The structure and writing style in this novel mirror the interior world of a child who has lived through traumatic experiences. Hollis is an orphan, abandoned by unknown parents immediately after she was born. She has spent her whole life in the foster care system and has never found a permanent home. Though we never hear Hollis describe any incidents that are overtly abusive, experts have found that the experience of repeated abandonment has a profound and traumatic effect on young people, even when it happens in infancy. It can cause children to act out, much as Hollis does by skipping school and talking back. Another classic symptom of trauma is the intrusion of memories on your daily life, taking you back to previous bad experiences.

While there is no way for the reader to know whether Hollis has post-traumatic stress disorder, it is certainly the case that Hollis is haunted by her memories. The present-tense action in the novel is often interrupted by Hollis flashing back to a previous experience or to the voice, remembered or imagined, of someone she’s known. It’s also one reason the novel is divided into “chapters” and “pictures,” the latter of which usually take place in the past.