The drama of life in America
America is presented to the reader not through the lens of order and knowledge, but through the eyes of an immigrant, brought to America as a strange land, more or less against her will to experience the positives of American life as well as the negatives. Unfortunately, the cast of this novel seems especially prone to negative aspects of life like racism and bullying, but that is part of the dramatic tension of what Maribel and her mother discover in America. When the father dies, they retire back to Mexico with America as a foundational backdrop to what makes them distinctly Mexican, culturally. This is typical for international literature.
The confusing illness
The illness is a symbol for dramatic irony because Maribel is the child of the family and therefore the person who bears least responsibility for her family's behavior. She is not calling the shots. She is merely a spongy-brained young person, rapidly absorbing whatever information is presented to her. It seems confusing that she should be disabled in the various ways that she ends up becoming disabled, and the confusion is part of what makes her character innocent. She does not know what life is really capable of, and she is having to suffer so much suffering which is not rooted in her ethical responsibility. She is an ironic symbol for suffering.
The unexpected love
A hopelessness begins while Maribel's attempts to adapt to life in America, but that hopelessness is ironically subjected to catharsis when she realizes that Mayor loves her. That does not come to fruition, but rather, it stays latent, providing a helpful symbol for what hope feels like. Hope feels like you might be falling in love soon, even though that seemed completely unlikely before it started happening. Romance is largely symbolic in this book, so in light of Maribel's identity crisis and confusing emotional landscape, hope is a symbol for acceptance, self-love, and shamelessness.
Insult and injury
The injury that leaves Maribel disabled also renders her sort of helpless, generally speaking. The fact that she is made fun of as if her abilities were an indication of her worth is adding insult to injury. The novel makes the ironic case through the symbolism of its plot that life has a way of handing more suffering to those who suffer. This is a confusing betrayal of fate, it seems, because although life seems like it should be about happiness and community, this novel shows a lonely, outcast person in need of approval and security.
Death and healing
The novel ends on two major ideas: the death of Maribel's father and Maribel's strange healing as the women return to Mexico to try their fate there. The synchronicity of death and healing is ironic because death is a finite symbol, but healing points to continuous life and regeneration. The symbolic connection is clear: Although in the end, life is suffering and death, there is enough love and miraculous healing in it to survive—but it helps to be rooted in the correct cultural environment. That's why healing is also attached to Mexico, even though they mourn the old Mexico whose death aligns with the father's death.