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Content Warning: This section of the guide includes discussions of mental illness, illness, death, substance use, and addiction.
Ollie shows up at Amy’s place of work, “a homeless person washing herself in the bathroom” (185). Amy takes her home and allows her to stay, though she knows that Ollie will only stay as long as she needs to rest. She decides not to tell her parents. Amy discovers that Ollie was recently living in a psychiatric hospital and calls the facility. Amy learns that Ollie’s treatment cannot be discussed unless Amy has a power of attorney. Marc grudgingly helps her.
Amy discovers that Ollie has been given electroconvulsive therapy because she is non-responsive to medications, according to the doctors. Ollie tells her that she had been staying with other men in between her periods with Hunt, to whom she seems always to return. She was placed in the hospital after being found in a train station bathroom. This appears to frighten Ollie, and she enjoys her respite with Amy.
Amy can tell that Ollie is getting ready to leave when her daily walks become longer. They go to see the tulips blooming along Park Avenue, and Ollie urges her sister to trample through the beds. When they return to Amy’s apartment, Ollie is again full of energy. Amy urges her to see a psychopharmacologist, but Ollie refuses. When Amy suggests that she only wants to ensure that Ollie is safe, Ollie replies that this is impossible.
Courtney invites Amy to brunch and tells her that she and Marc are seeing each other. While Amy is not entirely surprised, she is still hurt. She realizes that Courtney told Marc about Josh’s visit the night before her and Marc’s wedding. This betrayal bothers her the most. She thinks of Ollie trying to lead her along the skating rink, calling her “inchworm” as she carefully made her way around.
Amy meets an academic named TJ at a conference. At first, she expresses interest only in his work on empathy, signing him to a contract with her publishing firm. However, she cannot deny her attraction to him, even though he is married, and after editing the book together, they begin an affair. TJ’s book receives a great deal of attention; he is booked for appearances on national television. TJ’s wife contacts Amy, notifying her that she is aware of their affair—Amy is not TJ’s only indiscretion—but that he always returns to his home and his daughter.
Nevertheless, Amy continues the affair. She also begins swimming every day, making new friends. Courtney contacts Amy during this time to let her know that she and Marc are getting married. She wants them all to be friends, so Amy reluctantly meets with Marc. Amy forces him to admit that he and Courtney began their affair before he was divorced from Amy. They part in anger. Shortly thereafter, Amy breaks off the affair with TJ.
Amy gets a call about her mother: She fell at the art museum where she volunteers as a docent. Tests reveal that she has an inoperable brain tumor, and she immediately opts for hospice care. Amy calls Dad, but he does not visit.
Amy stays at her mother’s condo to be closer to her and tries to do everything she asks. Ollie comes, too, and the two sisters keep by their mother’s side. Mom worries about her daughters, and they say that they will take care of each other. Amy wonders why this conversation—of who might care for Ollie after their parents are gone—never came up.
Hunt attends the funeral, as do Marc and Courtney. A slide show in the background shows old pictures of the Shreds as a family. Amy visits Mom’s “man-friend,” as she preferred calling him, once after the funeral. The man, Sid, is already with another woman, but he gives Amy folders containing her and Ollie’s old report cards, along with the neon sign for Ollie’s failed business.
Amy becomes friendly with Josh again. She is lonely after her mother’s passing, and he provides company—though his behavior is often more impulsive than before. Amy helps him rent a car to attend his father’s birthday party, but she discovers that he went to the casinos instead. Eventually, he reveals that he has been using meth. She refuses to let him stay at her place or loan him any more money until he shows up outside her building. He is clearly very sick, and Amy decides to get him into rehab.
On the way to the facility, they get married so that Josh can utilize Amy’s insurance. When they arrive there, Amy discovers that Josh has been using every time they stopped for bathroom breaks. He nods off while Amy fills in the details of his history for the intake nurse.
When she returns home, she wants to call her mother. Remembering, again, that she cannot, she instead looks through the folders that Sid gave her. Behind Ollie’s report cards, there are psychiatric assessments with a diagnosis of borderline personality disorder. She also finds the reports from Dr. Lucie, who diagnosed Ollie with bipolar I and suggested that she would find success with the medication lithium. Amy wonders why Dr. Lucie’s treatment plan was not followed.
