Autobiography of a Face

by Lucy Grealy, Coleen Marlo (Narrator)

I spent five years of my life being treated for cancer, but since then I've spent fifteen years being treated for nothing other than looking different from everyone else. It was the pain from that, from feeling ugly, that I always viewed as the great tragedy of my life. The fact that I had cancer seemed minor in comparison.

At age nine, Lucy Grealy was diagnosed with a potentially terminal cancer. When she returned to school with a third of her jaw removed, she faced the cruel taunts of classmates. In this strikingly candid memoir, Grealy tells her story of great suffering and remarkable strength without sentimentality and with considerable wit. Vividly portraying the pain of peer rejection and the guilty pleasures of wanting to be special, Grealy captures with unique insight what it is like as a child and young adult to be torn between two warring impulses: to feel that more than anything else we want to be loved for who we are, while wishing desperately and secretly to be perfect.

Genres: Memoir, Nonfiction, Biography, Biography Memoir, Autobiography, Book Club, Disability

6 pages, Audiobook

First published January 1, 1994

About the author

Lucinda Margaret Grealy was a poet and memoirist who wrote Autobiography of a Face in 1994. This critically acclaimed book describes her childhood and early adolescence experience with cancer of the jaw, which left her with some facial disfigurement. In a 1994 interview with Charlie Rose conducted right before she rose to the height of her fame, Lucy states that she considers her book to be primarily about the issue of 'identity.'

Reviews

[Will Byrnes · Rating 4 out of 5]

At an early age, Lucy Grealy was found to have a rare form of cancer. It would define the rest of her life. A third of her jawbone was removed to try to stem the spread of this cancer. She endured two and a half years of chemotherapy and many subsequent years of radiation treatments. In addition, she had literally dozens of surgeries attempting to restore her face. Each time her body would eventually absorb transplanted material and sag back in on itself. Consider the garden-variety cruelty of middle-schoolers. Then add to it a severe facial disfigurement. The taunting and insults were constant. High school offered minimal relief. One benefit to Grealy of her many hospitalizations was that she got to skip so much school-time, so much taunting-time.

Autobiography of a Face is Grealy’s memoir of her experience, inner and outer. She offers a blow-by-blow recounting of her medical trials, accompanied by the emotional turmoil that inevitably resulted. How does one cope with a world that defines beauty as value when one is clearly damaged? Eventually, Grealy decided that she would become deep. If she could not succeed at being beautiful, facially, she would become as smart as she could. In an interview she said that beauty is a label. What people want is to be seen as graceful, to be accepted, to be loved, to be appreciated. Beauty is a label that people lay across things that we want. The same applies to wealth, which, per se, is meaningless, but stands in for other things, desirability, power, freedom.

This is a book about identity. Are you your face? Do you see yourself through the eyes of the world or through your own? Can you accept who you are, disfigurements and all? Grealy found success in the world as a writer, but carried the pain of her appearance and the world’s cruelty to her about it for the rest of her days. She expresses appreciation for the fact that while she has had barriers to contend with, in many ways she was blessed, with a roof over her head, plenty to eat, clothing to wear, and sees how many people, people with perfectly normal faces, lack those basics.

The book is memorable and moving, offering an inside look at the girl, then woman, behind the face, sometimes behind the mask. There is a bit of distance here between the author and her emotions, but with such an intense, long-lasting trauma, a bit of distance may have been the only way that Grealy could have written her tale. It may not rank with great memoirs, but is an interesting, thoughtful and engaging one.

PS - I learned, after reading Autobiography, that Grealy, who had become a successful poet and writer, had suffered an addiction to heroine following her last reconstructive surgery and died of an overdose at age 39.

Grealy became friends with Ann Patchett at the Iowa Writers Workshop. Patchett wrote about their friendship in Truth and Beauty: A Friendship.

Review first posted - July 2010

[emma · Rating 3 out of 5]

this memoir was recommended to me by one of the best memoirs i've ever read in my life, which was very exciting but ultimately set up a tough comparison.

lucy grealy is an excellent author, but her face was not the most interesting part of her. contrary to the title, i didn't want to know about her face itself, but the person behind it. the fact that i heard about this book from one as honest and raw as ann patchett's book about lucy made that hard to forget.

i wanted this to be longer, both in page count and in the time it covered, and more wandering, and more introspective. these may sound like a lot of criticisms, but they come from a place of wanting more of this. it's a good enough book that that's the kind of critique it warrants.

it's a tragedy we lost lucy grealy, an incredible talent, so young. it makes me wish even more this book had more of her in it.

bottom line: a book with so much promise it sets up impossible expectations.

3.5

[Evie · Rating 4 out of 5]

I first learned about Lucy Grealy through Ann Patchett’s memoir Truth and Beauty, a memoir dedicated to her complex friendship with Grealy. I almost wish I hadn’t read it first; in that case, I wouldn’t have approached this book with deep sadness for what the future was to bring for Grealy.

Grealy is a poet. Each sentence was crafted with so much love, meaning, and feeling. Throughout the book, she takes the reader into her confidence while relating her complicated relationship with herself, and acceptance of her imperfections. Diagnosed with cancer at the age of nine, Lucy spends most of her child and adult life in and out of hospitals battling the disease, and then reconstructing her face due to the aftermath of invasive treatments. Trying to define why she was destined to her painful fate, and coping with her fear of never being loved, Grealy dissects loneliness and conformity until it’s an uncomfortable kernel.

“I felt pulled in two different directions. I had tasted what it was like to feel loved, to feel whole, and I had liked that taste. But fear kept insisting that I needed someone else’s longing to believe in that love. No matter how philosophical my ideals, I boiled every equation down to these simple terms: was I lovable or was I ugly?”

I liked the way this book ended; it was almost hopeful. Grealy’s premature death was really sad. Any Google search will fill you in on the details. I wish she had been able to overcome her past, and find her happiness. What a deep loss.

