” 

Aza shares her fear that she is “fictional,” not a real person. This symbolizes Aza’s feelings that she lacks control over her life, over her thoughts and actions. This is a terrifying and disturbing feeling, that something or someone outside of herself determines how she lives her life. Aza points out that when she goes to class or when she eats lunch is determined by the school bell schedule, not her own choice. She does not even know who arbitrarily makes those determinations. The “Future Aza” narrating the beginning of the novel comments that if she had a different lunch period or if her tablemates chose a different topic of conversation, her life would have been different.

“Once I start thinking about splitting the skin apart, I literally cannot not do it.”

Aza’s OCD consumes her life, as her obsessive thoughts and compulsions are inescapable. Aza cannot resist the urge to split open her callus with her fingernail, drain out the blood and pus, clean the wound thoroughly, then wrap her finger in a fresh Band-Aid. It does not matter that Aza recognizes this compulsion as illogical. She must go through the ritual to relieve her anxiety.