Aza addresses the reader and says she first realized she might be fictional when she was in high school. She considers that there are forces much larger than herself at work that decide when her lunch period is and considers that if those forces had assigned her a different schedule, her story would've turned out differently. However, it's at this point that Aza begins to realize that a person's life is a story told about the person, not something the person tells, try as a person might to be the author of his or her own story.
The novel begins with Aza emphasizing how little control she feels she has over her thoughts and her life. She's entirely at the mercy of forces larger than herself and sees no space or opportunity to take on and challenge these forces. By placing this idea in terms of one's life being a story that's told about them, it suggests that literature and language are going to be other important concerns for Aza.
Aza describes sitting in the cafeteria and listening to the din of the many loud conversations going on around her. As she sits, she thinks that everyone thinks that they're all heroes in their own personal epics when in reality, they're all the same. She's eating a sandwich and tells the reader that she finds eating disgusting. She tries not to think about it. She's sitting with Mychal, an artistic friend, and Daisy, her best friend since elementary school. Aza shivers as she realizes she can hear the bacteria in her stomach digesting her sandwich.
Aza’s suggestion that she doesn't see herself as the hero or protagonist is ironic considering she is the protagonist of this book. Again, by putting these thoughts in terms of literature and storytelling elements, Aza tries to create a framework that will help her understand herself. Storytelling provides her with a system for organizing different people and events in her life.
Daisy interrupts Aza's reverie by asking if she went to camp with Davis Pickett. Aza assures Daisy she's been listening to the conversation, but instead thinks only about the sounds of the bacteria inside her. She explains that humans are made up of about 50% bacteria. Aza's palms start sweating. She tells the reader that she struggles with anxiety, but feels that being anxious about bacteria isn't at all irrational.
This is readers’ first introduction to Aza's mental illness: she struggles with anxiety and a fear of bacteria. These fears will guide and dictate her actions throughout the novel, as her fear of bacteria increasingly complicates her questions about identity and control.
Mychal explains that Davis’s dad, Mr. Pickett, disappeared mysteriously the night before a police raid was planned to bring him in on charges of bribery. Daisy seems to want Aza to say something, but Aza can't figure out what because she's worried she has contracted a parasitic infection. Mychal goes on to tell Daisy about his new art project that uses Photoshop to average people's faces. Aza thinks his idea is interesting and wants to listen, but is too distracted by the sounds of her stomach.
Mychal's project of averaging people's faces shows another character grappling with questions of identity and selfhood. Just as Aza struggles to understand what it means to be one person if people are made up of other organisms, Mychal toys with the idea of a single portrait made up of pictures of other people—a portrait of one person that, like all people, contains multitudes.
Aza explains that excessive abdominal noise can be a symptom of an infection from the bacteria known as Clostridium difficile. She pulls out her phone and rereads the Wikipedia article about C. diff. Aza has no other symptoms, hasn't been hospitalized, and has no fever, but her "self" reminds her that she doesn't have a fever yet.
Here, we learn that Aza has a voice in her head that feeds her anxious thoughts. In this way, she is made up of two different beings or voices. Readers hear "her" voice, and meanwhile she hears a voice that is also her, but a more intense and fearful version of her.
Aza only partially hears Daisy make some suggestions to Mychal about his art project. Aza wonders if "me" should still be considered a singular pronoun if half her cells aren't even her cells. She explains that as a kid, she began opening up a crack in her finger. The crack opens easily now and is always bandaged, but sometimes Aza worries she has an infection. When this worry starts, Aza splits the crack open, drains it, and re-bandages it. She begins this process at the cafeteria table as Daisy asks Aza if she's noticed her newly-pink hair. Aza manages to call Daisy's hair bold.
Aza exists in a liminal space between the fear and worry that goes on in her mind, and the real world going on around her. This creates a sense of chaos and a feeling that she's not in control, which leads her to repeat obsessive rituals like splitting open the cut on her finger. By performing this ritual, Aza creates something that she knows she can rely on: the cut will always be there for her to fuss with, and it therefore provides her a sense of control.
Daisy turns back to Mychal and Aza fears she's going to vomit. Daisy asks Aza if she's okay and Aza nods, though she begins to sweat. She puts a new Band-Aid on her finger and practices her breathing exercises her therapist, Dr. Singh, taught her to calm herself down. Aza checks the "Human Microbiota" Wikipedia article again, though she knows Dr. Singh would tell her not to. She tells the reader that spirals never end, they just keep tightening.
Checking Wikipedia is another compulsion of Aza's. Like re-bandaging her finger, it gives her a sense of control over her fears by giving her language and information to understand the bacterial world inside of her. Notice that when she describes spirals here, she describes them as tightening rather than spreading. For her at this point, spirals only go one direction: inward. This is expressive of her general mental state, in which he anxiety causes her to feel out of control.
As Aza gets up to throw her sandwich away, Daisy asks Aza (calling her Holmesy, and refers to her by this nickname for much of the novel) if she's okay again. Aza only says "thought spiral" in reply. Daisy suggests they hang out later as a classmate informs her that her pink hair is also staining her shirt pink. Daisy brushes off the classmate and tells Aza that they'll watch a Star Wars movie before she has to go to work. Aza agrees but can't think of much else to say as she continues to spiral anxiously. She thinks that she remembers being at camp with Davis. The two of them didn't talk much, but they looked at the sky together.
Aza's extremely anxious internal world very clearly keeps her from fully experiencing the world around her. This continues to create the sense that there are two Azas: the one inside her head, and the Aza that others see. Aza already has some of the language to describe her inner world to others (telling Daisy she's in a thought spiral), which helps integrate these two selves, though they're still very separated at this point.