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  • The realization that Summer will never be okay again.
  • Worse, the story is based on Ruth White's real life and her own sister's mental illness. She herself says that the nature of the story meant there was no possibility of giving Summer a happy ending, painful as it was.
  • Lyric attending the school musical alone and singing quietly along with the songs, heartbroken that she couldn't be a part of it due to Summer spoiling her audition.
  • Summer is aware she's slipping away, and even says so to Lyric at several points. She knows she's losing herself and there's nothing she can do about it
  • Music is a running theme throughout the story, since both of the girls like to sing, and at one point the following song is quoted: "...summer turns to winter, and the present disappears." If that doesn't hit the nail painfully on the head regarding the loss of Summer...
  • Lyric slowly realizing she's grown away from her roots in Glory Bottom, where she spent the first 13 years of her life. She describes her memories of the place as being more like a photo album than happening in real time, and she's even forgotten the names of her old friends and classmates. While Lyric is happy with her new life in Flint, it's sad to imagine the memories of one's childhood home becoming so faded and insignificant.
  • The second to last chapter, with Claude and Lyric taking Summer to the mental asylum. During the trip, Summer whimpers that she'll "be good" from now on, and Lyric, despite Summer having injured her and been so cruel to her last chapter, tells her "you're as good as you can be!" Then, when they finally get there, Summer doesn't even realize her father and sister are leaving her as she gushes over a nurse she believes is actress Jennifer Jones
    • When they next go to see her, they find out the doctor has given Summer electroshock therapy, and that just made her worse due to her fear of electricity. Claude cries when he finds out, and Lyric notes that this is the first time she's ever seen him shed tears.
    • The worst part is when the doctor tells them that Summer will never be her old self again, because he's never seen a schizophrenic recover completely. Lyric decides she doesn't like him because "he was the man with the watch on, and he'd told her the right time."
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