The question of magic or the mystical in Louise Erdrich's Love Medicine is distinguished between what is real magic and what is perceived as magic.

In the chapter entitled "Saint Marie," Marie Lazarre tells of the time when she was a young girl that she entered the convent. At age fourteen, Marie really doesn't know what she is getting into. As she puts it, raised in the bush, Mass was one of the few times she was able to get to town (other than school), and she wanted that more than anything. So she goes to the Sacred Heart Convent. She believes that this place will make her holy:

I was that girl who thought the black hem of [Sister Leopolda's] garment would help me rise. 

With these illusions, Marie joins the nuns and comes under the "care" of Sister Leopolda—a nun who sees Satan everywhere, and who becomes convinced that Satan is after Marie. Sister Leopolda begins to fight Satan for Marie...or that is what Sister says, and how Marie also sees it. She listens to Sister's words and fights Satan for the promise of being a nun and receiving Sister's love...and to one day be a saint.

In truth, Sister Leopolda is abusive. At one point, to burn Satan out, she pours scalding water on Marie's back, while pinning her to the floor with her boot. Later she puts a salve on Marie's back, but Marie defies the woman and accuses her of being caught in Satan's snare. Marie runs to the kitchen and Sister asks for her help removing the bread. In a moment of seeming madness (and in great pain), Marie tries to kick Sister into the oven and fails. Sister stabs Marie through the hand with the bread fork and knocks her unconscious.

When Marie awakes, she is being "worshiped." Sister has explained to the nuns that Marie's wound is a stigmata: a holy manifestation of the Passion of Christ. It is, of course, a lie, but Marie enjoys the power she feels, seeing Sister's hate, but knowing...

...she was over my barrel now.

However, soon Marie loses her sense of victory, instead feeling pity for this old, perhaps demented woman. There was no mystical experience for her at the convent: only a battle of wills with a woman who was brutal and obsessed by an evil she suspected all around. This shows that some experiences are not mystical at all. Here it is simply a young girl's perceptions.

However, in the chapter entitled "Love Medicine," there is true magic to be found. Grandma Kashpaw took in Lipsha Morrissey as a child. He cares deeply for his grandparents, and he (and others) knows he has a gift:

I know the tricks of mind and body inside out without ever having trained for it, because I got the touch. It's a thing you got to be born with. I got secrets in my hands...

Lipsha is able to heal with his hands. He has been known to do so with great success—though he cannot heal his grandfather's dementia.

There is even the magical in his grandmother, who was...

...constantly being told things by little aggravations in her joints or by her household appliances...someplace in the blood Grandma Kashpaw knows things...

With Marie, she believes in something that is not magical, but influenced by people. For the Kashpaws, their magic is a reality—something that is felt and the results of which can be seen. Erdrich doesn't espouse magic for its own sake. Like love, there is the speaking of it, and then there is the true manifestation: what one feels for another. Erdrich makes a clear distinction between the two kinds of "magic" in the book.