Second Nature, the latest from Jackie Mitchard, tells the story of a woman whose face is horribly disfigured and how her life and relationships change when her face is restored, more than a decade after the accident. Here's more from the author of Deep End of the Ocean:

Jennifer Haupt: How did you come up with the premise for this story?

Jackie Mitchard: The seed for this story was planted fifty years ago, when I was so young I'm not sure how much of the events themselves I actually remember and how much is invented memory. On the west side of Chicago, near where grew up, there was a fire at a school called Our Lady of Angels. One memory that I know is genuine is of seeing of my mother answering the telephone and then crying so hard that she slid down the wall and sat on the floor, the phone receiver just lying there. I remember even the height of the kitchen table next to my head. No one on the west side was untouched by what we called simply "OLA." I grew up with kids whose siblings and cousins died in that fire, which killed ninety-two children and three teaching nuns. It was, and remains, the second worst school fire in history.

You don't ever really recover from such a huge transformational event, even if you survive it. Of course, I never forgot it, and remember playing with friends whose mothers had a little shrine in the house with a photo of the child who died and candles and a status of the sacred heart. For years, I've wondered about the personal dimension of something like that, about the wounds that show and the wounds that don't - which can be much more serious. This is how I began to think of Sicily Coyne, and how being disfigured on the outside is different from being denatured on the inside.

JH: Why did you pull Beth Cappadora, your beloved character from Deep End of the Ocean, into this novel?


Beth grew up in the town where the Holy Angels fire happened, and her father was a firefighter there. The bonds of memory and proximity are strong. It was natural to intertwine those characters' lives, and to see what happened. But what happened was more than I ever expected would happen.

JH: How much research did you do concerning women who have been facially disfigured?

JM: This book was so research intensive that I nearly snapped my cap. I ordinarily do a great deal of research for books, rather than writing simply from my own experience. I write not just about what I know but what I want or need to know. So I talked with people who are facially disfigured and also with those who help them, including burn surgeons and anaplastologists who make prosthetic noses and ears, whose vital art form is going to be out-moded by soft-tissue transplants that can give people real noses that actually work and have nerves and sensory capability.

People who were maimed fell into two categories: There were those who went veiled, emotionally and physically, who withdrew from the world in agony and shame, with this behavior based in part of the level of their disability and in part on their personality before. The other group was like Sicily, who was almost, if you will, in your face about her disfigurement, daring anyone to treat her differently, fighting for a career and as much of a social life as was humanly possible. Those kinds of people often attract so-called "normal" partners, because their spirit is unique and deeply attractive. For Sicily, it was when she no longer had her broken face to explain everything about why she was the way she was that she began to flounder, and she was smart, knowing instinctively that it was always wise to be careful what you wish for.

JH: How is this novel a departure from your previous works? What was your biggest challenge in developing this story?

JM: This is a science fiction novel. It is fiction and it is about real science. It's not about aliens or a rogue virus, but it is about a future world. My early education was in science and I love it; most of my reading is in science, natural history, paleoanthropology and botany. However, I was breaking off a big chunk here, however, in part because there are no generalizations about face transplants yet, because of there having been no more than twenty cases. So I had to consult with doctors and potential candidates for face transplant procedures based on speculation; but it was educated speculation because these procedures are too important, for example, to burn victims, that they won't become more common and aesthetically spectacular.

JH: Why aren't these procedures more common?

JM: I think it's because of the emotional connotations for the families of donors. In just the same way as people can talk on TV about sexual abuse and selling drugs but draw the line at money, people give birth on TV but draw the line at faces (except in cosmetic surgery shows). The face is probably the most psychological private part of the body, even though, ironically, it's the one people see most. The face has mythic connotations, as the mask of the soul, with eyes the mirror or porthole to the spirit.

So, why are there so few face transplants? There are so few donors, I think. First, someone who donates a face for transplant has to be either healthy but brain dead or dying of a disease that has nothing to do with the health and strength of their soft tissue ... and who has a family who can come to terms with burying the beloved spouse or child or brother without a face, which is not the same thing emotionally, not at all, as burying someone without a heart or lungs. When we get past seeing this idea as "cosmetic," and realize how vital it is for people disfigured in accidents to be able to talk and taste and kiss their children, we'll see the ultimate humanity of this gracious gift. Part of the reason that the fictional Sicily, a medical illustrator, asks for this whole process to be documented photographically is to get past the weird science and 'Phantom of the Opera' aura that surrounds it. For me, the biggest challenge was wandering in the wilds of immunology, with my friends who are doctors pulling me back onto the trail.

JH: How do you find inspiration for your writing? Is there anything you do that, on the surface, has nothing to do with writing, but it actually helps your creativity?

JM: Travel and exercise are the big things. I literally can feel my mind get sharper and deeper as I see new things and tire my muscles. Reading is more obvious, but I try to confine my reading, during those times I'm writing fiction, to non-fiction - to subjects that are around the world from the research I'm doing or the story I'm telling because it's there than I find the nugget of information that gives my own work more texture.

JH: You teach a lot of workshops. How does teaching other writers nurture your creativity?

JM: I'm an adjunct professor in the Masters of Fine Arts program in Creative Writing at Fairfield University and I am a faculty fellow, earning my own MFA, at Southern New Hampshire University. While it's difficult to give my students everything they need with the demands of my other responsibilities in life. teaching is something I just will never give up. It really does fill the well, at the same time that it drains the well. You can't have ego, and you can't give halfway. When I'm at the residencies for the programs with which I'm associated, there is no time for me. I disappear into the teaching just as I disappear into writing or being a mother, and I emerge new and raw.

JH: What role, if any, does faith play in your writing life?

JM: Apparently, it plays a much, much bigger role than I understand. I would consider myself to have the life of the spirit of the average salt shaker. I certainly do not consider myself to be conventionally a believer, there is a huge portion of almost every story that turns on the hinge of faith and moral choices based on deeply held values. Sicily's aunt is a nun. When she prays for the recovery of her son, Ben, Beth Cappadora uses the words of the Latin mass, "Agnes dei ..." Where the heck did that come from? Who knew I even remembered it? I was a kid when that changed. Apparently, it's true what an old friend said about me, that I'm a Puritan who examines her soul every day and finds it wanting.

JH: What's the one true thing you learned from Sicily?

JM: I learned the truth of what Saint Teresa said so eloquently, that there are more tears shed over answered prayers than unanswered prayers.

New York Times bestseller Jacquelyn Mitchard's novels include The Deep End of the Ocean, Twelve Times Blessed, and The Breakdown Lane. She is also a journalist and author of The Rest of Us: Dispatches from the Mother Ship, a collection of her newspaper columns. She lives with her husband and six children in Madison, Wisconsin.

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