[Ron · Rating 4 out of 5]

I wasn’t sure where to begin in this review because so many things could be said. The book is not especially sad, but the end may leave you with that feeling for you. Sometimes there is not perfect resolution. I felt pain for this child who lived through cancer, and later the woman she had become which included strength of perseverance, and acceptance. Battling cancer was only the first part of her journey. It could be said that the living with the deformity caused by the cancer and the surgeries were the hardest part. After completing the book, I listened to an interview with Lucy Grealy. In the interview she was asked to explain her point in writing Autobiography of a Face. She said that ultimately it is about our identities: who we are, how we perceive and are perceived by others. All of that based foremost on appearance. Looking back, I see that in her words.

"I spent five years of my life being treated for cancer, but since then I've spent fifteen years being treated for nothing other than looking different from everyone else. It was the pain from that, from feeling ugly, that I always viewed as the great tragedy of my life. The fact that I had cancer seemed minor in comparison."

As a child, Lucy often hid her face. People stared. Many kids made fun. I was struck by the moment she described wearing a mask on Halloween. In that moment she was unbound. It was not the outward appearance of the mask that did this, but the confidence it provided a beautiful child whose self-identity had been shaped by her facial disfigurement. Lucy endured over 30 reconstructive surgeries throughout her lifetime to rebuild her jaw. She would come to terms with a final surgery in adulthood. Although she may not have been happy with her appearance, I believe she knew that “what I look like” does make me “who I am”.

[Elyse Walters · Rating 5 out of 5]

Update: a kindle $1.99 download special today. I read it along time ago but it’s one of those stores that you just never forget. If you’ve missed it it’s really worth reading and it’s selling for a great price today.


A friend sent me a recommendation at this book a few minutes ago.
I read it when it first came out.
I also highly recommend it

True story - sad- beautiful.
One of those stories one never forgets!

[Doneen · Rating 4 out of 5]

I'm so glad I read this book after reading Ann Patchett's "Truth and Beauty," which was her take on the friendship between the two women. I came away from reading the first book with a very skewed idea of what the relationship was like. I didn't like Lucy Grealy at all--she came across as a self-involved neurotic who totally wasted her life and died of an accidental heroin overdose. After reading Lucy's own account of her childhood cancer and all the hardships she endured because of her treatments, I think I have a much more balanced idea of what courage she actually displayed. This book was written several years before she died so her life may have disintegrated toward the end, but I had to admire her courage and very unique perspective on her own life. She had very little self-pity about her condition. The two books offer a stark contrast, with the truth probably being somewhere in the middle.

[jo · Rating 5 out of 5]

this book knocked me for six (this, i'm told, is a cricket-based metaphor. the only other cricket-related sentence i know is "the sound of willow on leather," which english expats like simon use with a quiver in their voices. this has absolutely nothing to do with this review). lucy grealy writes about her experience with a severely crippling childhood cancer which, besides putting her through years of chemo and radiation therapy with accompanying nausea, pain, terror, ill-being, baldness, and missed classes, also ended up the chopping off of a good chunk of her face. she was 9. it is not clear to me how happy her childhood had been till then. maybe it's not clear to her, either. but it is abundantly clear that the narrator of this memoir had an excruciatingly painful life at least starting at the age of nine till when she died of a drug overdose at 39 (while i don't doubt that she had moments of relief and even happiness, very few of these moments make their appearance in this memoir, and when they do they are a set up for further, more devastating falls).

the genius of this book is not the cancer narrative per se, but the narrative of a childhood trauma so powerful that it empties a soul from inside out and cuts away those tenuous, undefinable, yet essential resources that allow one to navigate life and find solace and comfort in the company of others and especially oneself. grealy's deepest disability is emotional.

since lucy grealy has a fabulous way with words and with feelings and sees really deep inside her pain, she depicts her cancer in the context of a family life marred by great emotional abstinence and isolation. adults are not good to lucy. the doctor who gives her her weekly injections of chemotherapy is always on the phone (yes, he gives her chemo while talking on the phone to someone else) and relates to her as if she were an orange instead of a child. they don't even exchange a word. for three years.

mom and dad, though obviously devoted to their children (if i remember correctly there are six of them, and lucy is a twin), fail to connect with lucy's pain either because they cannot deal with their own pain or because they are too ashamed and embarrassed (i.e. cannot deal with their own pain). by willing lucy's pain away and castigating her (gently but firmly) for complaining when she suffers, lucy's mother puts little lucy in a space in which pain is shameful and a sign of weakness. the adult author knows all too well that denying pain its devastation proliferates it and makes it fester, yet she can only look at the damage that was done and report on it. there is no transcendence in grealy's life.

a lot is made of peers' teasing (i can't imagine such horrible and relentless teasing happening when/where i was a child; ostracizing, gawking, and isolating, sure, but teasing like that? i don't think so. did i grow up in fairyland?), while hardly any mention is made of siblings. where are lucy's siblings, where is her twin while she walks to school among jeerings and attacks?

controversy arose when ann patchett published a memoir of her friendship with grealy. apparently patchett wasn't very kind to grealy's family. suellen grealy, lucy's older sister, felt moved to put out an angry article in defense of her family, her mother in particular. my review of this book has nothing to do with the reality of grealy's family, her siblings, her parents. it has to do only with the story the narrator of Autobiography of a Face tells us. she chooses to leave out her siblings and to depict her parents as emotionally unavailable. this has nothing to do with the reality of these things. nothing. anyone who misses this distinction does the grealy family the injustice suellen laments in her article.

having said this, i also want to say that, within the story, the traumatic impact of lucy's cancer is exponentially magnified by the bad emotional handling she gets from parents and doctors. in this sense, this is a tremendous testimony to the power of context in the genesis of devastating trauma.