When Amy goes back to work—she took time off to take Josh to rehab—she finds that her assistant has reported her to Human Resources. Amy will have to attend mandatory counseling to deal with her communication issues; the report will remain in her work file.
That weekend, the rehab facility calls to tell her that Josh has died. The autopsy report reveals that he had both heroin and methamphetamine in his system. She remembers the last time she saw him, at a family therapy session. They cried together and professed their love.
Ollie discovers that she is pregnant. The family hopes that the father is Hunt, though Ollie has refused his proposal of marriage. Amy flies out to talk to Hunt, and he admits that he did some rash things after Ollie’s rejection—including marrying someone else (briefly). Amy tells him about the baby, and he asks if the child is his. It is possible, but nobody knows for sure.
Meanwhile, Ollie is living with Dad and working at Juice World. When she is promoted to assistant manager, Amy worries about her having access to the register. Dad dismisses her concerns, and Anita attends Lamaze classes with Ollie. Ollie confides in Amy that she is still unsure whether she wants the baby or not.
Amy flies in the week before the baby is due. Ollie wants Amy, not Anita, to assist her in the delivery room. Amy is resentful—Ollie was not present for any of Amy’s milestones—and worried for the baby. Yet she agrees to be the baby’s guardian and helps Ollie in the delivery room. Ollie names the baby Raine, after her and Amy’s mother, Lorraine.
Amy visits Josh’s grave, feeling guilty for taking him to rehab. Afterward, Josh’s mother welcomes her for lunch and gives her a bag of leftovers and some of Josh’s things to take home. Josh’s father drives her to the train station, and he cannot help but criticize his son, even in death. Amy refuses to speak to him. When she returns home, she puts on Josh’s old leather jacket, which his mother gave her.
Amy’s father has a stroke—his second, the first having occurred just after Raine’s birth—and she flies back down to Florida. Ollie does not believe that he will die, but he passes away the night before she arrives. The sisters have to pick out an appropriate dress for her to wear to the funeral; Ollie pays, and Amy expresses surprise. Ollie claims that she no longer feels compelled to shoplift, and Amy decides to tentatively trust her.
After the funeral, Amy learns that her father’s estate will be divided unevenly between her and Ollie, with Ollie receiving the larger share. Anita volunteers that this is because Amy does not have children, though Amy believes it is because Anita does not like her as much. Amy intuited their affair before Dad was divorced.
Hunt decides to raise Raine as his own—no paternity test required. He claims that Raine has saved Ollie’s life. Though she experienced a severe case of postpartum depression, she is now calmer and devoted to the baby. In dealing with her depression, she connected with a psychiatrist who prescribed medication that Ollie promised to take for the sake of the baby. Two years later, when Amy attends Raine’s birthday party, she realizes that the three are now a family.
Amy enjoys her role as an aunt, and she and Ollie forge a new chapter in their relationship. When Raine asks for Amy to tuck her into bed at night, Amy fights back tears.
Kira has asked Amy to be one of her bridesmaids. Arjun has forgiven her, and what Kira calls her “re-arranged marriage” is an elaborate affair. Amy meets a wide variety of professionally accomplished and personally interesting women; she feels like she is in her element at last. She meets Ravi, someone with whom Kira wanted to set Amy up, and they share a piece of wedding cake. Kira reminds her that forgiveness, especially of oneself, is key.
Amy decides that her time in therapy has come to an end. At this point, her therapist has been “the most consistent person in [her] life” (264). He accepts her decision, telling her that she has worked hard. He hugs her at the end of their last session. Amy realizes that she will choose her own path forward from now on.
