We thought about talking about the theme of family in I Know This Much is True, but this is a story more about playing favorites within the family than it is about family values. In this book, Dominick is always concerned with whom his Ma loves more, why Ray picks on his brother more than him, and being conflicted with himself for both hating Thomas and feeling obligated to stand up for his brother. Bad news: If you think your parents don't have a favorite, you're kidding yourself.
Questions About Loyalty
Why does Dominick, as a teenager, often go along with Ray? Why doesn't he stand up to the guy instead?
How does Dominick feel when he discovers that Ma told Thomas things that she never told him? Does he feel betrayed? Why or why not?
Dr. Patel seems to choose Dominick over Thomas. Would it be possible for her to be loyal to both brothers, or does she have to choose?
Chew on This
Dominick takes care of Thomas not because he's his brother and he cares, but because his mother made him promise he would.
Thomas's illness is exacerbated by the fact that almost no one is loyal to him—everyone has betrayed him (Ray, Dominick, his doctors) or died (Ma). Dominick tries to regain his trust to keep him stable, seeking loyalty by being loyal.