In storytelling, the symbolism of the color red is complex and pervasive. Ancient myths, songs and fairy tales utilize the color red frequently. It denotes blood, fire, passion, sexuality, love, anger, war and death, and in general is associated with powerful human emotion.

One of the central events in this novel is Lipsha's attempt to work love medicine on his grandparents. He recalls that geese mate for life and he thinks this is the proper medicine to reunite them. But he gets lazy and instead of hunting for geese, he buys frozen turkey hearts from the Red Owl supermarket. The color red has a double symbolism here: first, the association of the color red with hearts, the romantic Valentine's Day version of this symbol of human love. In Lipsha's mind the idea of what hearts mean is more important than the authenticity of the love medicine; this might indicate he puts a more contemporary spin on tribal magic, and his idea that "any hearts will do" shows his connection to tribal ways is not as strong as he may think. He is not willing to put the physical labor and care into the medicine working (i. e. hunting the geese killing them and removing their hearts). The fact that the hearts are frozen also works symbolically; red suggests heat and life, but frozen hearts are more likely to be be blue or purple. These hearts cannot work in love medicine.

The color red is also in the name of the store he goes to: Red Owl (a grocery store chain in the midwest). In Native American mythology, owls have a complex symbolism; their appearance can mean death, or wisdom. They are also powerful hunting animals, and this is the opposite of the effort put forth by Lipsha, who is too lazy to hunt for wild geese. The death of Nector as a result of the love medicine is ironic, but also fitting, and Lipsha feels guilt for having betrayed his grandfather and his heritage.