The devastation of grief is a pervasive theme throughout the novel, and different characters offer perspectives on varying kinds of grief. Though Kate and Hugh have both dealt with losing one life’s partner, and that type of bereavement is the primary focus of Kate’s journey as a character, the novel also addresses losing a parent, the type of grief that attends illness or struggles with infertility, and the sorrow of watching a child grieve. These losses are shown to be related through the ways characters address and attempt to recover from their wounds.

Even while Cam is still alive, Kate must confront how his Alzheimer’s disease poses a loss, as she begins to grieve the end of their relationship as she knew it and learns how to deal with him in ways that accommodate his diminishing cognitive and physical capabilities. Cam’s illness makes Kate’s grief more complicated and also extends her loss, giving her that much more to recover from as she moves on to a new stage in her life.

Cam’s death is an event that completely changes Kate’s life, and her grief comes to define her for much of the book. She has identified herself as one-half of Kate and Cam, and without Cam, she doesn’t have a sense of her own identity.