1. What do you think the role of humor is in Moonface and Charlie’s relationship?

2. Imagine Joel’s thought process as he decides to donate his kidney to his sister. If a family member needed a kidney, would you volunteer to get tested as a possible donor? Why or why not?

3. What do you know about our current system for people who need a donated organ? Should donors be compensated for donating an organ? Would compensation be seen as coercion, or as unfairly pressuring people from lower socio-economic backgrounds into donating?

4. How does Moonface’s outlook on her medical condition change throughout the book? How does meeting Charlie affect her perspective on her illness? How does losing the second kidney further affect her perspective?

5. How do you imagine Moonface and Charlie explaining the illness and the kidney donation to Birdie?

6. For much of the story, Charlie and Moonface move from one town to another. How does Moonface use the scenery or landscape to express the state of her health or mood?

7. Moonface brings up the issue of pain a few times in the book. What different kinds of pain is she talking about? In what ways does she try to suppress or to deal with the pain she’s feeling?

8. Were you surprised when Charlie confessed to the surgeon that, given the opportunity, he wouldn’t donate his kidney over again? Why or why not? How do you think Moonface’s interpretation of what Charlie said differ from what Charlie meant to say?

9. Moonface seems to have trouble accepting the sacrifices that people have made for her. Why? What helps her come to terms with her feelings?

10. How do you think Moonface and Charlie’s relationship would be different if they didn’t have the transplant? How have the crises in your own life affected your personal relationships? Could you imagine your life without these crises?