The Extraordinary Life of Sam Hell

Ten years have passed: It’s April 1999, and Sam has moved to San José, Costa Rica, with a medical outreach organization called Orbis. Mickie lives in Sam’s home in California. Sam returns home periodically to spend time with his mother and father. Max has regained some speaking function, and the family enjoys taking wheelchair accessible trips to national parks and other tourist destinations. Though Sam finds his work fulfilling, he still carries guilt about Trina’s death. However, he’s also rediscovered some sense of spirituality, one different from his mother’s:

I didn’t consider my work as ‘God’s work,’ largely because I didn’t believe in my mother’s God. If anything, I’d classify myself as a Buddhist. I believed that every living thing came from the earth and was to be respected. I meditated and I chanted and I found that it helped me sleep—as did the exhausting schedule I purposefully kept. [… I]n some way, this was not my way of helping others as much as it was my penance for the death of Trina Crouch (379).

Back in Costa Rica, a villager brings a six-year-old orphaned boy named Fernando to the clinic. He has ocular albinism, and the people in his village refer to him as “the son of the devil” (381). Fernando is shy, but Sam charms him with humor, and the boy warms to him. Sam removes his contacts, revealing his red eyes. He tells Fernando he is a child of God and that everything will be all right. Sam promises the boy he will never conceal his red eyes again because they led him to Fernando. Sam calls Mickie to tell her about Fernando, but she tells him he must come home soon to see his mother.

Madeline has advanced breast cancer and has known for many months but told no one, choosing to forgo treatment. When Sam returns home to see her in the hospital, she is weak, but they exchange heartfelt words. Madeline is proud of the work Sam is doing, but he must return home to care for Max. Madeline tells Sam Sister Beatrice is also in the hospital dying, and Madeline has been visiting her every day. When Sam also visits the nun, she asks for forgiveness for the way she treated him when she was in the throes of alcoholism; she explains that she used alcohol to cope with her own trauma from being bullied as a child. She ruminates every day on how she emotionally abused him, and she’s been trying to contact him so she can apologize. Sam tells her she doesn’t need his forgiveness and that he knows it was the alcohol, not truly her, who mistreated him. She tells him he is his mother’s son.

Sam tells Mickie his plans to adopt Fernando. He mentions marriage, and the two kiss. They passionately make love, and Mickie does not leave the next morning. Sam reads the newspaper and sees a story about Donna Ashby, who is going to jail for sexually exploiting a minor. Sam regrets the time he spent with Donna.

The money Sam invested in Ernie’s company has made him wealthy. He wants to fly his mother on a medical plane to Lourdes, France, to see the Blessed Mother. Mickie will accompany them to help care for Max. They take the trip against Madeline’s doctor’s wishes and arrive safely with the help of two nurses Sam hires for the plane ride. The townspeople built the Basilica of Our Lady of the Rosary after a young girl named Bernadette saw a vision of the Immaculate Conception in Lourdes. The vision told the girl to dig, and when she did, she uncovered a spring. People have visited the spring for over 140 years, believing it has divine healing powers.

Father Pat Cavanaugh, a former chaplain at St. Joe’s, is also in Lourdes and helps Sam with his parents. Sam goes to confession and asks for peace for his parents. At the pilgrimage site, there are separate pools for men and women. Max and Sam are both submerged, and Sam thinks he hears a voice saying, “Have faith, Samuel” (405). Sam emerges from the pools changed and, in his heart, forgives David Bateman. He sees a familiar statue, though he cannot place it. Madeline is beaming, but she collapses into Sam. Her vital signs deteriorate on the flight home. She and Sam share one last conversation where she tells him she prayed he could accept himself. Her last words are “Everything happens for a reason, Samuel” (410), but she does not pass away until they are home. Max dies six weeks later.

Several months after Sam’s parents’ deaths, Mickie and Sam have converted their ophthalmology practice into a free clinic. Sam proposes to Mickie, but she has always been uncomfortable with the idea of marriage, and she says he deserves someone better than her. Mickie leaves to attend a conference in Mexico, and when she does not call, Sam is worried. Her hotel tells Sam that she checked out early. Sam prays with his mother’s rosary and asks God to protect Mickie. He falls asleep, and the church bells awaken him to Mickie returning home. She reveals she cannot have children because she had a hysterectomy when she was younger; she kept it hidden for years because she knew Sam wanted to be a father. However, before Madeline died, she and Mickie worked with an agency to expedite the adoption of Fernando (Madeline lied to the agency, telling them Sam and Mickie were married). Sam proposes with a ring he made with his mother’s diamond and a circle of rubies.

In the Epilogue, Fernando is home with Mickie and Sam, who intend to enroll him in public school. However, the principal of OLM calls a meeting with them: Madeline paid for all eight years of Fernando’s tuition at OLM. Sam drives Fernando to OLM in the Falcon to place flowers at the statue of Mary, the same one at Lourdes.