Contrary to what the title might suggest, this is not a memoir of drug addiction. Writer and poet Tom Andrews has hemophilia, and codeine is the analgesic he requires during excruciatingly painful internal bleeding episodes. In this diary, begun while recovering from a leg injury, Andrews reflects on his particular experience of life and hemophilia. He makes clear that " . . . hemophilia is only one of the stories my life tells me . . . " (p. 29)

The memoir interweaves the author's physical, emotional, and existential journey through the convalescent period with flashbacks of childhood and his relationship with his ailing brother, now dead, to whose memory the book is dedicated. Brother John's fatal illness with kidney disease shaped--and continues to shape--Tom's life as much as did the hemophilia.

On the one hand their parents' concern for John took Tom out of the spotlight and allowed him to pursue his own interests. These extended to motorcycle racing, playing in a punk band, and setting a record for continuous hand clapping--at age 11--that was recorded in the Guinness Book of World Records. On the other hand, Tom's guilt over surviving John's early death may account for an almost reckless disregard of his own precarious physical condition. A constant subtext is the deep grief and abiding love of the living brother for the dead one.

But this is not a mournful book. It is an engaging memoir that provides unusual access and insight into the world of hemophilia, especially with regard to the painful "bleeds." It is the sense of exile and separation from others that is most disturbing for Andrews when in the throes of unrelieved pain. He takes us through the mental concentration required to endure this pain and the liberating relief to mind and spirit provided by codeine. Memory, perception, and writing provide the additional resources he needs to re-connect with the world.


The journal project is an example of what the author finds necessary to do when he is recovering from a serious bleed--"to occupy my mind . . . so that it won't seize on itself, blotting out all light and wonder and possibility." The result is this well-written, witty, observant, informative, and highly individual memoir. It is an exploration and documentation of a (still young) life being lived to its fullest capacity, and of a mind continuously engaged with both the internal and external world.

The down side of this experience elicits one of the (few) indictments that Andrews makes of the medical profession: "Of all the transactions I've had over the years with doctors, the ugliest and most humiliating by far have been those concerning pain and pain medication. There is a ruthless dialectic at work in the transaction." (P. 73) Physicians and prospective physicians would also do well to read the chapter, "The Island of Dr. H." (pp., 155-161) on the hostile interaction and struggle for power that can occur between patients and medical experts.

Other particularly astute observations are developed in the chapters, "Ars Moriendi" (pp. 135-137) and "Thirteen Ways of Looking at My Mother and Father" (pp. 187-207). In the former, a doctrinaire, insensitive priest tries to administer last rites to a woman who resists being labeled a sinner. In the latter, Andrews describes his family's complex parent-child relationships, their evolution though time, and the special superimposed narrative of mourning imposed by his brother's illness and death.


Little, Brown

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