- When Izzy first arrives at Willard, she’s afraid to go inside
the old buildings because they remind her of visiting her
mother in the psychiatric ward. She also has a difficult time
handling the contents of the old suitcases because they remind
her of the dead and dying. Some people would find
the abandoned asylum fascinating, while others would stay
away. Would you want to go inside the buildings? Would
you want to go through the old suitcases?
- Before coming to live with Peg and Harry, Izzy cut herself
to deal with her emotions. Self-harm is most common in
adolescence and young adulthood, usually appearing between
the ages of twelve and twenty-four. Have you ever
heard of self-injury as a way of dealing with emotional pain,
anger, and frustration? Why do you think some people hurt
themselves as a way of coping? What do you think would
have happened to Izzy if she had lived during Clara’s time?
- Displaying opposite ends of the spectrum when it comes to a
mother’s protective instinct, Izzy’s mother shoots her father to
protect her, while Shannon’s and Clara’s mothers do nothing
to protect them. Discuss the maternal instinct. Do you think
it’s stronger in some women than in others? Do you think the
difference is due to circumstances, as in the way women are
brought up, or do you think the difference is due to genetics?
- Clara tries everything she can think of to get out of Willard.
Is there anything else she could have tried?
- New York State has sealed the medical records of former
mental patients, even denying access to the descendents.
Why do you think they remain sealed? Do you think this
law should be changed?
- How do you think Izzy changed over the course of the
novel? How did Clara change? What were the most important
events that facilitated those changes?
- At first, Dr. Roach truly believes Clara needs help, partly
because of Clara’s father’s stories, and partly due to the era,
when emotional outbursts were often seen as a sign of mental
illness. Why do you think Dr. Roach refused to release
Clara even though Bruno confirmed the truth about why
she was there? Why do you think Dr. Roach committed
Bruno to the asylum? Do you think Dr. Roach was more
worried about his reputation and his job, or concealing the
fact that he took Clara’s child?
- Izzy refused to visit her mother in prison because she was
afraid. Do you think she was angry with her mother, or just
sad and scared?
- Clara refused to go along with the arranged marriage to
James because she was in love with Bruno. She had no idea
her father would send her to an insane asylum. Hindsight is
always 20/20 and, in Clara’s time, women were still subject
to the whims of their husbands and fathers, but what would
you have done in that situation? Would you have obeyed
your parents’ wishes and married James? Would you have
continued seeing Bruno?
- Bruno had no idea Clara was at the Long Island Home because
he never received her letters. Izzy couldn’t understand
why her mother shot her father until she read her
mother’s letters. Can you think of an instance in your life
that would have turned out differently if you’d had more information?
Do you think most people jump to conclusions,
or that they try to find out all sides of a story?
- Nurse Trench presented a tough exterior while hiding a soft
interior. How did you feel about her when you first met
her? How did you feel about her when she was an old
woman? Do you think Nurse Trench could have tried
harder to help Clara while she was at Willard? What could
she have done?
- Izzy feels like nothing will ever change when it comes to
bullying. What do you think? What can be done to make
those changes? Do you think we’ve made progress when it
comes to bullying, or do you think things have gotten
- Clara is sterilized after she gives birth, because Dr. Roach
felt it was his duty to keep her from passing along “inferior”
genes. Do you think it was right for doctors to make that decision
for patients who were considered mentally ill? Do
you think the government should have a say in who can and
cannot reproduce? How far do you think we’ve come when
it comes to a woman’s reproductive rights and the right to
- Bruno had to nail Clara inside a coffin for them to have a
chance to escape. Would you have been able to stand being
nailed inside a coffin if it meant a chance to be free?
- During the flood in the electroshock therapy room, someone
grabs Clara underwater. Who do you think it was?
- Do you think reuniting Clara with her daughter helped Izzy heal? In what way? How do you think Clara felt when she saw her daughter?
- What She Left Behind is composed of two interweaving
story lines—Clara’s in the past and Izzy’s quest in present
day. Discuss the structure of each narrative. Did you enjoy
the alternating stories and time frames? What are the
strengths and drawbacks of this format?
- Which “voice” did you prefer, Izzy’s or Clara’s? Is one more
or less authentic than the other? If you could meet one of
the two characters, which one would you choose?
- How are Clara and Izzy the same? How are they different?
- What do you think Izzy’s future looks like? What about
Clara and her daughter’s future?