The growth is not necessarily life-threatening. But its removal may threaten Sister John's faith in God, and thus her whole vocation. That's the basic conflict of this novel, stated merely as a thesis. But if you read this book you will feel some of the exquisitely painful and joyful anxieties Sister John feels. This novel is not one that has a clear conclusion.
Spiritual mysteries have nothing to do with clear conclusions.
The reader is left at the end of this lovely book wondering if Sister John is more or less holy and virtuous as a result of losing her visions. There is no simple answer to such a question. But we are very fortunate that Mark Salzman gives us a glimpse of the tension between an ordinary life of good works and an extraordinary vision of deep faith. Maybe, Salzman suggests here, the two are not very far apart after all. For other book reviews, see the archive .