While a non-fiction memoir does not have any artificial motifs, "the Bump" (as the family comes to call it) on Johnny's head serves as a recurring physical and often emotional indication of his health. It changes throughout his illness, growing and subsiding, developing a second bump, and retreating into a concavity. Each time it transforms, the doctors believe new things (not always true) about Johnny's condition. After a doctor is unable to extract much fluid from the Bump near the end of his life, Johnny feels its stone-like rigidity and weeps; its unyielding position says more to him than any negative doctor's report could. The Bump is also the only obvious indication that something is wrong with Johnny, as he has to have his head shaved periodically for operations and must dress it with bandages every day.