Billie Jo has a nightmare that draws together all the hardships and tragic experiences she's been through, up to and including the fire accident. In the dream, she's walking home in a dust storm, the dust, grit, and sand coating every part of her body.
She arrives home to find that the dust has blown into every nook and cranny of the house because Ma failed to cover the floors and windows.
After discovering the piano covered in a pile of dust, she cleans it off and tries to play, but it only omits a discordant, disturbing noise. Daddy asks Billie Jo to bring a pail of water because Ma is thirsty—and when she drinks the water, she gives birth to a baby made of fire.
Frightened, Billie Jo runs away to the neighbor's abandoned farmhouse and finds a piano inside. She plays, and the music sounds like it should, unlike the noise at home. So she hauls the piano back to her own house, only to discover that her hands are swollen, painful and weeping with pus.
She wakes up to find that really, the nightmare wasn't a dream after all. The accident really happened—and her hands are in dire pain.