Alas, another of Carissa Lake's patients isn't quite so lucky. Despite her warning that Richard Emmons not go off his prescription drugs, he does exactly that. In fact, during an asthma attack, he takes the homeopathic law of similars--the belief that "like cures like"--to an entirely new level. This tragedy embroils Carissa in an investigation of her practice and forces Leland into a decision that is to alter not only her life but his:

Upstairs, my daughter slept. And for a long time we sat on the floor before the tree, neither of us saying a word, as I worked out in my mind exactly what I would have needed to prosecute this case if a summer cold had not lasted into the fall, and I had not met Carissa Lake. Once I knew, nothing seemed quite so hopeless, and I began to sketch aloud for her exactly what we would want to create in the morning, and exactly what we would want to destroy.