Valentine's Day arrives causing Melinda to remember past Valentine's Days. She remembers that in grade school, everyone got a valentine card and celebrated the holiday openly. In middle school, crushes were shared covertly through an intricate network of friends who passed messages to each other. When she gets to her locker in the morning and sees a valentine taped to it, she is so shaken up she can't read it and goes directly to biology class instead. She wonders and kind of hopes the note is from David. As they sit together in biology, Melinda pulls at her thumbnail, causing it to bleed. David hands her a tissue, inspiring her to write him a thank you message in her notebook. They pass the notebook back and forth for the rest of class, sharing messages and drawings. Melinda's hopes are crushed after class when she opens the valentine to find a message from Heather, thanking her for being so understanding about their ended friendship. Melinda, heartbroken and lonely, hides and cries in her janitor's closet.
The next time Melinda ditches school, she misses the bus stop for the mall and winds up at Lady of Mercy Hospital. She wanders the halls, lounging in waiting rooms and enjoying the cafeteria food. She considers stealing the green gowns given to patients and finding an empty bed to sleep in, but then decides she is not really sick and does not really belong there.
In these sections, Anderson once again uses motifs of memory, physical wounds, and naming to characterize Melinda's internal conflict. In "Cutting Out Hearts," Melinda's memories about Valentine's Day are very similar to her memories of fifth grade and the apple orchard. All of these memories are characterized by a sense of innocence and security. For instance, in Melinda's memory of grade school Valentine exchanges, she takes pleasure in the fact that everyone gave and received notes — no one was left out, as she is now. Through these memories Anderson is able to show us Melinda's desire to have her feeling of innocence returned to her.
Secondly, Melinda's torn thumbnail is another item in the ongoing motif of her self-inflicted wounds. In this section, Melinda tears her nail as a way to distract herself from her concern about the Valentine she received and her feelings for David. David notices her bleeding thumb and helps her by giving her a tissue. The exchange of messages that follows is what makes this instance of self-harm different in that, instead of it being a sign others ignore, it is a sign to which someone (David) compassionately responds. Through David's kind response to her pain, Melinda experiences a brief spell of happiness and emotional connection.
The name of the hospital that Melinda finds, Our Lady of Mercy, symbolizes Melinda's deep need for mercy. For much of Melinda's visit to the hospital she seeks out mercy. She visits various waiting rooms, eats in the cafeteria, and contemplates stealing a hospital gown. Yet none of these activities truly make her feel better — she even goes so far as to conclude she is not sick (well, not the kind of "sick that you can see") and does not belong there. Thus, Anderson indicates that the kind of mercy Melinda needs is not necessarily physical, but emotional — perhaps even spiritual.