Symbolism, Imagery, Allegory
There are three large buildings that play a role in Stitches. Let's take a look at them and what they represent one at a time:
The Dream Temple
After his surgery, David begins having a recurring dream about a church. He walks through the door and finds a series of smaller doors. When he crawls through the last one, he finds a large, gutted temple full of rubble. The first time he has the dream is in panel 3.228, after imagining that his parents will be able to hear the screaming in his head. When he wakes up, he's underneath the kitchen table.
We're not exactly dream analysts here at Shmoop, but we'll take a stab at interpreting this one. First of all, there's the parallel with Alice in Wonderland, in which Alice discovers she's too big to fit through the door to the garden. And while we've got more to say on Alice in Wonderland as a symbol elsewhere in this section, it's worth noting here that this dream is part of that symbolic trajectory within Stitches.
David first has the temple dream after imagining he lives inside his own mouth. Crawling through smaller and smaller doors could represent limitation, such as the loss of a social life and the loss of trust in his family. When he reaches the gutted, unusable room, then, it can be seen as representing his lost voice, which is a result of having someone physically destroy a part of him.
The dream temple, then, is sort of a symbol for David's body. With the loss of his voice, he becomes trapped inside it. And while a different family might double down their efforts at communication after such a traumatic development, David's family does not—a response which only serves to amplify the destruction of the loss of his voice.
The Boarding House
When David moves out of his parent's home at age sixteen, he moves into a large, dilapidated boarding house. There, he begins to paint brick walls and closed doors "without realizing how perfectly they represented my blocked state" (4.154). Thanks, David, for unpacking this symbol for us.
The house is so large it has a tower room, in which a couple named Bill and Gina live. The floor of the tower room has collapsed, so they're forced to live on the edge of the hole, sleeping on a bare mattress. Here we have another formerly grand building in rubble, an echo of the dream temple. Call it a symbol of a symbol, folks.
The Insane Asylum
The last large building we see in Stitches is the mental institution in which David's grandmother died. It represents all David's worst fears; it's the place where the worst of his relatives ended up. When David sees the building in his final dream, it, too, is large and grand, and could even be mistaken for a castle from a distance. However, like the temple and the boarding house, it's old and dismal.
When David recognizes the building, he refuses to go inside, even in his dreams. It's a visual representation of everything he fears, but his subconscious is now strong enough to resist. Insofar as his fears all go back to his family, then, we can understand buildings as symbolizing his familial structure—and his decision not to enter the mental institution at the end as a refusal to call this house home any longer.