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Greg first interacts with Rachel in Hebrew school to make her best friend, Leah, jealous. Greg likes Leah and believes if he can show her how kind he can be to her friends, Leah is certain to fall in love with him. Leah does fall in love, but with the idea of Greg and Rachel as a couple. They’re cute together, and he makes her laugh. But to Greg, Rachel’s big teeth and frizzy hair are no match for Leah’s beauty.
When Greg first reconnects with Rachel after her diagnosis, her big teeth and frizzy hair are still predominant, as is her unique snort-laugh reaction to just about anything Greg says. She is familiar to Greg, and after an awkward start, they fall into a relatively easy rapport.
During her chemo treatments, Rachel loses her hair, so Greg comes to associate her with her lumpy, bald head or the fuzzy hat she eventually uses to cover it. The sicker she gets, the less he seems to recognize her physically, especially when she becomes too ill to laugh. When she does laugh, Greg notices she must reorganize her face to work with the pain it causes her, and the noise she emits is nothing like the snorts he is so used to hearing.