1. General Impressions 

Gather initial thoughts and broad opinions about the book.

• What knowledge or impression did you have of Hansen’s disease prior to reading the novel? How did the novel shape or change your understanding?
• At what points in the novel did you find yourself angry or frustrated with Mirielle, and in which instances did you sympathize with her? What makes Mirielle a complex character?
• In many of her novels, as in The Second Life of Mirielle West, Amanda Skenandore builds fictional scenarios that are based upon historical facts. Consider any of the Skenadore novels you have read: What did they show you about history that you were previously unaware or unknowledgeable of? 

2. Personal Reflection and Connection 

Encourage readers to connect the book’s themes and characters with their personal experiences.

• Consider circumstances in which you have either cared for an ill relative or friend or been the patient in need of care. What challenges does such care pose, beyond the medical ones? What skills make an effective caregiver? 
• Though the circumstances are different, the quarantine enforced in the novel parallels that of city-wide shutdowns during the 2020 COVID-19 pandemic. What was your experience like during the pandemic? How did a forced quarantine change your daily life? What lasting impact did it create?
•  The title suggests that Mirielle is given the opportunity to remake herself during her time at Carville.