The novel’s narrator, Dominick, is a complicated character. By age 41, he has spent his life wrestling with conflicting love and animosity toward his twin brother, Thomas. Bold and self-sufficient, Dominick is frustrated by the responsibility of caring for Thomas—something he has been doing in various ways since they were both children. The multiple traumas that Dominick has experienced, including abuse by his adoptive father, the death of his infant daughter, the end of his marriage, and the death of his mother from cancer, have left him hardened and broken. To cope with these losses (as well as the stress of caring for his brother), Dominick approaches the world with bitter sarcasm. Still, he acknowledges that he loves his brother and wants the best for him, and this causes Dominick to proactively obtain his release from Hatch. What Dominick views as proactive and self-sufficient, however, is sometimes reckless and short-sighted, as his stubbornness prevents him from accepting help. His lack of foresight and poor coping skills when facing stress cause Dominick to end up hospitalized and in need of the kind of care he has prided himself in providing for his brother.

As the novel unfolds, Dominick gradually undertakes the work of unpacking the emotions he has stifled throughout his life.