Themes are the fundamental and often universal ideas explored in a literary work.

The Dangers of Self-Interest

David Henry, a doctor, and Caroline Gill, a nurse, violate the first principle of their Hippocratic oath (“Do no harm”), which is a pledge required of people who hold the power of life and death in their hands. To show how and why they set aside this sacred trust to separate Phoebe from her mother, the narrator reveals David and Caroline’s motives of self-interest. David Henry’s childhood experience of neglect and poverty informs his intention to protect his idyllic life, and he frames his act of giving away his baby as protecting his wife, Norah. Caroline dreams of significance and romance, and she casts her act of taking the baby Phoebe in a heroic light. In the ensuing twenty-five years their scheme lasts, both characters endure guilt over its destructive effects and tragic consequences.

Safety versus Risk-Taking

In a story of abduction, death, and grief, the notion of safety figures prominently. The characters make decisions based on the reality of financial security and the feeling of psychological security they chase. The characters who grew up without a sense of security prioritize the feeling of safety above other values. David Henry and his son Paul exemplify this tension. David was raised in an impoverished home in West Virginia, his father reduced to capturing snakes to sell to zoos for necessary income. David works to provide an affluent lifestyle for his son Paul, who aspires to an uncertain performance career. David’s frustration that his son doesn’t value the financial security he provides is a constant source of conflict. Meanwhile, those who grew up with financial security seem to take more risks. Caroline Gill was raised by older, risk-averse parents who restricted her activities to guarantee her safety. Willing to take risks, Caroline leaves her home and job to live off her savings until she establishes a new life. Doro March, who lives with financial security because of her father, takes a risk by accepting Caroline into her home and, later, by giving her the house.

The Benefits of Change

The novel showcases the benefits that result for those who risk change. Geographic escapes create new opportunities for characters. Caroline relocates from her solitary life in Lexington to a community of support in Pittsburgh. Norah globe-trots for her travel business and learns independence. Paul steals a car and drives from Lexington to Louisville after his argument with his father and experiences the kindness of a stranger who declines to press charges. Rosemary leaves her home, moves into David’s vacant house in West Virginia, and meets a benefactor. Al Simpson crisscrosses the country for a trucking firm and meets the love of his life in Caroline. Phoebe openheartedly meets her lost family and gains a brother’s love and protection. The vignettes serve to counterpoint David Henry’s introversion into his photography that alienates his family and isolates him in an unreal world. He abandons his photography when he becomes Rosemary’s benefactor, creating a household with her and her son Jack. Change in the novel ultimately drives growth, creativity, and connection.