Thomas's Self-Mutilation and Dominick's Despair
On October 12, 1990, Dominick Birdsey learns his identical twin brother, Thomas, has cut off his own hand in a public library. Thomas believed this was a sacrifice to God to stop the Gulf War. He is then committed to Hatch, a maximum-security state mental hospital. Dominick, a house painter in Three Rivers, Connecticut, feels anger, guilt, and a need to protect his brother, who has paranoid schizophrenia. This event brings up Dominick's old pain and forces him to deal with the lifelong responsibility of caring for Thomas, while also facing his own difficult life, including a recent separation from his wife, Dessa.
Struggles with the System and Family History
Dominick works to get Thomas moved from the harsh, underfunded Hatch institution to a more supportive facility. Dr. Rubina Patel, Thomas's psychiatrist, resists this, saying Thomas is a danger. During this time, Dominick's personal life gets worse; his separation from Dessa becomes more tense, and his painting business struggles. He starts thinking about his difficult childhood, with an abusive stepfather, Ray, and a long-suffering mother. The story often goes back to their upbringing, showing the beginnings of Thomas's illness and Dominick's own anxieties and resentments.
The Revelation of Thomas's Diagnosis
Dominick continues visiting Thomas at Hatch, often leaving frustrated by Thomas's delusions and the hospital's depressing atmosphere. Dr. Patel eventually helps Dominick understand Thomas's diagnosis of paranoid schizophrenia, explaining the chronic nature of the illness. She explains that Thomas's self-mutilation was a psychotic act. This makes Dominick slowly accept the reality of Thomas's condition and that he cannot 'fix' him, changing his view from anger to a deeper sadness and sense of duty.
Dominick's Emotional Breakdown and Therapy
The stress from Thomas's situation, along with his marriage problems and old childhood pains, pushes Dominick to a breaking point. He has panic attacks, nightmares, and trouble functioning. His mother and others encourage him to see a therapist, Dr. Sheffer. In therapy, Dominick starts to face his own psychological pain, including his anger towards his stepfather, Ray, and his complicated relationship with his mother and twin. He slowly starts to uncover old memories and feelings that have shaped his adult life.
Thomas's Release and a Brief Respite
After months of advocating, Dominick gets Thomas transferred from Hatch to a less restrictive halfway house. Thomas, now on medication and getting more personal care, shows some improvement, though his delusions still appear. Dominick feels relief and hope, thinking Thomas might finally have a chance at a more stable life. This time gives Dominick a break from the constant fight, though worries about Thomas's long-term well-being remain. He continues his own therapy, slowly making progress in understanding his past.
The Grandfather's Manuscript and Hidden Family Secrets
After his mother's death, Dominick finds a hidden manuscript written by his maternal grandfather, Domenico Onofrio Tempesta. The autobiography, 'The Confessions of Domenico Onofrio Tempesta,' tells of his grandfather's life as an Italian immigrant and reveals that Dominick's biological father was not the man he thought, but his mother's first husband, Henry. The manuscript also suggests a dark secret involving abuse and murder, making Dominick rethink his entire family history and the origins of their family's 'curse' of mental illness and bad luck. This discovery greatly affects Dominick's sense of self and his understanding of his mother's past.
Uncovering the Truth About the Twins' Paternity
With the manuscript, Dominick confronts his ailing mother, Ma, about its contents. She eventually admits the truth: Dominick and Thomas are the sons of Henry, her first husband, who had severe mental illness and was institutionalized. She had believed Henry was dead and remarried Ray, Dominick's abusive stepfather, to provide a father. This revelation shatters Dominick's understanding of his identity and explains much of the family's hidden pain and the genetic tendency for mental illness that Thomas inherited. The weight of this secret, kept for decades, adds to Dominick's emotional turmoil and his complex feelings towards his mother.
Thomas's Deterioration and Tragic Death
Despite the short period of stability, Thomas's mental health worsens. He stops his medication, his delusions return stronger, and he becomes more agitated and difficult at the halfway house. Dominick struggles with the new crisis, feeling helpless as Thomas declines. In a sad and unexpected turn, Thomas drowns in a lake, an apparent accident or possibly suicide. This loss devastates Dominick, who feels a deep sense of failure, grief, and emptiness, even as he deals with the relief that his lifelong responsibility for Thomas has ended.
Reconciliation and Forgiveness
After Thomas's death, Dominick slowly starts to heal. He begins to reconcile with his estranged wife, Dessa, as they both mourn Thomas and think about their shared past. Dominick's therapy with Dr. Sheffer deepens, helping him process his grief, anger, and his family's complex history. He starts to understand his mother's and grandfather's reasons and suffering, leading to a profound, though difficult, process of forgiveness. He accepts the abuse from Ray and the secrets his mother kept, finding some peace in accepting his family's imperfections and his own life.
Embracing the Future and His Daughter
As Dominick processes his grief and accepts his past, he starts to rebuild his life. He continues to work on his relationship with Dessa, finding a more mature connection. He reconnects with his daughter, Joy, who was born from a brief affair during his separation from Dessa. Dominick embraces being a father, finding great joy and purpose in this new relationship. The novel ends with Dominick having accepted the 'truth' of his family's history, his own struggles, and the lasting power of love and forgiveness. He can finally move forward, carrying the lessons of his past but no longer defined only by its pain.