Familial Communication

The primary theme of "A Primer for the Punctuation of Heart Disease" is familial communication and the ways that family members interact with one another. The speaker structures the story as a "primer," or instruction booklet, that highlights different punctuation marks that he sees as specific to his family's way of speaking. Through the use of these punctuation marks in conversational examples, the speaker is able to show that his family struggles with speaking directly about serious issues like their heart problems and World War II. Both of these topics haunt members of the family in different ways, and the speaker uses punctuation to illustrate how the family avoids discussing them altogether.

It is also important to note, however, that the speaker's punctuation marks indicate a deep understanding of his family and the struggles they face. While the story might begin as an ironic representation...