In Louise’s Erdrich’s novel, the intertwining strands of family love and obligation provide much of the plot structure. The ways that individuals move away from their birth families and form new families, and the kinds of family-like but socially unsanctioned relationships, are equally important for Love Medicine’s characters. Erdrich also implies that those who struggle to reconnect with their families, or are left isolated or alienated from social bonds, often feel incomplete; some of those characters completely rupture their ties through taking their own life. The extent to which community, especially through shared Native American heritage, can expand or substitute for immediate kinship relations is also explored throughout the novel. We see this especially in Gerry Nanapush as he embarks on the journey of political activism through the American Indian Movement (AIM).

Going back to the earlier generations, Erdrich shows how one person’s decision can have lasting consequences. June Kashpaw’s literal inability to reach her home, connected with her emotional and psychological distance from Native life, sets in motion some of those effects. Although in future generations, Albertine pursues a “white” occupation of nursing, in striving to learn her heritage, the uncomfortable truth is not always welcome.

Along with the Kashpaws, the other main lineage that Erdrich traces are the Lamartines. The devoted but imperfect matriarch Lulu Lamartine, for example, has complex relationships with her sons. When Henry returns damaged from the war, his re-entry problems and ultimate suicide affect his brothers, especially when they find they cannot be honest with their mother, thus confirming the limits of family bonds.

This novel is all about family: the legacy a family can leave behind, and the influence of family members upon one another. Love Medicine is a novel that contains a series of related stories about different generations in the family. In the stories set during the contemporary era, characters refer back to their older relatives, or to some who lived generations before. The stories of the various family members sometimes provide life lessons, or romantic or thrilling tales of love or survival, or cautionary tales on what not to do (for example, when Nestor tries to work love medicine on his grandparents, he freely admits he did not follow the old ways, and his laziness causes him to do a poor version of the ritual, which he blames on making their situation worse).

The deep connection of the family ties is evident in every character's story in this volume, so it is a constant theme. But the family legacy is also its own sort of folklore, in that generations repeat the stories and treasure them as being part of their own individual experience, even if they were not personally involved. There is a sense of the family stories being important, a tradition to be carried on, and in some cases the characters are heroes or heroines, having lived through trying times (like the story of the winter of 1918, when the family was starving and Eli must learn to hunt elk) or performing great acts of selflessness or bravery. But there are also villains in the family storyline, and these are considered as significant as the admirable characters, perhaps because of the lessons their stories impart.