With its first sentence, the author dives into figurative language, serving up not one, but two similes in tandem ("like trailer trucks," I was tempted to add), with the heroine "scrubbed clean" like "a sky after a storm" and/or like "a tub after a good grouting." Though made of concrete things like storms and tubs, since they are figurative and not literal similes and metaphors aren't terribly solid: they're symbols for things, not things themselves. And so this opening sentence puts us firmly in abstract territory.
Each of the two similes presents problems, with the problems compounded by their union. First, what is "scoured clean"—the woman's body, or her mind? Presumably her mind, since we're told nothing about her body in the ensuing paragraphs. And since readers yearn for concrete things, whoever reads these words will likely picture a woman whose flesh has been"scoured clean."
If, on the other hand, her mind has been scoured "like the sky after a storm," does it help, then, to compare it to "a tub after a good grouting." Does grouting a bathtub scour it? Similes and metaphors are like those little step stools people keep to reach high shelves in kitchens, to be used when needed to help readers reach a solid impression or image. Here the grouted tub clashes with the storm-scoured sky and isn't likely to help anyone.
The next line gives the first hint of action. "Ana gates was home," but as verbs go none is less active or concrete than the verb "to be." No other action is indicated by the opening paragraph.
The last lines of the opening paragraph give us the condition of Ana Gates' mind, with her unable to decide how she feels about being back home. On the one hand "she should feel good about being back"; on the other Fairview Clinic was "a haven for sanity." But then it's "hard to know what feeling good means," though "she's alive and that might eventually count for something."
"Scoured clean as the sky after a storm" is one way to describe the mental state evoked by these thoughts. "Foggy headed" is another. For sure Ana Gates is confused, and it might be best to let her confusion speak for itself through solid actions and descriptions.
Unlike the first, the second paragraph presents a concrete and vivid picture of Ana in her present circumstances, bundled up in her afghan and looking out the window of her lakeside home while eating breakfast, pulling her breakfast toast apart. But here, too, the author feels compelled to resort to bald abstractions ("Mornings were still rocky") instead of relying on the moment at hand to speak not only for itself but for the character's general state. If Ana feels "jittery," her coffee cup might tremble as she brings it to her lips. If she dreads mornings, her dread might be evoked through a description of her breakfast from deep in her point of view ("the bread crusts looked as appetizing as strips of cardboard."). Only when she swallows the toast and the "warmth spread[s] across her belly," do I at last enter into Ana's body—and, through her body, her psyche. But the effect is undermined by the paragraph's concluding clause which generalizes about Ana's cramping and her miscarriage from beyond her present state, and not from her viewpoint, but from that of an intrusive author.
Here, then, is what a more grounded version of the same opening might look like:
Three days after arriving home from Fairview Clinic, Ana Gates sat at the kitchen table of her summer cottage, pulling her toast apart and sipping black coffee while watching a squadron of Canada geese skid and flap across the surface of Lake Waramug. As she brought it to her lips the coffee cup trembled. With each sip she braced herself, expecting a jolt of pain when the warmth reached her belly. But the moment passed, and she sighed with relief and gratitude. Ever since she'd arrived home from Fairview, the cramps had been coming less frequently.There's no set rule against abstract openings. In beginning Great Expectations with, "It was the best of times, it was the worst of times," Dickens no doubt had good reasons for favoring broad abstraction over concrete events. Through a series of parallel constructions Dickens settles his readers into an epic whose events span generations and confront life's paradoxes across a broad spectrum. Without narrowing his focus, he could hardly have opened with a singular event.
The crusts of toast on her plate tasted and looked like cardboard. She shoved the plate aside, took up the notebook that Dr. Beckman had presented her with on her last day at the clinic, slid the slim fountain pen (also Felix's gift) from its spiral binding, and pressed its nib to the blank first page. "Write about what you feel now," Felix had suggested. So—what did she feel now? Emptiness. Cold. She drew the crocheted afghan more tightly around her shoulders. Even this late in May the winds off the lake turned the cottage into a refrigerator...
But a novelist of humbler ambitions does well to consider whether static abstractions are truly the best foot forward into his or her story.