The Chrysler Building is featured in the cover design for both the British and the American printings of Elizabeth Strout’s novel, but the designs suggest subtle differences. The British cover features the stylized window and the empty chair of the mother’s ever-illusive presence in the daughter’s life, while the American cover slices the building with the author’s name and the book’s title. The two designs reflect the tensions that exist in the protagonist’s life. Struggling to be heard or even be noticed as a child is partly resolved in the older professional who makes her mark on the publishing world. It’s another novel that studies the power of limitation to motivate success. The charm comes in the dramatic irony; the narrator never quite understands what she clearly reveals to her audience.

The bulk of the novel is set in five days during the protagonist’s nine-week stay in the hospital to overcome the mysterious aftermath of an appendectomy. The period of hospitalization is peculiarly redemptive. It becomes the occasion for the narrator to climb back into the womb and listen to the murmur of the mother’s voice. She revisits the life she knew as a child but without the isolation and silence. It’s an exercise in the revision of family history.

Hospitalization offers as much psychic healing as it offers physical healing. It’s a place of secure warmth as opposed to the cold of the garage where the family once lived, a place where her physical needs are met as opposed to the meager bread and molasses of her childhood. Visited regularly by a doctor she adores, a sort of high priest of the medical world, the patient is blessed by the rituals of caring.

While the security of the extended hospital stay allows Lucy Barton time to process the deprivations and hardships of her childhood, it also reenacts the same dissatisfactions that are woven into her past. The mother’s voice is at the same time comforting and distant. The nurses are caring but unable sit down and talk. The doctor disappears from her life when her illness ends. The depths of her neediness can never be filled by others. There will always be a psychic disconnect in her life. She is left with the task of declaring her own name.