1. As a neurosurgeon, Matt immediately realizes that Elle’s brain damage is severe. Why do you think he lets Phil operate? Do you think he betrays Elle by letting Phil do so? What about when Matt decides to keep his wife on life support?

2. Do you think Linney is overstepping her bounds when she opposes Matt’s decision to keep Elle on life support? How much of Linney’s behavior do you think is motivated by her experience as a nurse? Or by guilt over her decision not to intervene when Alice was dying/ suffering?

3. As teenagers, Matt and Elle find themselves about to have a baby. What do you think would have happened if Matt had approached his parents for help? Why doesn’t Matt’s dad, Dennis, do anything when he finds out Elle is pregnant? How do you think Hank would have reacted? Do you think Matt could have gone to one of his older brothers?

4. When Elle miscarries the first time, she says a name is important because it is the only thing they will ever be able to give the baby. Do you think it’s important to give a name to grief?

5. Matt wants to keep the court case private, but it becomes a media circus. How much influence does the media have on events like this? How much should they have? Is their involvement an expression of freedom of speech or is it an invasion of privacy?

6. Matt keeps talking to Elle while she’s in the hospital, even though he knows she can’t hear him. Why do you think he does that?

7. Elle says women are stronger because they can discuss their sadness and men feel as though they have to mask their pain and insecurities. Do you think that’s true?

8. Matt describes Adam as a controlling prick, but at another point Matt describes himself as a controlling spouse with a medical degree. Why would Elle choose two men who, on the surface, are quite different from each other? Or are they more similar than Matt believes?

9. Do you think Elle or Linney actually hastened Alice’s death? Do you think Matt would have actually gone to the authorities with Elle’s diary? Would you have given Alice an extra “dose” to relieve her suffering?

10. Matt tried desperately to resuscitate his and Elle’s stillborn son. How do you think that loss affected Matt? Elle? And, as a doctor, was Matt’s “failure” to save the baby a deeper loss for him?

11. Matt does not hold Christopher in high esteem. What do you think the origin of Matt’s animosity is? Do you think Christopher is aware of Matt’s feelings about him? Was Elle?

12. Why do you think Elle never gave Matt her medical power of attorney? Have you made an advanced directive? Who would you designate to make those decisions for you?

13. At the end of the story, Matt sees a fleeting figure in the trees and for a moment he thinks it is Elle. In the aftermath of loss, have you ever briefly forgotten that your loved one is gone? Do you believe some part of them stays with you forever?

14. In some states, pregnancy invalidates a woman’s advanced directive. Are you familiar with the laws in your state? Would you want to be kept on life support if you were pregnant?