On the day of her operation, Tally isn't super happy. First, she's all alone. Still. Second, the surgery she's about to have is super extensive—they're going to grind her bones and stretch her body. Ow! (Luckily, it's all covered by her insurance.)
Third, she's still sad about Shay leaving because she couldn't find an argument to get her to stay.
(Also, we get to hear about the other stuff this surgery does, like fix eyes and teeth, and make people healthy for a long time.)
A middle pretty drops off Tally at the hospital. (Middle pretties are the authoritative-looking adults who run the city.)
After a long time waiting at the hospital, someone comes to tell Tally that there's a problem.
This guy is a strange-looking pretty—beautiful, but scary: "Instead of wise and confident, the man looked cold, commanding, intimidating, like some regal animal of prey" (42).
He tells Tally to come with him, which again, should be marked by a "do not do this at home" sticker: "Strange, scary-looking man wants me to follow? Sure."