In the final part of the book, the sisters finally begin inching their way—as the title, “Inchworm,” implies—toward each other and toward mutual acceptance and cautious forgiveness, marking the culmination of the novel’s exploration of Familial Trauma and the Power of Forgiveness. When Ollie comes to stay with Amy, showing up unannounced at Amy’s place of work, Amy does not berate or shun her; she welcomes her. She also protects Ollie, as best she can, and keeps her to herself: “I knew I should have called our parents. I felt guilty and a little mean, but she had come to me this time” (186). Amy’s possessiveness toward her sister reveals how deeply she misses her—although she also continues to engage in the predictable patterns of silence surrounding Ollie’s situation that have so long been enforced by the family as a whole.
Nevertheless, Amy experiences a different version of Ollie during her brief stay: “She was on the other side of her mania, a side I had never witnessed so clearly” (191). Understanding the various dimensions of Ollie’s lived experience brings Amy closer to her and elicits not only compassion but also recognition of shared struggles. When Amy tells Ollie that she only “want[s] [her] to be safe,” Ollie replies honestly, “There’s no such thing” (193). While Amy is still reluctant to let Ollie go, she appreciates her words in a way she previously would not have: Amy, too, has experienced instability in her life, particularly after the divorce, rendering her more cognizant of the limitations of her own impulse toward security. Similarly, when Ollie shares with Amy the experience of running through the tulips, she comes to represent a kind of freedom that Amy can admire, even if she cannot attain it. Such parallels and inversions develop the theme of Sisters as Opposites and Mirror Images.
Amy’s re-evaluation of Ollie and their relationship even partially (if retroactively) transforms her understanding of their shared childhood. When Amy is blindsided by Courtney’s engagement to Marc, her ex-husband, she remembers her older sister’s encouragement at the skating rink, calling her “inchworm” and helping her along the rink. While Ollie’s behavior has caused Amy (and her family) much pain and worry throughout the years, she also exhibits great kindness and overwhelming joy. This reconsideration of the past coincides with a newfound emphasis on the future as Amy and Ollie enter a new phase of their lives, their bond further strengthened by dealing with the deaths of their parents and the birth of Ollie’s child. Amy admits, “I loved being an aunt” (257)—partly because of Ollie’s transformation once becoming a mother. However, her words also suggest that new roles have opened up to Amy and Ollie: As they become the older generation in their family, both sisters are free to reimagine themselves outside the roles in which they were typecast.
Indeed, Amy goes through a variety of transitions and transformations in the wake of her divorce and her mother’s death. After her divorce, Amy begins an affair with a married man, following established family patterns. When discussing her affair with her therapist, Amy specifically remembers the lunch she shared with her father and his assistant, Anita: “Anita’s hand wiping my father’s mouth” (205). She links her father’s long affair (which resulted in her parents’ divorce and his remarriage) directly to her own furtive coupling with TJ. This association, along with her daily swimming regimen, enables her to break the connection. She “admonish[es] [her]self: sink or swim, Shred” (206). When TJ next invites her on an excursion, Amy turns him down even though she is lonely. From now on, she will have to be true to herself and her own values.
Amy also has to confront the addiction and death of her former lover, Josh, and here, too, her response evidences greater awareness of how she may be reliving familial traumas. Josh’s death hits her hard: She feels guilty for having taken him to rehab, where he presumably procured the drugs that killed him, and she also feels betrayed because he would not (or could not) keep himself clean and alive. However, she also finally accepts that Josh is much like Ollie: “Josh couldn’t accept a higher power. He didn’t believe he was powerless over anything” (248). This is also the case with Ollie, who has always relied on her wits and energy, never explaining or apologizing. However, just as Amy turns over a new leaf by confronting the ways that Ollie’s presence has haunted her life, so, too, does Ollie depart from Josh’s trajectory by deciding to have—and take responsibility for—her child, Raine. This gives her access to medication and, thus, the stability to embrace a family.
Amy’s ability to move past her abandonment issues partly reflects the help of her therapist. Ultimately, she embraces a fresh start, meeting a promising suitor along with some potential new friends at Kira’s wedding. However, relationships with others cannot solve all the problems of the self. As Kira tells Amy, “[Y]ou have to forgive yourself” (263). Moreover, Amy must learn to trust herself, which is why the book ends with her decision to leave therapy: The decision signals Amy’s understanding that she must choose her own path forward.
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