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The theme of this book is undeniably family--as an institution as the people you choose to surround yourself with. However, this book tackles to many issues as well:
War--her Brother Matt goes missing
Growing Up--Twigs tries to redefine herself as Madeline
Relationships--the Boyfriend away at college
Learning to Stand Up for Herself--job and relationships
Abuse--not in Twigs family but in a sub-character. This could tie into family if there wan't so much going on...
And lastly there is the pink-loving, disaster of a woman who destroys the pharmacy in the opening pages and throws open bottles of hair dye at Twigs giving her a sort of tiger make-over. This lady adds the most value to the story and entertainment as well. Rather than being a problem for Twigs, she takes her as family while her marriage is falling apart. She made this book and really made it ripe for discussion.
However, I think this book could do more. It touches on substantial issues and while predictable at times it is believable and honest. I think the themes need to be flushed out more to be a truly great book but I do think teens will gravitate towards it and emerging adults as well.