“Now he’s downstairs frying sausage. I can hear the fat spitting, the slosh of gravy in the pan. I’m not sure I should be able to hear that from all the way upstairs, but nothing surprises me any more.”

Tessa’s illness removes her from the world in many ways, yet also gives her a heightened sensitivity to other people. That she is able to hear the sounds of her father cooking downstairs speaks to the fixedness of her routine and the quietness of her days. Yet it also speaks to a strange omniscience that her illness occasionally seems to give her, as if she is already halfway to being a ghost. 

 “She’s very pale and very blonde and her acne makes her look kind of savage. I’ve never had a spot in my life. It’s the luck of the draw.” 

There is a certain amount of irony and understatement in this observation about Zoey’s acne, given Tessa’s own, much more significant health problems. It is not the first time in the novel that Tessa will muse about the randomness of fate.

“If I keep dancing, the dark corners of the room won’t creep any nearer, and the silence between tracks won’t get any louder.” 

Tessa is often motivated by the idea that constant motion and activity will fend off her illness and allow her to act out her anger. While her manic activity may keep her hopelessness at bay for a while, it also prevents her from really noticing the world around her.