Chapter sixteen opens in 1913, with Henry on a ship in rough weather. He is delighted to be at sea again, even though he is not working as a sailor. He is going to visit Rachel and attend her wedding.
One night while walking home from a movie, Francine steps on a nail. She does not know she has injured herself because she has no feeling in her foot. By the time she discovers the wound it is too late, and Francine dies. Rachel feels lost and alone because Francine was the last of the Bishop Home girls that Rachel grew up with.
In the days after Francine's death, Rachel begins to feel tired and nauseous most of the time. She thinks it is due to depression over losing Francine, but eventually she goes to Dr. Goodhue. Dr. Goodhue discovers that Rachel is pregnant. Rather than being overjoyed, Rachel is sad and angry. She knows that on Kalaupapa, babies born to leprous parents are taken away so the baby does not get infected. Rachel decides to secretly give birth at home rather than in the infirmary so that she can have one night with her baby. A midwife assists Rachel. After the baby is born, Kenji and Rachel have a few hours before they take the baby to the infirmary. They name the baby Ruth after Sister Catherine's given name.
When it comes time for the baby to be taken to Honolulu, Sister Catherine volunteers, and Rachel is grateful.
