Kate’s miscarriage is a sudden medical crisis and a profound loss, but it also becomes a moment of shared grief that reshapes how Tully understands care, family, and Kate’s marriage. As Kate is taken from home to hospital, Tully stays at her side; afterward, the child’s death and Johnny’s reunion with Kate expose the depth of the family’s attachment and unsettle Tully’s long-held belief that Kate was second to her in his affections.

The emergency

The crisis begins as Kate rises from the couch feeling light-headed and unsteady. Her confusion intensifies, and she collapses after seeing blood on the sofa cushion and the decking. Tully reacts immediately, steadying her and insisting on accompanying her in the ambulance. Beside Kate, who is conscious but barely responsive, she repeats that she is there. When the ambulance reaches the hospital, staff hurry Kate inside, leaving Tully outside the open doorway to absorb the danger of what is happening. The possibility that Kate could bleed to death turns a frightening episode into a fear of losing her closest friend.

Loss and the limits of comfort

While Kate sleeps in a small hospital room, Tully sits with Mrs. Mularkey. Nearly two hours have passed since Kate lost the baby, and Johnny has been called but remains away on assignment in Spokane, across the state. Tully tries to console Mrs. Mularkey by calling the loss early, but Kate’s mother gently challenges that reassurance: at four months, the miscarriage is not early, and she recalls that Bud used the same kind of consolation after her own miscarriages. For her, it had never felt like a blessing; it felt like losing someone she loved. Tully accepts the correction and admits that she wishes she knew what would help. The exchange gives her a practical lesson in grief: support does not require explaining loss away, and listening may matter more than finding a comforting phrase.

Johnny’s arrival and Tully’s realization

Johnny arrives exhausted, carrying flowers, and goes straight to his wife. He apologizes for taking so long; Kate breaks down and tells him that the baby was a boy. Johnny cries with her. Watching them, Tully recognizes that her memory of her own night with Johnny had distorted her view of their marriage. She had imagined Kate as his second choice, but his grief and tenderness make that belief untenable. Mrs. Mularkey gently draws Tully away so the couple can be alone. The miscarriage thus brings Tully into intimate proximity with Kate and Johnny’s loss while clarifying that their bond is not a consolation prize.

Aftermath and significance

The scenes of crisis and mourning establish a pattern that recurs in the friends’ lives: when one is overwhelmed, the other offers presence rather than distance. Tully’s own first response to Kate’s approach is to stiffen and then begin crying; Kate hugs her, and Tully finds herself clinging to the unexpected comfort. Later, after Tully tells Kate that she was raped, Kate again responds by asking whether she is okay. These earlier moments frame the miscarriage’s hospital scenes as part of a durable friendship in which care is enacted through staying close, listening, and allowing grief to take its course.

The loss also resonates with Tully’s other experiences of abandonment and bereavement. When Kate asks whom she is angry with, Tully names Cloud, Gran, and God, then reveals that Gran died while Kate was away. Kate’s embrace gives Tully the sympathy she had been waiting for. In the hospital, by contrast, Tully is the one trying to support a grieving family, and Mrs. Mularkey helps her understand the limits of easy reassurance. Across these losses, the novel distinguishes presence from solutions: Tully cannot undo the miscarriage or make grief smaller, but she can remain beside Kate, as Kate and her family have remained beside her.