1. Like many physicians, Stuart "Doc" Jordan, the narrator of the novel, works long hours. Is there any reason in his particular circumstance why he puts in such long hours?

2. Doc Jordan is, as he himself admits and as his friend, Cecil Clegg says, a Yankee, an outsider in this insular world of mountain people. What makes him such an ideal narrator? Why not a narrator who is from Hubbard County?

3. The Prologue begins with the following quote: "What I know of death is how hard we work to deserve it and how little we appreciate it when it finally comes." Given what happens later in the novel, what is the significance of this statement?

4. The women in Doc's life, his estranged wife Annabel and his new lover Bobbie, have very different personalities. What attracts Doc to each woman? Does he love each one?

5. Babies as well as the process of childbearing is very important to the novel. Discuss the various ways babies and woman giving birth are significant to the story.

6. The Appalachian Mountains and its people have been portrayed in various stereotypical ways, from Lil Abner to Deliverance. Doc himself admitted that when he first came to the region he also harbored similar stereotypes. Yet he says, "Slade, like most of the new South, was rapidly changing, sloughing off its small-town, bible-thumping, good-ole-boy skin." Discuss the ways the area is changing, breaking away from those stereotypes, and the effects those changes are having on its people and their traditions.

7. Doc Jordan is a man who is confronted by several moral, emotional, and legal choices? What are those choices and what are the repercussions of each?

8. There are several contradictions in Doc's life. For example, his day job, as he calls it, is nurturing life while his night job, that of part-time ME, is "working the other end of the line." Discuss this and other contradictions in his life.

9. Though Annabel says she wants Stu to be happy she continually returns and throws his life into chaos. Why does she keep coming back and why does he keep taking her in?

10. Several other women are important to Doc. Who are they and how are they significant to him? How do they affect him?

11. After Doc's meeting with Leonard Blackfox, when he learns about the events of the night of the murder, there's one thing that is still unclear to Doc. What is it and how does he handle it?

12. Dreams are an important device in the novel, starting right with the title. Discuss how dreams are used here.

13. At the end of the novel, Annabel leaves. However, even now Doc imagines her calling or returning some day. Do you think she will return?