Chapter fifteen opens in 1911 with a letter from Henry. He tells Rachel that he cannot go to sea anymore. When his health worsens, he is at first delighted because he believes he has leprosy and can go live with Rachel. Henry does not have leprosy. He has gout.
Emily's health deteriorates, and Rachel moves in. After Emily dies, Lani is excited to show Rachel something. Lani shows Rachel her chest and what she believes are female breasts. Rachel believes that the changes might be tumors and convinces Lani to see Dr. Goodhue. While Rachel and Lani wait to see the doctor, they meet a young Japanese man. Dr. Goodhue says that Lani's breasts are the result of a hormonal imbalance that has caused her to grow breasts. Lani is ecstatic and believes her prayers to be a woman have been answered.
Rachel continues to see the young Japanese man, and each time he seems to be angry or brooding. One day while surfing she sees him swim out and not turn back. Rachel paddles her board after him and eventually convinces him not to swim out to sea. While the two ride her surfboard back to shore they talk and get to know each other. The man's name is Kenji. He comes from a Japanese family in Honolulu. Kenji explains that in Japanese culture to have a family member with leprosy is a source of shame. Rachel and Kenji spend a great deal of time together over the next several months and become intimate.
Lani catches influenza and soon dies.