While this is a work of fiction, Ko was inspired by real-life stories of immigrant families separated by deportation and the complex realities faced by undocumented immigrants in America. The novel emerged from her desire to explore the human cost of immigration policies and cross-cultural adoption.

The alternating perspectives between Daniel/Deming and Polly provide a comprehensive view of both characters' experiences, allowing readers to understand both the child's sense of abandonment and the mother's impossible choices, creating a more nuanced and empathetic portrayal of their situation.

The title works on multiple levels, referring not only to those who leave (like Polly) but also to those left behind (like Deming). It explores the complex dynamics of departure and abandonment, suggesting that everyone involved in such situations becomes a "leaver" in some way, whether by choice or circumstance.