1.　In this novel, Matt breaks up with Katie by leaving behind a diary written by his wife Suzanne for their young son, Nicholas. Suzanne pours out her feelings about Matt, Nicholas, about her joys of being a country doctor in Martha's Vineyard, about being a wife and mother, about her love for the Island and for the sea. Matt tells Katie he can't see her anymore, but leaves the diary for her. Was he courageous or cowardly? (We later learn that he doesn't like to talk about sad things.) What is the best way to tell a new partner about a past life? Should he have put Katie through this agony?

2.　The lasting lesson in　Suzanne's Diary for Nicholas　is the story of five balls. In it Life is a game in which you are juggling five balls. The balls are called work, family, health, friends, and integrity. Every day you keep them all in the air. Then you come to understand that work is a rubber ball. If you drop it, it will bounce back. The other four balls are made of glass. When dropped, they will probably shatter. Suzanne's glass ball was her health. Is there anything she could have done to keep all the balls in balance? Should she have given up more to save her life? Stopped being a doctor, hired help for Nicholas? Gone to other specialists?

3.　Matt is the forgotten one in this book, because we never really get to know how he feels. The diary is written by Suzanne and the story is about Katie's reaction to the diary. He's a complex guy with a library filled with classics. He writes poetry, paints houses, went to an Ivy League college. He likes to dance and race cars. He's a caring father and husband. In fact, he seems to be too good to be true! Yet like many writers, he put much of his emotion in his writing, as we can tell from the last anguished chapter in the diary. How can we help people like Matt who hurt, yet are so emotionally blocked that they seem not to need any help?

4.　Katie is an enigma. She's a sensible, hardworking woman. She lives by the country creed she was taught: Hands to work; hearts to God. Yet her love for Matt blinds her and causes her usual caution to go out the window. Why did she get pregnant without a certain future? Having children wasn't yet in their plan. Of all the characters in the book, it seems as if Katie profits most from the lessons of the five balls. She is trying to find balance, but it's a tough juggling act because she's put her whole life into her work. Which ball is most likely to shatter for you, and how can you stop this from happening?

5.　So many books about love and loss take place on peaceful islands surrounded by idyllic seacoasts, salty breezes, and ocean sounds, Alice Hoffman's Illumination Night comes to mind. Could the story have the same power if set in landlocked Iowa or New York City streets?