“I’ve always delighted in the free fall between sleep and wakefulness. Those precious few semi-conscious seconds before you open your eyes, when you catch yourself believing that your dreams might just be your reality.”

The opening lines (which also begin the last chapter) establish the symbolic importance of Amber’s coma. The coma symbolizes Amber’s own ironic relationship with the truth, the novel itself suspended between reality and fantasy, between Amber’s account of events and her self-confessed addiction to lying. That unreliability makes suspect any element of what Amber shares.

“We’ll start rumors on social media. We’ll take control of the situation. You know what you have to do.”

This plan, hatched by Amber and her only friend at work, Jo, betokens Amber’s decision to strategize against being terminated after the New Year at the radio station because of the friction between her and the radio show’s iconic star. It is Jo who spearheads the Facebook campaign to spread rumors of Madeline’s imminent departure and Jo who advises Amber to dress up for work to show Madeline that she is there to stay. What is odd is that Amber is in fact plotting with an imaginary friend.

“The harder I try to hold us together, the faster we fall apart.”

Early on, Amber reveals her deep concern over the condition of her marriage and specifically her hopes that a baby might help resolve her estrangement from Paul. She expresses her fears, uncomplicated by any evidence, that he and Claire are having an affair. In her mind, their marriage is doomed even though what evidence we can gather from the hospital bedside would indicate Paul is a conventionally loving husband doting over Amber during her medical crisis.