1. According to Ginger, "whenever a ship is going to go down you can hear something like singing in the wind. Bankers say it's mermaids calling the sailors . . . they say when you hear it, you have no choice but to follow it, and you end up on the shoals." What is the significance of this myth for Siddons' characters? Did any of them hear the mermaids singing, yet not "end up on the shoals?" If so, what saved them? Who are the mermaids in Kate's life?

2. Kate can't help but imagine her cancer cells as microscopic "Pacmen." How might this metaphor help her? How does it harm her? What is it that finally enables her to no longer fear the Pacmen? What does she mean when she thinks the Pacmen, "went with that other Kate, when she died on the Outer Banks?"

3. What does Kate mean when she refers to herself as an "abyss walker?" What is her abyss? Do you consider yourself one of the "non-abyss-people?" What role does her father's suicide play in Kate's understanding of her own abyss?

4. Kate muses, "how truly terrible, that it is easier to live a total lie, become a lie yourself, than assimilate to the hated truth." Which characters weave fictitious lives for themselves? And why? What is it that forces each of them to confront reality?

5. How are the four grown women who return to the Outer Banks different from the young sorority sisters they were 28 years ago? Which of them have been "battered, beaten up, kicked" by life the most? How so?

6. How would you characterize the different kinds of friendships and loves explored in Outer Banks? Which have the capacity to heal, and which to harm? Is it possible to have one without the other?

7. Why do you think this novel was set on the Outer Banks? What role does the sea play in these characters' lives? Why are they all drawn to the ocean? How relevant are the pirate and mermaid myths for these characters?

8. What is it about Dorothy Parker's poetry that so captivates the young Kate and Cecie? What is their relationship to her acerbic lines as they get older? Why do you think it changes?