The story of a woman artist's slow decline into dementia and death as told through the eyes, words, and reflections of her philosophy professor son. Through his memories of their 1950s life together, he reconstructs a speculative analysis of her early married life with his soil-scientist, Russian-immigrant father.

The one older brother becomes a neuropathologist who investigates the very disease that slowly strips their mother of herself. Their father tends to her growing needs at the family farm, but he dies suddenly and she must be placed in an institution where one nurse alone seems to respect her dignity.

The brothers' rivalries and misunderstandings are recapitulated in their different responses to their father's death and their mother's illness: the physician retreats to scientific explanations of the "scar tissue" in her brain; the philosopher looks for evidence of personhood and for reassurance that death should not be feared. His obsession with his mother's condition stems from a deeply felt sense of guilt; it destroys his marriage and condemns him to depression, hypochondria, and shame as he creates and diagnoses the same illness in himself, long before it can be detected by doctors.


A hauntingly beautiful narrative, written on several levels from flashback, to pop-scientific journalism (including allusions to the writings of Oliver Sacks), to academic speeches and essays on the nature of Death, composed by the protagonist for his students, public, and publishers. The novel traces the difference between "disease," as defined by various professionals who make an appearance, and "illness," as it may be experienced by a patient and a family member.

The protagonist contemplates the various permutations of disability through an encounter with his brother's patient, Moe. The opposite of his mother, Moe has an intact mind in a body ruined by amyotrophic lateral sclerosis (ALS). Which disease would you rather have? In grappling with his own identity, aging, and fear, the answer "neither" seems clear; yet, the depressing fact that some disease is inevitable invokes the attempt at control offered by choice.


Scar Tissue was shortlisted for the 1993 Booker Prize.



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