On September 9, 1909, the new lighthouse goes into operation. Three lighthouse keepers and their families move to Kalaupapa. One of the keepers, Jake Puehu, arrives as a single man and soon attracts Rachel's interest.
Rachel learns that if one more test for her leprosy is negative she will be eligible to leave Moloka'i.
Rachel and Jake become acquainted and have a mutual interest in books. After many outings including horseback riding, Jake invites Rachel to see the inside of the lighthouse. Rachel hopes that Jake will kiss her, but instead he moves away, and Rachel sees apprehension in his eyes. Rachel remembers that to outsiders she is a contagious leper, and she leaves the lighthouse in shame.
After her next test is positive, Rachel volunteers to be a patient at the new United States Leprosy Investigation Station that will soon open. Rachel is one of nine initial patients at the new facility. The patients soon discover that the rules at the facility are even stricter than in the rest of the colony. One by one the patients leave the facility and return to the settlement. Rachel is the last remaining patient out of the original nine.
One night, after seeing Halley's comet and then having a dream that instead of Jake moving away in the lighthouse the two had sex, Rachel decides to leave the facility and return to life in Kalaupapa.