The setting is essentially the sanitarium from The Magic Mountain transported to the locale from Drive Your Plow Over the Bones of the Dead. The book shares themes with both of these predecessors. The most obvious leitmotif is misogyny and a woman's place in the world: Tokarczuk includes an author's note revealing that the character's ideas are all paraphrases of esteemed writers ranging from St Augustine to William Burroughs.
Each person possessed a point of least resistance, a weakest point, this was the famous Achilles' heel, and it was like the law of the pearl: just as in a mollusk the grain of sand that chafes is neutralized by mother-of-pearl...so all the developmental lines of our psyche will arrange themselves around this weakest spot.... We are shaped not by what is strong in us but by the anomaly, by whatever is weak and not accepted.
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