Mitchard handles this fraught material unsensationally, adding plenty of convincing research-backed detail. If she doesn’t terminate the pregnancy, the powerful immunosuppressants she is on may damage the fetus if she foregoes the drugs, she may literally lose her face and possibly die from sepsis. Characters from other Mitchard novels, the Oprah-blessed Deep End of the Ocean (1996) and its sequel, trigger a crisis: Beth (mother of the kidnapped child in Deep) is documenting Sicily’s metamorphosis in photographs, but it is her older son Vincent, a filmmaker, who truly transforms Sicily-after their brief but tumultuous affair, she becomes pregnant. A comatose teenage organ donor whose mother reluctantly takes her off life-support provides the visage, and after the intricate surgery and arduous recovery Sicily finds herself again being stared at-in admiration. She seizes the opportunity to undergo a still-experimental facial transplant. Her plans of adjusting to her “specialness” are rudely dashed when she learns that Joey watched his brother set the fire and that Joey has hid his complicity all these years. She becomes a sought-after medical illustrator and is engaged to be married to her childhood friend Joey, who was at the church but who survived the fire unscathed. Her Aunt Marie, a glamorous newscaster, raises her after her mother’s death. Still, she manages an almost normal life. After several corrective surgeries, she must wear a prosthetic nose and heavy greasepaint to emerge in public. However, her beloved father, a firefighter, is killed in the blaze, and Sicily’s face is severely disfigured. She is luckier than many of her choirmates-she escapes with her life, dashing from a partially blocked church entrance. Sicily’s life is forever changed in eighth grade, when the Chicago church in which she is attending choir practice burns down in a freak fire (two Christmas trees ignite). A face transplant transforms a burn victim into a beauty, but presents new dilemmas.
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