Joy

Joy is the novel’s central character, narrator, and protagonist. At the time the story begins, she is 19 years old, in a Hospital for what she believes is going to be medical care, and very much aware of trauma in her past. One trauma she can easily identify – having been abandoned by her mother shortly after birth. This trauma, and Joy’s determination to deal with it, lead her to beliefs and decisions about her mother’s identity that define key moments in the narrative’s plot – specifically, Joy’s escape from the increasingly frightening Hospital and her journey across America to reunite with the woman that she believes gave birth to her.

Another trauma that Joy seems to be aware of is one that she cannot identify. Her time in the hospital, and the first few weeks after her escape, are defined by an increasing awareness that...