Chapter 59 Summary & Analysis – Polly Calls in a Prescription

⚠️ Spoiler Warning: This guide contains detailed spoilers for the entire novel. Proceed only if you've finished reading or are comfortable knowing the plot.

Summary

Polly sits at the desk in the upstairs office—a room originally meant to be a nursery but now used for bookkeeping and storage. She finds a piece of paper with Dr. Chloe Passaro’s medical identification numbers, numbers she once used when calling in prescriptions as the nurse working alongside the doctor. Now she impersonates the doctor directly. She dials a Walgreens pharmacy and identifies herself as Dr. Passaro, ordering a prescription for “Polly Thompson” (using her own date of birth). She requests Cephalexin 500 mg twice a day for fourteen tablets (no refills) and enoxaparin syringes for a month’s supply. The pharmacist asks for an NPI number; Polly reads it from the paper. She expects the order will be ready by afternoon.

The antibiotics are not for herself—they are for Tegan. Polly chose an antibiotic safe for pregnancy after a skin infection developed in Tegan’s left ankle wound from the accident. She worries the infection may have spread to the bloodstream, requiring IV antibiotics in a hospital, but impersonating a doctor is her only option. She judges the risk low because she is not ordering narcotics.

Polly returns to the basement to check on Tegan, who is sleeping and barely responsive. Tegan’s cheeks are flushed with fever, and Polly fears checking her temperature because she knows it will be high. She pulls back the sheets and examines the ankle: the skin is red and shiny, the wound oozing pus. Polly cannot feel a pulse in the foot and suspects the infection may have reached the bone, potentially requiring amputation. She cleans the wound with warm water and Betadine, wraps it in Kerlix gauze, but Tegan barely stirs throughout the process.

Finally, Polly retrieves a stethoscope from the nightstand drawer and listens to Tegan’s belly. She hears a fetal heartbeat—weak, but present. She concludes the baby is still alive for now, but time is running out. She knows she must get the antibiotic into Tegan and then deliver the baby before it is too late.

Key Events

Polly retrieves Dr. Chloe Passaro’s identification numbers from the office desk.
She calls a Walgreens pharmacy, impersonates Dr. Passaro, and orders an antibiotic (cephalexin) and a prophylactic blood thinner (enoxaparin).
The pharmacist accepts the prescription without suspicion.
Polly returns to the basement and finds Tegan feverish and unresponsive.
She cleans and bandages Tegan’s severely infected foot wound.
Using a stethoscope, Polly hears a weak but present fetal heartbeat.
She resolves to get the antibiotic administered and to perform a delivery.

Character Development

Polly: Shows resourcefulness and medical competence, impersonating a doctor and choosing the correct antibiotic for a pregnant patient. Her actions shift from passive hiding to active intervention. She risks legal trouble to save Tegan and the baby, indicating a growing sense of responsibility—perhaps maternal guilt or a desire for redemption.
Tegan: Remains incapacitated, an object of care rather than an agent. Her condition deteriorates, raising the stakes for Polly’s next move.
Dr. Chloe Passaro (mentioned): Functions as a tool for Polly’s deception; her identity is exploited offstage.
The pharmacist (unnamed): Performs her role without suspicion, allowing the plot to advance.

Themes, Symbols, or Motifs

Deception and Risk: Polly’s impersonation of a doctor is a calculated gamble. She avoids red flags by ordering only common antibiotics, but the act underscores the moral compromises she is willing to make.
The Basement as a Womb/Tomb: The basement where Tegan is held is both a makeshift prison and a medical ward. The space mirrors the paradoxical themes of confinement and gestation.
Infection as a Physical and Moral Decay: The spreading infection in Tegan’s foot symbolizes the ethical decay of Polly’s choices. Her attempt to clean the wound is too little, too late, echoing her delayed decision to act.
The Fetal Heartbeat: A symbol of fragile hope. The heartbeat is weak but present, representing the slim chance of a positive outcome if Polly moves quickly.
The Unused Nursery: The office that was meant to be a nursery highlights Polly’s childlessness and the emptiness that may have driven her to kidnap a pregnant woman.

Why This Chapter Matters

Chapter 59 marks a turning point. Polly moves from passively holding Tegan captive to actively trying to save her life and that of the unborn child. The medical deception sets a ticking clock—the prescription will be ready soon, and Polly must retrieve it before Tegan’s condition worsens irreversibly. The chapter raises the stakes from psychological captivity to medical emergency, forcing Polly to confront the consequences of her actions. It also deepens the moral ambiguity: Polly is both kidnapper and would-be savior.

Study Questions and Answers

1. Why does Polly use her own date of birth when ordering the prescription for “Polly Thompson”?
She uses the name “Polly Thompson” and her own date of birth to make the prescription appear legitimate for the patient named Polly Thompson. Since she is impersonating a doctor and the pharmacist does not know the patient, using her own details ensures the order goes through without arousing suspicion.

2. What medical risks does Polly identify in Tegan’s condition, and how does she address them?
Polly notes the infected foot wound with pus and loss of pulse, indicating possible deep infection or bone involvement. She also suspects the infection may have spread to the bloodstream (sepsis). She addresses these by ordering oral cephalexin (safe for pregnancy) and prophylactic enoxaparin to prevent blood clots, and by cleaning and bandaging the wound.

3. How does the unused office-turned-nursery reflect Polly’s emotional state?
The room’s original purpose as a nursery reminds the reader of Polly’s unfulfilled hope for children. The fact that it is now a cluttered office symbolizes how she has repurposed her dreams into mundane tasks (bookkeeping). This backstory helps explain her fixation on Tegan’s unborn baby and her reluctance to end the pregnancy.