At age 9, Lucy is diagnosed with Ewing’s sarcoma, a form of cancer with a 5% survival rate. She has to undergo an operation to remove half of her jaw, followed by two-and-a-half years of chemotherapy and radiation treatment. The treatment is so unpleasant that Lucy is frequently reduced to tears. However, her mother, unsure of how to support her daughter, chides her for this, insisting that she “mustn’t cry” (78) and telling her that she is disappointed in her whenever Lucy does burst into tears. From this, Lucy develops a set of self-imposed rules, including the directions that “one must never, under any circumstances, show fear and, prime directive above all, one must never, ever cry” (29-30), learning to suppress her pain and fear in order, she believes, to gain her mother’s love.

The removal of half of her jaw gives Lucy a “pale and misshapen face” (6) and the chemotherapy causes her hair to fall out. Despite this, she does not initially have concerns about her appearance, looking at herself only “with a preoccupied preadolescent view” (104) that observes and does not judge. This changes when she returns to school and is routinely teased for her appearance. Slowly, she grows aware of how different she looks and becomes convinced that she is “so ugly” (145) that it is inevitable that she will be bullied and reviled.