[Cathrine ☯️ · Rating 3 out of 5]

3.5★
There is much said about this memoir from many POVs and my thoughts about it are complicated. As one reviewer pointed out the title says Autobiography of a Face and that’s what it is. Hoping to find a more holistic view to other aspects of life in the aftermath of her childhood experience left me disappointed. She spends the majority of this book in those early years and quickly wraps it up after college. Like others I wondered how she could so clearly recall the details and memories from such a young age. As it turns out, according to an afterward not included in my copy “I didn’t remember it. I wrote it. I’m a writer.” So we are left with the imaginative retelling of a woman’s self-obcession with beauty and lifelong belief in her unworthiness. That imagination and her wonderful writing filled a void but would not be a path to healing and wholeness. Lucy was unable to dispel her demons and I don’t know that I could have lived that life any better under the oppressive burdens and circumstances. Read for my book club it received 3, 3.5, and 5 stars.

[Alexis · Rating 3 out of 5]

Lucy Grealy’s memoir AUTOBIOGRAPHY OF A FACE was met with wide critical and popular acclaim when published. The book is overrated in my opinion, and it provides a good test case for Vivian Gornick’s concepts of the “situation” and the “story.” “Every work of literature has both a situation and a story,” Gornick writes in her book THE SITUATION AND THE STORY. “The situation is the context or circumstance, sometimes the plot; the story is the emotional experience that preoccupies the writer: the insight, the wisdom, the thing one has come to say” (13). Grealy’s situation is compelling: as a young girl, she is diagnosed with the rare and formidable Ewing's Sarcoma and has an operation to remove the malignant tumor from her face. Her prognosis is dismal, and she is left with a disfigurement that makes her “ugly.” This sense of her own ugliness looms over her, and thus the story is about her unsurprising search for beauty and truth. Or, so she says.

Grealy’s search for truth falls short for me, in part because I suspect that she was conflicted about her own truth at the time of the book's writing, but her search for beauty is a strong, well-developed theme. Her musings on beauty and ugliness, in fact, as well as her excellent descriptions of the alien hospital world, were what made me stick with this book when I wanted to put it down. What was missing for me on the whole was complex story development; her situation is dramatic, while the story lacks shape and texture—in many places. I suggest that this flatness has to do with the book’s early avoidance of the shadow side of her experience during the time of her diagnosis and early treatment. She doesn't engage with her own doubt. Here’s an example of this flatness from a passage set during her initial hospital stay:

"This sense of comfort continued in the following days and weeks. There were definite problems to face here, but to me they seemed entirely manageable: lie still when you’re told, be brave. It didn’t seem like so much to ask, really, considering what I got in return: attention, absence from school, occasional presents, and,though I wouldn’t have articulated it, freedom from the tensions at home...Some of the other visiting parents, the ones who came in every day, felt sorry for my lack of visitors and sneaked me contraband food items. I played up to this expertly whenever I sensed a particularly orphan-sensitive audience. My mother would have been appalled if she’d known" (38).

The problem I had with this scene and others like it is they struck me as disingenuous. She never develops these “tensions at home” any further, but since she continues to refer to fraught family relationships, we have to take her on her word. If part of her identity was that of emotional orphan or orphan of illness, she doesn’t illustrate the “becoming” of that identity. In fact, mom and dad seem pleasant, caring, and supportive, albeit fuzzy, as characters. If there are tensions at home, show the reader. I don’t doubt that parents could do their best, and a child could still feel differently, could feel lost and alien. But Grealy doesn’t take us through the formation of this important alienation that underpins the story.

The flatness in the beginning is, I think, a problem of persona. Her early persona is one of a young girl trying to keep her chin up, to appear strong, and to avoid whining. While a perfectly believable pose for a child to adopt, a pose to spare her parents and to spare her shame, what she doesn’t write about is the underside of these exhausting heroics and overtures. We don’t get inside of how it felt to be her, struggling for strength in a time of what must have been unimaginable fear. In fact, her protestations against whininess come off as, well, whiny. The reader can be told that this conflict is heartbreaking, but we don’t feel it. She doesn’t let us deep inside the conflict—at least not initially. So for the first 50 or so pages, we are met with a somewhat unreliable narrator, one whom we suspect is holding back. When she does begin to share her conflicted interiority, it feels too late in the story.

Another problem I had was Grealy's reliance on summary. There were plenty of interesting scenes, but we were held back from them frequently, or we were told what they meant or stood for. Grealy’s problems may well have to do with narrative distance and persona. The story is either too close or too far, and in both cases the effect is loss of clarity. One technical issue that contributed to this distance was her overuse of the conditional tense: “I would,” “We would", “they would.” This approach veers too easily toward summary, and the effect is one of drifting through generic time—what life was like generally. Grealy writes some scenes in simple past, too, but the conditional is overused in order to avoid climbing inside of discrete, crystalline moments. Perhaps it was too painful for the writer to do, but this approach distanced me from story.

On the whole, I am glad I read the book. It did get better as she went; the insights became more felt, the persona more honest as she grappled with the mess inside. Grealy was at her best when grasping the minutiae of daily hospital life; here she seemed expert not only of a hidden world, but expert of herself, clear about her own responses to her peculiar alien existence. In these sections of the book, I felt the truth of what Gornick said about how clarity of persona energizes the story. Ultimately, I hope my criticisms of Grealy will help me puzzle out my own problems as a writer--narrative distance, time and tense, and compensating for story with capital-V voice.

[Darlene · Rating 5 out of 5]

While reading this book, I was reminded of something my daughter used to say when she was little and she came to me after one of her brothers or a friend hurt her feelings. She would say.. "Mommy, my heart hurts." Well, that sentence seems the perfect way to describe my feelings about this book.

I discovered 'Autobiography of a Face' by Lucy Grealy at a used book store. The photo on the cover immediately caught my eye… it was startling! The photo caught me, and the story pulled me in and ultimately broke my heart. This story.. Lucy's story.. is heart wrenching; but it also demonstrates how resilient human beings can be.

In this memoir, Lucy Grealy writes about her life. Although she hadn't been on the planet for long, her memories ranging from her childhood to the time she became a young woman are difficult and even shocking to read about. Lucy was diagnosed at age 9 with Ewing's sarcoma.. a rare cancer which required the removal of half of her jaw bone, 2 years of radiation and chemotherapy and countless unsuccessful reconstructive surgeries over many years of her life.

