In her best-selling novels, Emily Giffin asks questions most of us can’t imagine answering. What if you fell in love with your best friend’s fiancé—and he loved you back? What if you and your husband agreed not to have children—and then he decided he wanted a baby? And what if you realized you had a shot with the “one that got away”—after you were happily married to someone else?

It’s tough, provocative questions like these that inspire Giffin, and have laid the groundwork for blockbusters like Something Borrowed (soon to be a film—more on that here), Baby Proof and Love the One You’re With. A single lawyer on the cusp of 30 when she wrote her debut novel, Giffin has matured along with her protagonists. Now, in her fifth novel, Heart of the Matter, she explores what happens to a marriage when another woman enters the picture.

“I don’t think my books are very plot-intensive,” Giffin says during a lively phone call to the Atlanta home she shares with her husband and three young children (read more about how Giffin balances work and family life). “They are much more about how situations are described and how events unfold. I write about characters who are unsympathetic in some ways—or if they’re not unsympathetic, they’re at least making unsympathetic choices. And I think that’s very true to life. If you sample the people in your life, even ones you respect and love, you can go through pretty much all of them and think of a time when they’ve made a choice that you wouldn’t have approved of, or you would have strongly discouraged. But that’s what makes us human, the fact that we can make mistakes and we can hurt the people that we love, but those sorts of offenses don’t make us unlovable as a person.”

And that’s the issue at hand in Heart of the Matter: Can you make mistakes, hurt the people you love and come back out on the other side?

Nick and Tessa Russo appear to have it all; they are a happily married couple with two young children living in an upscale Boston suburb. Nick is a renowned pediatric surgeon and Tessa has recently left her career to raise their children full time. They love each other, their life together and their children. But when a freak accident at a neighborhood sleepover lands six-year-old Charlie Anderson—and his shell-shocked single mother, Valerie—in the hospital under Nick’s care, everything changes. Nick becomes deeply involved in Charlie’s care and recovery and finds himself growing more and more attracted to Valerie, while Tessa struggles to retain her identity in her new role as full-time mom. Valerie knows she has feelings for Nick, but she is unable to distinguish actual romantic desire from her appreciation and affection for the man who saved her son’s life. And though she can’t seem to shake her feelings, Valerie is not the type of woman who would ever want to break up a marriage.

Giffin was inspired to write about the complex doctor/patient bond in Heart of the Matter after she attended a charity function at a children’s hospital she supports. At the benefit, a young mother described the care she received when her son was born with a severe facial deformity that required countless surgeries. The moment she delivered her baby, the birth room fell silent, and the woman knew something was wrong with her son. “It was really dramatic as she was telling her story,” Giffin says. “She described the surgeon who came into the room. He introduced himself as one of the leading plastic surgeons in the world and said, ‘I’m here to take care of your son,’ and she was just overcome by instant gratitude and affinity for this man who was basically saying, ‘I am going to save your son—and I’m going to save your family.’ And I just thought to myself, oh, how close she must have felt with him. Because in the beginning, I didn’t know for sure I was going to write about infidelity, it was going to be more about a marriage in crisis. But that was the inspiration for Valerie’s story.”

Told in alternating perspectives—Tessa in the first person and Valerie in the third—Heart of the Matter is an exercise in the “will they or won’t they” scenario. In fact, more than half of the novel goes by before we learn if anything ever happens with Nick and Valerie. The book is really more about the “what if” questions that arise in a complicated situation like this—for Tessa, Valerie, Nick and their families—than the actual act of infidelity.

Giffin says, “It’s one of those stories that seems very easy to interpret—that if this happens, then this happens. Infidelity is not that uncommon, but it’s something that people—particularly women—fear. It’s discussed all the time and some people feel that if it were a strictly physical thing, well, you could get over that. Others feel, well, if you’re going to betray, you better feel something. And I think showing both narrative sides of the story is a way to highlight the complications of marriage, how complex infidelity can be and how really the grass is always greener. You can show that a lot more effectively by having two narratives. And I wanted to be closer to one of them. I think the book is a bit more about Tessa and Nick as individuals, and their marriage. That’s why I chose to write Tessa in the first person.”

Because the reader is privy to both Tessa’s and Valerie’s perspectives, we know more about what’s really happening at any given moment than either woman does. But we still don’t know whether or not Nick will cross the line with Valerie, or what might happen if he does. And that’s the beauty of Giffin’s work: You think you know what’s going to happen. You think you know what you would do if it happened to you. But really, you have no idea.

“Life is not black and white. And no two situations are ever alike,” Giffin explains. “Every relationship is so different—every friendship, every mother/daughter relationship, and certainly every marriage is different. When people make missteps or when people betray each other or make mistakes to hurt each other, it’s never the same. Just as there is no relationship that’s the same, no betrayal is the same. Ultimately the story is about forgiveness, and down the line, everyone has someone to forgive.”

Heart of the Matter is a messy, complicated, often uncomfortable portrait of a marriage—and two families—in crisis. But it has everything readers love about Emily Giffin’s books: the heart, the empathy, the truth. “I have plenty of vices, but one thing I think I do right in life is I try to look at things from someone else’s point of view,” Giffin says. “If you can feel empathy for people, you’re a lot farther along in understanding and getting along with people—and having a greater understanding of yourself.”

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