On October 12, 1990, Thomas Birdsey cuts off his hand—taking literally the Biblical injunction to “cut off thy right hand if it offends thee” (Matthew 5:30)—in an act of protest against the US military’s intervention in the Persian Gulf. Thomas is taken to a hospital but refuses to allow his hand to be reattached. Though Dominick Birdsey, his twin brother and caretaker, can override Thomas’s wishes and force the hand to be reattached, he does not. A few days later, Thomas is discharged, and Dominick drives him back to the Three Rivers State Hospital, where Thomas has lived off and on for the past 20 years. He tells Dominick that he is a prophet of God and that this role is a burden.

The librarian on duty later asks Dominick to sign a statement absolving her of any responsibility for Thomas’s injury.

When Thomas and Dominick are 10, their house catches fire when the television bursts into flames. Their mother, Concettina Tempesta Birdsey, is able to save her prized photo album. When the twins are 36, she is diagnosed with breast cancer. Dominick, wishing to give her something meaningful, sets about remodeling her kitchen, but his mother says that she wants only a small gesture of love instead.