Sibling love and devotion, ethical dilemmas, and an unforgettable character who’ll stir your soul, break your heart, and leave you transformed by her kindness and profound understanding of human nature, Hannah Bent’s When Things Are Alive They Hum deserves to be praised to high heaven, and read far and wide.

At its heart is twenty-year-old Harper, who was born with a congenital heart disorder and has Downs syndrome, though she prefers to call it Up syndrome. Satisfied Harper is in a stable situation, her older sister Marlowe has moved to London to study rare butterflies, but rushes home to Hong Kong when Harper falls seriously ill.

When Harper is deemed unsuitable for a life-saving transplant, Marlowe is prepared to take drastic measures to try to save her little sister’s life. 

Extraordinarily moving, and brilliantly written, this will make you cry, make you want to hug your loved ones close, and make you think about big ethical issues.

With that in mind, here are some topics and questions to kickstart book club discussions about When Things Are Alive They Hum. For more ideas, browse our book club recommendations category, and explore more discussion questions. 

1. What are the main themes of When Things Are Alive They Hum?

2. What’s the significance of Marlowe being a lepidopterist? Consider the symbolism of butterflies in relation to the novel’s themes.

3. Discuss how Harper’s Up syndrome influences the decisions medical professionals make about her. 

4. Discuss the writing style. What did you think of the dual narrative structure of the novel? How are the sister’s personalities and outlooks reflected in the writing styles?

5. “As a child I had sworn that I would fight for Harper, and perhaps this was a way to do it”.

Does Marlowe always do what’s best for Harper? To what extent are her actions the result of the sisters losing their mother at a young age? In Marlowe’s position, would you have pursued the chance to secure Harper a transplant in the way she does?

6. Is Irene a “step-monster”?

7. How did you feel after finishing When Things Are Alive They Hum? What did you learn from reading it? Will you recommend the novel to family and friends?