Readers will be left unchallenged if they are creeped out by old people, scared of epilepsy, scared of hospitals (and ice) and scared of facial disfigurement. I can’t recommend the book as these horror elements are too obvious and not fair to those who do have disabilities – no matter how the author has tried to cover her traces with a moral discussion. This might be why some readers don't engage with Delaney as character - she's too busy going 'yuk' at the people around her! There are places where philosophical complexity enters the mix – Delaney changes her view of ‘what makes us human’ from 23-pairs of chromosomes, ‘bipedal’ and with ‘four-chambered hearts’ to accommodate Downs syndrome people (who have fewer chromosomes), and those without legs. She settles on humans being those with ‘undamaged… correctly wired brains’. This becomes problematic for her as her brain seems to be leading her astray. But I held out hope that the author would revisit this topic, which she does. What made me angry was that the book accumulates disability for horror purposes and special effects throughout. First Delaney expresses disgust at age in church (‘Old is dangerous’) and then towards old people who give her the creeps (‘Nothing against them personally, but just like everything else they would crumble and decay’). Later a school friend Carson stops taking meds for epilepsy (under medical guidance; they think he may have grown out of the condition) but Delaney can sense his imminent death and wants to save him. This whole scene is played out for maximum horror. Even though the writer (via the 911 service) informs Delaney that death from epilepsy is very rare and Carson must have more than one seizure and it must last for more than four minutes, both these things then occur. Delaney struggles to save Carson’s life and rolls him from the car into the snow to do CPR. The detail, the vomit, etc. are all played for horror. Delaney no longer feels human (blaming herself for Carson’s death: she thinks had she died he would still be alive). So she asks her doctor what he thinks ‘human’ is. He offers that we are ‘the only species aware of our own mortality… And you care. You try to help.’ The final horror moment is when Delaney and her Mom go into a garage and the guy who comes to serve them is missing his lower jaw! He also limps ‘his lagging foot scraped against the floor, whining in objection to each step’. He has the ‘pull of death’ about him and so of course, Troy has turned up. I won’t spoil the ending, or describe the fresh idea Delaney finally arrives at, because for all the ‘talk’, the imagery that the author uses throughout (disgust and horror at those who are old or disabled) undermines the supposedly life-affirming message. I wasn't convinced that Delaney had changed.