As if the cancer was not more than enough for one person to bear, Lucy also endured 'care' by a doctor who seemed completely disinterested in her care, often talking on the phone throughout his examination of her. She often missed huge amounts of school but whenever she did manage to attend, she was teased and picked on mercilessly. And her mother…. well, I couldn't decide if she was simply self-absorbed or was just unable to cope.

Many of the reconstructive surgeries Lucy elected to have were a result of her longing to have a face which would allow her to feel as if she belonged. She explains the constant conflict she felt over wishing people would NOT stare at her face; and yet at the same time, longing for a face which people could look upon without her seeing their obvious feelings of pity and disgust. She wrote…" I spent five years of my life being treated for cancer, but since then I've spent fifteen years being treated for nothing other than looking different from everyone else. It was the pain from that, from feeling ugly, that I always viewed as the great tragedy in my life. The fact that I had cancer seemed minor in comparison."

I couldn't stop thinking about Lucy's eloquent words. Her words encouraged me to consider something that I have never thought much about…. how much of our identities … the way we see ourselves and FEEL about ourselves is intertwined with the way we look? More importantly, how much of our identities is related to the way we feel OTHER PEOPLE view us?

It was agonizing to read about each surgery Lucy elected to undergo… she was wistfully hoping and at the same time, trying NOT to hope each time the grafting of first, skin and then bone from one part of her body to her missing jaw bone would prove miraculous.. only to eventually discover that her face would once again collapse into itself. She writes of accidentally seeing herself in the mirror of a dressing room after one of her surgeries….. "spending as much time as I did looking in the mirror, I thought I knew what I looked like so it came as a shock to me one afternoon.. when I saw my face in the harsh fluorescent light of the fitting room… walking up to the mirror, reaching up to touch the right side, where the graft had been put in only a year before, I saw clearly that most of it had disappeared, melted away into nothing….".

Although Lucy's struggles with identity continue throughout her memoir, she DOES manage to discover things in her life which bring her pleasure. She discovers a love of horses and she finds relief and escape in exercising the animals at a local stable. She loves poetry and begins not only reading but writing her own verse. She gets accepted into Sarah Lawrence College and develops some true friendships. She travels through Europe; and eventually, she gets accepted into the renowned Iowa Writer's Workshop….. which is about where she leaves off in this memoir… leaving you with a sense of cautious optimism for her and her future. Closing the book didn't end my thoughts about it, however. I find that even now, months later, I continue to ask myself… how would it feel to look in a mirror and see an image that doesn't match the image I have of myself in my mind? I'm not a religious person but I know that many religions teach that our physical bodies are not who we are. So why then does it feel as if our identities are tied so closely to how we see ourselves and how we believe others see us? As you might guess, I have no real answers to these questions.


* I need to add that if you are curious or interested in what happened to Lucy Grealy AFTER the events she recounts in this memoir, I can suggest that you read 'Truth and Beauty' written by Ann Patchett. I realized halfway into 'Autobiography of a Face' that Lucy's story seemed familiar to me. I did a bit of research and discovered that many years ago, I had read 'Truth and Beauty' by Ann Patchett… who was a close friend of Lucy Grealy…. they met at that Iowa Writer's Workshop that was mentioned. At that point, recognition came flooding back and I can say that I wish I had read 'Autobiography of a Face' first. Before I had a chance to finish Lucy Grealy's book, I already knew how her story ends and if possible, her story felt even more heartbreaking.

This story, although incredibly sad, was eloquent and at times darkly funny and always thought-provoking. I highly recommend both books… but read this one first!

[Jessica · Rating 1 out of 5]

Ehm...at the risk of sounding completely cold, I did not like this book. I spent most of the book so consumed by frustration for Lucy's mother and Lucy's own perceptions that I couldn't allow myself to feel anything else for her.

Yes, she was a cancer survivor, and she was treated horribly by her peers growing up. But sometime after the large portion of her jaw was removed, she admits that she didn't even understand that she had had cancer until many years later! She thought that people stared at her because she had lost her hair due to chemotherapy, not because of the shape of her face. She spent so much time deluding herself into believing a warped reality that she lost out on a good portion of her life. She came off as horribly selfish when detailing her many hospital stays and her initial reaction upon finding out her father had been hospitalized (her chances of getting a pony diminished significantly at that time). She obsessed about being loved, but did not make a very strong case for her being an ideal recipient of love.

The mother was frustrating solely for her inability to "mother". Your daughter is sitting in front of you having poison pumped directly into her body, and you chastise her for crying? Then you remark on how disappointed you are at the fact that she's "letting the treatment bring you down"? Seriously, if there was ever a child who could have used a pat on the head and a comforting, "There, there", it was Lucy.

She tended to dwell on things, and that lead to unnecessarily long and detailed sections that could have been left out. If you ever wanted to know which flavor of pudding to consume for a more pleasingly aesthetic vomit, this book will tell you. It will also tell you how to induce pneumonia by inhaling your vomit. Yes...lots of vomit talk, which goes back to my original point - it really could have been left out.

The last thing I want to say is that I'm not so callous as to not feel sympathy for the things that Lucy had to deal with in her life. It couldn't have been easy. But, here's the thing. The back jacket should not have promised a novel that told her story "without sentimentality", because that's not the same book that I cracked open. If those passages on love, acceptance and her place in the world weren't an example of wallowing in the sentimental, I don't know what is.

