Sara acts first and foremost as a mother throughout the novel, and her need to keep her daughter, Kate, alive motivates her more than any other impulse. Whatever other problem she encounters, be it Jesse’s delinquency or Anna’s need for independence, the matter holds less importance for her than Kate’s survival. Paradoxically, by focusing so much on being a mother to Kate, Sara does not always fill the role of mother for her other children. For instance, Sara tends to disregard Jesse’s self-destructive behavior, which Jesse uses to call out for attention, and she doesn’t stop to think that Anna might be genuinely unhappy when Anna files the lawsuit for medical emancipation. Although Sara undoubtedly loves Jesse and Anna, she has difficulty considering them as people separate from Kate. Similarly, though Sara is a wife to Brian and a sister to Zanne, her relationships with these people also revolve around Kate. Sara struggles to talk to Brian about anything other than Kate, for instance, and the few times she sees her sister occur when Zanne comes to take care of Jesse and Anna because Sara is going with Kate to the hospital. Even with Kate, Sara focuses mostly on her physical, rather than emotional, health. For example, when Anna reveals on the stand that Kate doesn’t want to live any longer, Sara does not believe it because she has never spoken to Kate about these feelings.