Chapter Eleven is threaded with images of potentially rich metaphoric meaning. The "trach", a surgical cutting through of superficial tissue designed to increase oxygen intake, can be seen as metaphorically similar to Quintana's anger with her mother, an emotional and verbal cutting through of superficial feeling designed to increase spiritual release. The juxtaposed descriptions of Quintana's frail body with a house formerly owned by the family destroyed right after they sold it can be seen as metaphorically evoking both the frailty of memory and of actual physical experience both the body and the house are, to varying degrees, irrevocably damaged by the process of life. The story of how she and John witnessed the sudden death of the nearby motorist and then moved on can be seen as a metaphoric representation of her experience in witnessing John's sudden death of her husband and having to eventually move on.
The Year of Magical Thinking