[Emma Deplores Goodreads Censorship · Rating 4 out of 5]

This is a very good memoir about the author’s experience with childhood cancer and a resulting facial disfigurement. It’s written in a very compelling and readable way, which along with being relatively short encourages quick reading (or at least I read it pretty fast). It also does a fantastic job of conveying the complexities of the author’s inner life as child—while I don’t have much experience with “sick child” books, I suspect this is very different from most, especially fictional ones. Grealy spends time on her imaginary world, and on complicated feelings about hospitals and surgeries (as a kid she sometimes liked these experiences, for a variety of reasons), on her complicated relationship with her own illness—the way she liked feeling special and saw it as a way to prove her worth, even while refusing to confront the seriousness of her illness and turning the conversation into a joke when adults tried to raise it. The book feels real and authentic where my impression of novels on the subject is that they tend to be overly precious tear-jerkers. (And it manages to be in large part about medical treatment while neither romanticizing those involved nor turning it into an exposé.) Her experiences of how others respond to her appearance also feel real and authentic to me where a lot of writing goes over-the-top.

What this book and its reviews had me thinking about most was the way we as a society want to avoid acknowledging suffering, and reward people for denying their own, likely because it spares us discomfort. Grealy’s parents are fairly complicated characters here, although also somewhat peripheral, and while some readers have seen her mother in particular as emotionally cold and neglectful, that wasn’t ultimately my reading of the text. It seemed to me that the mother was so unable to face her child’s suffering that she essentially told her not to suffer, or at least not to show it, causing Lucy to elevate this goal as the highest measure of her self-worth, and to feel like a failure for admitting suffering even to herself. When forced to confront hard things the parents were also inclined to retreat into platitudes like “but you knew that was going to happen”—and ultimately Lucy feeds herself platitudes too, comparing her situation to those of people experiencing genocide for instance, and telling herself that by comparison she has nothing to complain about. Unfortunately, denying one’s pain isn’t actually a great way of dealing with it for long-term health (as can be seen by other accounts of Grealy’s adult mental health issues, her ultimate addiction and her death by overdose at the age of 39), and it seemed to me that in their unwillingness to just sit with their child’s pain, the parents denied her a source of connection and comfort that might have helped her cope better.

However, I don’t actually mean that as a dig against the parents so much as at a dysfunctional society (and this took place in the 70s with parents who, although they were living in the U.S., were recent immigrants from Ireland, so it’s fair to say this is a pretty established way of dealing with problems). A lot of the same toxic attitudes show up too in reviews of the book itself: people complaining that Lucy isn’t stoic enough, or using her experiences as a way to tell themselves they don’t get to suffer. While less directly addressed in this book, it’s made quite clear in Truth and Beauty—a memoir about Grealy by her friend, Ann Patchett—that Grealy was not interested in being anyone’s inspiration porn. See this exchange, for instance, at a book signing for this memoir:

“ ‘You were so incredibly brave,’ a woman began. ‘If it were me, I wouldn’t have been able to survive it.’

‘Meaning what, you would have died?’ Lucy said. ‘It doesn’t work that way, unless you kill yourself.’”

Which crystallized some of the things I was thinking about while reading this book and people’s responses to it—it’s a bit odd to praise someone as “brave” when they actually had no choice in the matter. The child Lucy does sometimes try to get out of chemo for instance, by making herself too sick to go, and while she also shows plenty of fortitude, she doesn’t really have other options.

At any rate, I did read Truth and Beauty right after this and pairing Grealy’s account—mostly of her childhood, though she touches on her adult life more briefly at the end—with a friend’s depiction of her as an adult is particularly interesting. There are certainly things Grealy leaves out (I don’t believe she mentions getting breast implants in grad school, or her virtual inability to eat regular food, for instance), but overall I found the memoirs pretty consistent with each other—it’s certainly no surprise given all her experiences that Grealy wound up struggling a lot as an adult, in ways that often weren’t pretty. Patchett just shows that with an outside perspective that no one is really capable of turning on themselves.

All that said, I wasn’t completely in love with the book. It does at times stick with generalities, particularly around Grealy’s family—perhaps she just wanted to respect their privacy, but she often references but never shows the tensions in her parents’ home, and her siblings are rarely seen; I was especially surprised by how little role her twin seems to play in her life. And the section about her adult life is somewhat rushed. Nevertheless, I wound up appreciating this book a lot and it made me think about issues that affect all of us. I would recommend it.

[Jenni · Rating 3 out of 5]

Autobiography of a Face chronicles Lucy Grealy's battle with the physical and psychological effects of Ewing's sarcoma, a cancer that robbed her of much of her jaw. Grealy touches upon some of the more negative aspects of her ordeal, such as her need for attention and her tendency to blame all of her problems on her face, yet it is clear some of the tale is left untold. The writing itself is wonderful: flowing, elegant sentences filled with succinct vocabulary.

Grealy and author Ann Patchett (Bel Canto; Patron Saint of Liars) became friends in graduate school and remained friends until Grealy's death in 2002. Grealy, who endured many failed surgical attempts at facial reconstruction, became dependent on OxyContin and later on heroin. Her death was a drug overdose, but it remains unclear whether or not it was a suicide. Patchett's book, Truth and Beauty: A Friendship, written after Grealy's death, is a must-read counterpoint to Autobiography of a Face. An article in New York Magazine http://nymag.com/nymetro/news/people/... by Patchett was the impetus for Truth and Beauty; Grealy's sister Suellen responds in a Guardian Unlimited article http://books.guardian.co.uk/departmen....

[Bill Kupersmith · Rating 5 out of 5]

