Chapter twenty opens in 1943 at Kenji's funeral. After the funeral, Rachel walks to the beach and sits in the sand for a moment. When she stands and walks toward the water, she hears Catherine's voice asking to join her on the beach. Rachel says she would prefer to be alone, but Catherine stays anyway. During the evening, several friends come to Rachel's house to keep her from being alone.
Because Hawaii is under martial law during the war, Crossen's trial is administered by military authorities. Rachel notices that military justice operates much faster than civilian proceedings. During the trial, Rachel sees all the military uniforms and remembers that Crossen was a sailor. She does not believe that the military authorities will punish Crossen, and she is surprised when the military authorities sentence Crossen to thirty-five years in prison. Because there are no nearby prisons that can take an inmate with leprosy, Crossen is confined to a room in Kalaupapa.
Rachel's leprosy symptoms increase over the course of many months. First she stays in Bishop Home, and then as her condition worsens, she is transferred to the hospital.
On April 1, 1946, a tsunami strikes the Hawaiian Islands. No one is killed at Kalaupapa, but there is much property damage. Rachel watches from her hospital room window as crews repair the damages, and she feels useless and near death. A month after the tsunami, a doctor says he would like to try a new drug that has helped patients at the leprosarium at Carville, Louisiana.
After three months, Rachel notices significant improvement. In June of 1947, she welcomes the settlement's new superintendent, her friend the former governor Judd.
Now in her sixties, Rachel is eligible for release from Kalaupapa. Immediately before leaving Kalaupapa, Rachel visits Crossen. She tells him that she is leaving, but he is staying. She says that even if his leprosy is cured, he will be transferred to a prison.
Rachel boards a plane and leaves Kalaupapa.
Nine days later the body of Crossen is found floating in the sea.
