Brief Book Reviews: November 2025

Popular Books Relevant to Mental Health

Autobiography of a Face

Lucy Grealy; Harper Collins, 1994

256 pages; $10 (paperback)

Reviewed by Edmund S. Higgins, MD

Lucy was 9 years old when she fractured her jaw in dodge ball. The bones failed to heal, and she was eventually diagnosed with Ewing’s sarcoma, a notoriously aggressive cancer in the early 70s. For several years she suffered through numerous surgeries, grueling regiments of chemotherapy, and radiation. When she was 14, the doctors were pleased to pronounce her cured, but the price for survival was a disfigured face.

Lucy is an engaging writer who presents a captivating story about her struggle with her appearance, and what seems like endless ridicule from others. Why are middle school boys so mean? The drunks in London were equally cruel, and their frontal lobes had supposedly myelinated.

Appearance is a difficult topic to discuss. Of course, beauty is in the eye of the beholder, but Lucy’s disproportioned jaw was obvious to everyone—and she repeatedly saw the shock, or even revulsion in stranger’s expressions. Lucy calls herself “ugly,” a word so onerous when it comes to personal appearance, we rarely hear it spoken.

How do we help someone who is overtly disfigured, not just from cancer, but all the other conditions that affect one’s appearance? Lucy comments that exposure did not help. “No matter how much I braced myself, the words stung every time they were thrown at me.” Our medications, although not indicated for such treatment, can help some people become more tolerant of the insults of life. Lucy thought cosmetic surgery was the answer, and endured over 30 surgeries, each with unrealistic expectations.

Truth & Beauty: A Friendship

Anne Patchett; HarperCollins, 2004

257 pages; $8 (paperback)

Reviewed by Edmund S. Higgins, MD

Anne and Lucy attended the same college. Then roomed together at the Iowa Writer’s Workshop while getting their Master’s, where they developed a close friendship which lasted for decades.After Lucy’s death, Anne wrote her experience of being with Lucy.

This pair of books offers a unique, contemporaneous perspective on a single life—a memoir and a biography. The first gives the internal perspective and the latter external observations. If you are going to read them both (my recommendation), read Lucy’s book first.

Anne’s biography complements Lucy’s memoir, but provides a different perspective on Lucy’s struggle, and while loving, is not especially flattering. Lucy comes across as needy, self-absorbed, and irresponsible.

From our perspective, this combination of stories is a reminder that our most common method of making a diagnosis (self-report) is fraught with problems. Although we do not know how Lucy would present in a clinical setting, in her memoir she obscures her use of sex to substitute for social connectedness, and only hints at her substance abuse. Her repetitive and exhausting requests for assurance (“Do you love me? Am I your favorite?”) are barely mentioned.

This is not to criticize Lucy. We all harbor distortions of our reality—seeing ourselves in the best light or simply failing to be aware of our blind spots. And certainly, Lucy had a difficult life.But we cannot see the back of our own eyeball and often fail to recognize aspects of ourselves that are readily apparent to everyone around us—our weaknesses and flaws—further affirmation about the importance of external validation.

One wonders why Anne stuck with Lucy. It would be interesting to read another book, one from a third person describing Anne Patchett’s relationship with Lucy.

Dr Higgins is an affiliate associate professor of Psychiatry and Family Medicine at the Medical University of South Carolina.