Lucy Grealy was a poet, essayist, and autobiographer. She was born in Dublin in 1963 and her family immigrated to Spring Valley, New York, when she was four years old. Her father worked in television. Lucy was a graduate of Sarah Lawrence College and received an MFA degree from the University of Iowa Creative Writing Program (the “Writer’s Workshop”).
The crucial experience in Lucy’s life happened at age nine, when as a result of a playground accident to her jaw, she was diagnosed with Ewing’s sarcoma, an especially aggressive and usually lethal form of cancer. Lucy underwent repeated stays in hospital and outpatient treatments with radiation and chemotherapy. The chemo treatments were especially painful and left her feeling nauseated and physically wrecked. But the treatment was successful, at least with respect to the cancer. But it was to destroy most of Lucy’s right lower jaw, as well as costing Lucy most of her teeth, so that throughout her life she couldn’t close her mouth normally, eat solid food, or kiss. Her mutilated face made her the butt of cruel teasing by other children, and she saw herself as an ugly monstrosity that no one would ever love.
Autobiography of a Face is her memoir, recounting Lucy’s life from childhood into her twenties. It was published in 1994 to considerable critical acclaim and is still in print. When literary figures, such as Joan Didion, write books about grief and loss, these are usually reviewed by other writers. But as reading Autobiography of a Face, we felt challenged to try to understand Lucy’s experiences not from a literary point of view, but as trained chaplains and spiritual care givers.
Unless specifically assigned to a pediatric unit, a chaplain is unlikely to see a pediatric patient except with a referral from the child’s mother. And quite often, especially in the case of young children, most of our pastoral care is devoted to supporting the parent, not the child. For Lucy the situation was particularly tricky. As a nine year old she was mature enough to be very conscious of what was happening to her, but too young to be taken seriously by adults. And the support she received from her parents was anything but helpful.
Lucy received chemo on Fridays, which then involved two very painful injections administered by a physician while he was distracted by talking on the telephone. Outpatients are very poorly cared for by spiritual care departments, which are just not set up for them. Of course if one of us knows we are scheduled for a procedure and want some spiritual support, we’d arrange ahead of time to meet a chaplain at the clinic. But then we know our way around a hospital. It appears that during all the time she was treated at Columbia Presbyterian Hospital, Lucy and her family never saw a chaplain, Presbyterian or otherwise. Why couldn’t a nurse or a receptionist have got in touch with pastoral care and said, “We’ve got nine year old girl who’s having some very painful chemo treatments, and she and her mother are usually kept waiting for a couple of hours every Friday afternoon. Could you drop by the waiting room and see if you can do anything for them?”
Lucy’s mother seems only to have exacerbated the pain of her daughter’s treatment. She insisted that however painful they were, Lucy must maintain a stoic attitude. She explained to Lucy “how disappointed she was that I’d cried even before Dr. Woolf had put the needle into me, that crying was only because of fear, that I shouldn’t be afraid” (78), Lucy adds, “my mother didn’t know how to conquer what I was afraid of, nor could she even begin to tell me how to do it for myself.” A caregiver would try to help Lucy respond quite differently, to be able to articulate her fears. Pain is an evil and pretending it is not there. Fear is not something that needs to be “conquered”; it simply needs to be acknowledged as a normal response to pain and loss.
As Lucy’s treatments continued she tried to find on her own, with only a child’s perspective to draw on, ways of coping with the intolerable. One was simple evasion, to make herself ill enough that the treatments would have to be suspended. She went out in a storm at night getting chilled and drenched and hoping it would raise her white blood cell count. She tried drinking dishwashing liquid to feel nauseated, inhaling water to cause pneumonia, and jabbing herself with rusty nails. Apparently Lucy’s sense of self-preservation kept her from doing anything so extreme as to cause permanent injury.
Lucy’s family were religious skeptics, but somehow Lucy somehow found herself on a prayer list and was deluged with sentimental tracts and letters. Lucy wanted to become a believer so that God could give her peace and healing, but how? “After all, I was sold, I wanted to have Jesus help me out and make me good and strong and pure . . . —but exactly how was I supposed to do this? . . . In secrecy I sat down in my bedroom on the blue carpet and asked, ‘God, if you exist, prove it to me.’” But of course there was no voice; the carpet didn’t change color; there was no sudden light. “I knew I only half expected an answer. Was my partial belief preventing God from speaking to me? Didn’t I have to fully believe, or did all this simply mean that there was no answer. . . . I couldn’t bear to think I was wrong, that somehow everything I was going through didn’t actually have meaning.” That everything I was going through didn’t actually have meaning—this is a very succinct summation of a common symptom of spiritual distress, as was Lucy’s sense that God was absent or indifferent.
Good pastoral care would have reassured Lucy that her pain and fear were real and that her mother’s insistence that she should hide them was the opposite of helpful. It would have helped bring Lucy to awareness that God does not perform magical healing that is conditional on ignoring her doubts, but that despite her doubts and fears, Lucy was not alone, that God was with her in all her suffering and would give her the strength to deal with the painful effects of her treatment.
During the period that Lucy was in junior high school the chemo and radiation treatments were successful in eradicating the cancer, but the after effects left her with a mutilated face that was to be her curse for the rest of her life. Other children regarded her as a sort of monster, and the only occasion where she associated normally with other children was Halloween, when she could hide behind a mask. Lucy perceived her mutilated face as transforming her into something that no one could ever love.
Trying to bargain with God was one of the devices Lucy adopted to make her suffering bearable. Another, which many of us have attempted to use, was to reflect on how many there are who are enduring worse. After she finished the course of treatment, she had to humiliation of being ridiculed for her facial appearance. How trivial that seemed compared to the atrocities being perpetrated in the world. “My inner life became ever more macabre. Vietnam was still within recent memory and pictures of the horrors of Cambodia loomed on every TV screen and in every newspaper. I told myself again and again how good I had it in comparison. What wonder it was to have food and clothes and no one torturing me. . . . I bombed and starved and persecuted my own suffering right out of existence” (126).
What gives a particular piquancy to Autobiography of a Face is the narration. While much of the story is seen from the perspective of a child, when Lucy wrote the memoir she was already in her thirties, an accomplished literary stylist, who offers an especially insightful comment on her youthful attempt to will away her own suffering by reflecting on the greater sufferings of others: “I had the capacity of imagination to momentarily escape my own pain, and I had the elegance of imagination to teach myself something true about the world around me, but I didn’t have the clarity of imagine to grant myself the complicated and necessary right to suffer” (126-27). The mature Lucy beautifully phrased those different powers of her imagination. Capacity of imagination is the ability to escape from the painful present, elegance of imagination is the ability to use what apply what we imagine to our circumstances—that is the quality we use when we imagine ourselves into a character in fiction. It is also what a chaplain draws on to empathize with a patient. But clarity of imagination allows us to compare and contrast, to perceive whether the situation we imagine fits the actual perceptions of the patient. One of the hardest lessons to learn as a chaplain is that the patient’s perception was the reality. In Lucy’s case she had to be her own chaplain and alleviating her suffering by reflecting on the greater sufferings of others simply does not work.
When she was in high school Lucy read Hesse’s Siddhartha, and like so many of us in the sixties and seventies, she went through a Buddhist period. Having encountered the noble truth that all suffering is the result of worldly attachment. “Desire and all its painful complications, I decided, was something I could and would be free of” (178). Of course instant enlightenment through popular fiction proved as illusory as Lucy’s previous attempts to alleviate her suffering. Surgery to repair her jaw proved ineffectual. The aftereffects of the radiation treatment prevented skin grafts from being successful; they were simply reabsorbed.
In college at Sarah Lawrence and graduate school in the Writer’s Workshop at the University of Iowa, Lucy finally discovered friends who could love her as well as some literary success. There is a beautiful memoir, Truth and Beauty, by the novelist Anne Patchett, who was Lucy’s housemate in Iowa City, lovingly depicting her friendship with Lucy, a friendship that only ended with Lucy’s death at the age of thirty-nine. Sexually Lucy was very promiscuous, obsessed with having sex to prove to herself that she could attract men, as well as addicted to heroin.
Some readers of Ann Patchett’s memoir cannot understand how Anne could have put up with such a manipulative and clingy friend as Lucy. But those of us who have had a relationship, however difficult, with high maintenance high-octane persons like Lucy will understand. By comparison relationships with others just seem dull.
As an adult Lucy continued to undergo surgeries and attempted to find treatments, including moving to Scotland, where Lucy’s Irish citizenship made her eligible for the National Health Service. “How could I pass up the possibility that it might work, that at long last I might finally fix my face, fix my life, my soul?” (215).
According to Ann Patchett, Lucy underwent thirty-six surgeries. None of which was more than temporarily successful. Surely her surgeons must have been partly to blame for encouraging so many procedures when it must have been obvious that there was little chance that they would be effective. But it was Lucy herself who saw her face as her only “hope” for a life that she could accept.
We come away from reading Autobiography of a Facewith the sad insight that by the time she was a teenager Lucy had already focused all her hopes on the wrong object. In spiritual care we distinguish between cure and healing. Lucy was obsessed with a cure, with “fixing” her face so that she could become an object of love, and then her real life would finally begin. But for her to be healed would have meant that being able to accept that she already was loved and was worthy the love of her friends, and of herself.

