The novel switches between past and present, showing Setsuko's transformation from an idealist who supported the war to a hardened realist who contracts tuberculosis.
[1] Marilyn Jeanne Miller wrote for World Literature Today that the novel has a "compelling story and subtle craft in telling will speak to everyone".
She also wrote that the use of a notebook-based narrative was "fine-honed into a marvelously vibrant, gripping fictional technique.
"[3] Kris Kosaka of the Japan Times wrote that the novel "realistically portrays [...] conflicting emotions" when paralleling Setsuko's experience with Naomi's.
[2] Charles Solomon of the Los Angeles Times notes that the letters, memories, and conversations between Naomi and Setsuko that make up the novel reads like "a mosaic wrought from the shattered pieces of the heroine's tragically brief life.