Vann reflects on his three marriages, focusing specifically on Irene, his second wife. At the same time, Irene is getting prepped for open-heart surgery. Vann thinks about a photograph that Irene sent him after their divorce, and how he couldn't bear to hang it up or get rid of it, instead carrying it around, boxed up, from place to place. Simultaneously, Irene is beginning her surgery, and her daughter anxiously awaits her mother's return. Vann is working on a new hospital wing connected to the hospital building in which Irene is undergoing her surgery. Suddenly, dust and debris begin to fall into the hospital from the vents and the surgeons have to close up Irene, causing her to go into cardiac arrest. They get her heart to start beating again, but she quickly falls into a coma. Although Vann thinks that he didn't do anything wrong, he quickly discovers that this has happened because of his team and their construction work. Vann goes outside to smoke and sees a young woman smoking as well. When she turns around, he recognizes that she is Frances, Irene's daughter. Vann goes to see Irene and realizes that she is the only one he's ever loved, and now she will never get to feel that love. Vann and Frances sit in the lobby of the hospital, coming to terms with what has happened.