[Caitlin Constantine · Rating 4 out of 5]

Several months ago, the mug shot of a criminal suspect landed in my work inbox. When I opened the email, I was so shocked that I gasped out loud, then giggled nervously as I quickly closed it. The young man was horribly disfigured, to the point that his face looked like the creation of a special effects artist in a horror movie. I saw his face in my mind for days afterward, sometimes seeing it in odd shadows in half-light rooms, and each time I was revolted. My very visceral horror was compounded by my shame at seeing myself laid bare as a superficial, shallow person, then furthermore at my deep sadness when I tried to imagine what that kid's life had been like, how alienated he must have felt from the rest of the world, how much cruelty he'd seen, or maybe how much pity. Imagine dealing with the transient sociopathy of early adolescence that way. I know I had my share of shit flung in my direction, and the only thing "wrong" with me was that I was exceptionally tall and had glasses.

Reading this book gave me a glimpse of what I had tried to imagine, about how it would feel to know that the one thing about yourself that you could not hide is something that inspires people to treat you as if everything about you was wrong and defective and unworthy of love. Good lord, it broke my heart to read this book. Yet it was so good and so essential and so beautiful. Grealy's background as a poet who studied at Iowa shone through every page. No superfluous words, no excessive sentences, every image and every observation flawlessly rendered. Several times I put down the book to luxuriate in a perfectly-turned phrase or to consider a particular idea. The book is slim, about 220 pages, but the content within is substantial.

I'd heard a bit about her relationship with Ann Patchett before reading this, and also about her fatal drug overdose, and I'd worried that this knowledge would color my experience of the book, you know, the way knowing about David Foster Wallace's suicide leaves many of his readers combing his essays and fictions for clues. That external knowledge surfaced from time to time, but for the most part, the book was so beautifully written that it was easy to immerse myself in Grealy's world as I read.

[Book Concierge · Rating 4 out of 5]

Lucy Grealy was nine years old when she was diagnosed with Ewing’s Sarcoma, an aggressive bone cancer, in her right jaw. The surgery and chemo helped save her life but left her with disfiguring scars.

What is more important to your sense of self than to recognize yourself in the mirror? What if the face you saw in the mirror was one you could not bear to look at? A face that could not possibly reflect the you inside?

Grealy became a renowned poet, and her way with words shows here. She writes so eloquently and honestly about what she went through and how she felt growing up “ugly.” She writes about being the “special” kid in a family of four, getting more of her parents’ attention, skipping school, good friends, how she dealt with bullies, and how she became addicted to the pain killers she was prescribed following major surgery. Her life was not all tragic, however; she also remembers moments of joy and humorous escapades.

The memoir was first published in 1994. The edition I had included an afterword written after Grealy’s death in 2002, by her friend and fellow Iowa Writers Workshop student, Ann Patchett.

[Stephanie · Rating 4 out of 5]

TIP: To be read AFTER Ann Patchett’s Truth and Beauty. This autobiography is very engaging and well written. The author tells of her experience with cancer, but she states that while she spent only a certain amount of her youth being treated for cancer, she spent the rest of her life being treated for looking different than everyone else. This is an exploration into a very interesting and intense individual far more than it is a documentary about the affects of cancer. It is rich in language and raw in experience. When paired with Truth and Beauty, I think the literary experience is amazing. Be sure to read this one second. The reverse order causes the reader to feel as though they are attacking their beloved Lucy rather than understanding her more clearly.

