1. Is Sarah better off at the end of the novel than at the beginning? If so, in what ways? 

2. Sarah has a series of anxious dreams in the nights leading up to the accident. How would you interpret these dreams? What do you think her subconscious is trying to tell her?

3. Is Sarah a better mother before or after the crash? How do you think she would answer that question? Consider the amount of time she spends with her kids, her ability to keep track of them and the level of participation in their lives. 

4. The second time Sarah and Bob meet with Charlie’s teacher about his progress in class, they learn that he is the target of some bullying. Ms. Gavin tells them many children experience this whether or not they have disabilities. Do you agree with Charlie’s teacher? Do disabilities like ADHD make a child more of a target than other kids?

5. Sarah’s Type A personality seems like it should help her through her physical therapy, but her friend and therapist Heidi believes she needs to stop trying to “win” and learn how to “adjust.” Do you agree? Do you think by adjusting to her new limitations, Sarah holds herself back from a quicker recovery? 

6. If Sarah had recovered completely, do you think she would have gone back to her high-pressured job at Berkley Consulting? 

7. While Sarah is in the rehabilitation hospital, she and Heidi trade watches, even though Sarah’s is clearly the more valuable of the two. Toward the end of the novel, Sarah notes that Heidi is still wearing her expensive watch, but never asks for it back. Why do you think she doesn’t reclaim her watch?

8. After Sarah’s accident, Bob uses his cell phone at least once while driving in the car with Sarah and their kids. Why do you think he does that? Do we sometimes make exceptions for ourselves and do something unhealthy or risky in the interest of saving time or getting more done (like texting or using a cell phone while driving) even when we know it is dangerous? Why do you think that is?

9. At one point Bob argues that he doesn’t think Vermont is a place to live full time when they are young. He sees it as a place to spend their retirement. Do you agree? What are the benefits of living and raising a family in a suburban setting versus a rural one?

10.Which character do you identify with the most? Which the least? Who is your favorite?

11. Is Sarah’s mother’s response to Nate’s death understandable or unreasonable? 

12. What did Sarah miss out on by having such a withdrawn mother? If her mother had been more available, do you think Sarah would be as high achieving? 

13. Sarah’s trauma gives her a chance to reconnect with her estranged mother. Why is it so hard for Sarah to forgive her mother?

14. Can working mothers really have it all --- a successful career, well-adjusted children, a great marriage, a sense of well-being and personal happiness? Or is that a myth? Does something always have to give? 

15. Sarah’s work/life balance before her disability is weighted toward work, whereas after it is weighted toward her family. How would you categorize your own work-life balance? Does LEFT NEGLECTED make you reconsider any of your career decisions?

16. The back cover states that the novel is “about what we ignore and neglect in ourselves, in our families, and in the world around us.” What do you think you are neglecting in your life? Yourself? Your relationships? Your home? Your job? 

ENHANCE YOUR BOOK CLUB 

1. Sarah’s ideal life is to live in Vermont, close to winter sports and away from the bustle of the city. Imagine an alternative life for yourself. What does your Vermont look like? 

2. The New England Handicapped Sports Association is a real organization in New Hampshire. You can check out their website at http://www.nehsa.org. The Photo Gallery, in particular, has a lot of great pictures that can help visualize Sarah’s snowboarding experiences.

3. Before the accident, Sarah muses about all the things that she wishes she and Bob could do, but don’t make time for. Make your own list of things that you don’t do as often as you’d like. Pick one to do before your next book club meeting, and share it with the group!

4. While she loves her high-powered job, Sarah periodically lets herself have timed crying sessions to cope with stress. Go around the group and share the coping mechanisms you use in your own life.