The unforgettable Cappadoras are back.

They first appeared in Jacquelyn Mitchard’s debut novel, The Deep End of the Ocean, which dealt with a distraught mother, a kidnapped child and a family in crisis.  Selected as the first novel in Oprah Winfrey’s Book Club, The Deep End of the Ocean was named by USA Today as one of the ten most influential books of the past 25 years. It was also made into a feature film produced by and starring Michelle Pfeiffer.

In Second Nature, Mitchard adds Sicily Coyne to the mix. At the start of her teenage years, the pretty Irish/Italian/American survives a horrific fire while watching her firefighter father die. She is badly disfigured and begins her adolescence without a face.  She receives countless reconstructive surgeries and rebuilds her life with the unwavering emotional support of her Aunt Marie.

While preparing for her wedding to a childhood friend, Sicily discovers a shocking truth that shatters her carefully constructed world. She decides to have a facial transplant, a real possibility in this futuristic novel, set in the not-too-distant future. While the medical technology has improved, there are still substantial risks and definite consequences for the impulsive 20something Sicily as she plunges into an unlikely romantic entanglement with a Cappadora who has “a vocation for making bad choices.”

At times, I felt like shaking Sicily. I could certainly empathize with her aunt’s tirade on a memorable Christmas morning:  “You’ve put your life in real danger now. Thank you for that. You’ve stuck pins in hearts all over town…I’m sure that I’ll get over wanting to pinch you ‘til your arms bleed.

Mitchard has impeccable research skills.  In a recent interview, she described the six months devoted to researching this novel.  She spent long hours with firefighters and gained insight into their dual nature as “both the most cautious people on earth and utter adrenalin junkies.” She added to her pre-med background by interviewing anaplastologists who make noses, ears and fingers and learning all about the anti-rejection protocol that might allow a young woman to live a normal live after a face transplant.

The result is a moving and riveting story which effectively deals with the medical and emotional obstacles encountered by Sicily as she navigates the unexplored terrain of post-transplant life. The ending is a bit disappointing, ambiguous at best as the Cappadora clan gathers around Sicily and Beth Cappadora muses about “statistically impossible odds.”

Is Jacquelyn Mitchard planning another sequel?