Everyone greatly underestimates protagonist Patricia Campbell. At the beginning of the novel, she is prone to apologizing for herself and is selfless to a fault, neglecting her own needs. She joins the book club formed by Kitty and Maryellen because she is seeking friendship and community. 

Patricia longs for more out of life than being a wife and a mother; though her ultimate desire is to return to nursing, “the one thing [she] loved” that she left behind “because [she] wanted to be a bride” (362)—ironically, of course, being a nurse is just another kind of caretaking. Patricia uses her medical skills whenever the opportunity arises, administering CPR to James Harris when she finds him unconscious, and gaining the trust of Destiny’s mom Wanda Taylor in Six Mile. Patricia sees nursing as a challenge:

[S]he yearned to see what she was made of. Sometimes she remembered being a nurse before she married Carter and wondered if she could still reach into a wound and hold an artery closed with her fingers, or if she still had the courage to pull a fishhook out of a child’s eyelid (31).

The gruesome imagery here foreshadows the blood and gore that will color the rest of the novel, letting us know that Patricia is up to the challenge of James Harris’s viciousness.