Chapter 1 begins in a hospital room in 1980s New York City, where Lucy Barton spends nine weeks recovering from surgery. She experiences unexplained complications after getting her appendix removed. Lonely, she becomes attached to her kind doctor, the descendant of Holocaust survivors. Her young children visit her while her husband refuses to visit as he does not like hospitals. Unexpectedly, Lucy receives a visit from her mother, whom she has not seen in years. Her mother stays with Lucy for five nights. Lucy finds comfort in her mother’s presence and learns that her husband called and arranged for her mother to come. Lucy’s mother has never been on an airplane before. Lucy and her mother do not discuss her husband or her father. Her siblings live with or close to their parents in Illinois. Lucy’s mother tells her stories about people in their small town to pass the time.

Lucy grew up in rural Amgash, Illinois. She recalls how her family’s poverty set them apart from the other townspeople and how, from a young age, she knew “that we were different” (20). Lucy and her siblings would often go hungry and suffer abuse from their mother.