[Sheri · Rating 4 out of 5]

I read Ann Patchett’s Truth and Beauty a while back and was intrigued by Greely’s story. I was excited to read Greely’s version (especially since there was such controversy between her family and Patchett). As a former student of physical attractiveness (my MA dealt with the mechanics and development of measuring facial physical attractiveness), I was curious to read about Greely’s experience. Unfortunately, I was disappointed.

I think part of my disappointment in this book was due to my knowledge about Greely’s life from Patchett’s book. I was surprised that there was no mention of Patchett (at all). I was disappointed that Greely didn’t really discuss much of her adult life, but I was not completely surprised because Patchett describes Greely as having rushed to finish the book. It comes across this way; she spends 2/3s of the book from the age of 9-13 and then the last third rushes through college and grad school. I would have liked to know about Greely as an adult.

I was also skeptical about some of her details (and this probably comes form some pre-conceived notions about Greely’s tendency to re-write history that I got from Patchett). Why does she not know her siblings’ ages? Why is she so flip about her mom never visiting and hating to come into the city only to describe in the next chapter about how her mom ALWAYS drove her to chemo and how her mom’s hospital visits were comforting because she (her mom) would just sit and knit and not expect to make conversation. Why is there no mention of her breast augmentation surgery? She presents herself as struggling with (but sort of ultimately rising above) her appearance, but she doesn’t mention her adult body modifications.

I think I was most disappointed that she only mentioned her twin sister Sarah in passing. Frequently she wonders what she would have looked like if she hadn’t had cancer. I would assume that Sarah might provide a decent approximation (unless, of course that she and Sarah are fraternal, rather than identical, twins but she says so little about Sarah that the reader doesn’t even know this crucial detail). I was also curious about their friendship (or more likely lack of); aren’t twins supposed to be closer than normal siblings? Why is it that Lucy almost entirely omits Sarah from the book?

Greely does have a few good observations and her use of language is certainly poetic. Some of the quotes that I liked were:
“Anxiety and anticipation, I was to learn, are the essential ingredients in suffering from pain, as opposed to feeling pain pure and simple.”

“Part of the job of being human is to consistently underestimate our effect on other people”

“Everybody…was always looking at someone else’s life and envying it, wishing to occupy it. I wanted them to stop, to see how much they had already, how they had their health and their strength. I imagined how my life would be if I had half their fortune. Then I would catch myself, guilty of exactly the thing I was accusing others of.”

“I discovered what it was to love people. There was an art to it, I discovered, which was not really all that different from the love that is necessary in the making of art. It required the effort of always seeing them for themselves and not as I wished them to be, of always striving to see the truth of them.”

“most truths are inherently unretainable, that we have to work hard all our lives to remember the most basic things.”

And, my favorite quote reminded me of the pain of labor. As I told my husband, it wasn’t so much the pain as that I couldn’t catch a break between contractions. Each time I was supposed to “rest”, I was instead gripped with the knowledge that the pain was gonna return (and soon). Greely captures this well with her description of the cycles of chemotherapy: “This presented a curious reversal of fear for me, because I already understood that with other types of pain the fear of not knowing about it usually brought about more suffering than the thing itself. This was different. This was dread. It wasn’t some unknown black thing hovering and threatening in the shadows; it had already revealed itself to me and, knowing that I knew I couldn’t escape, took its time stalking me.”

Overall it is an interesting book, but I was disappointed in the scope. Rather than describer her life, Greely spends most of the time simply enumerating her surgeries and her life as a patient. I was hoping for a memoir and instead, this is a book about cancer and medical intervention.

[Rachel B · Rating 4 out of 5]

"The pain these children brought with their stares engulfed every other pain in my life." p XV

This is a heartbreaking read. Although I've never been physically disfigured in the way Grealy was, I resonated strongly with her thoughts on beauty and acceptance, and her fear of never being loved.

Because the main themes of the book were so serious in nature, I wasn't expecting for this to be nearly so funny as it was. That really helped to balance the book, kept it from being overwhelming.

As for morally objectionable content, there were a few sexual comments, nothing overly descriptive. God's name was used in vain.

The ending seemed abrupt somehow. I really wish there had been some sort of epilogue or afterword, especially since the edition I read was published after Grealy's death at age 39. (According to Wikipedia, she died of a heroin overdose after becoming addicted to her pain medication.)

This is one of those books that stays with you and makes you think.

4/24/25: Reread. I still really liked the book, but realized my memory of it was a bit off. I was thinking it would be great for a high school class but now I think college level is probably more appropriate.

[Jen · Rating 5 out of 5]

Wow! A truly touching story filled with so many little life lessons. A story that makes me cringe a little with guilt when I realize how good I have it yet how often I sometimes take my life for granted, my health for granted, my friends and family for granted... Ms. Grealy opened my eyes up to another world where she had every right to let life beat her down yet she continued to find strength and confidence and continued to somehow pull herself back up, hold her head high and continue to face the unsurmountable challenges that each day delivered to her. She fought until she could fight no more and for her courage I can only stand up and applaud for I'm not sure if faced a day in her shoes if I could have found the same kind of courage to contnue on.
This is a must read for anyone and everyone. We all need a little wake up call every now and then to realize how insignificant our "problems" really are.

[John Sundman · Rating 5 out of 5]

I've wanted to read this book since reading the magazine article that precipitated it in 1994. Even if the book had sucked I probably would have given it three stars for the title alone. "Autobiography of a Face". It gives me gooseflesh.

Now that I've finally read it, I can report that book lives up to its title. Five stars.

William Carlos Williams concluded his introduction to Allen Ginsberg's poem "Howl" saying something like, "Ladies and gentlemen, lift your petticoats. You're about to walk through Hell." Grealy's book, which is as poetic in its own way as "Howl", merits a similar warning. "Autobiography of a Face" is about a pleasant stroll through hell, as told by a sublimely intelligent, detached and observant child: Dante reincarnated as a nine year old girl. But like "Inferno", like "Howl' (together with "Footnote to Howl") "Autobiography of a Face" gives its readers an opportunity to experience a transcendent joy: the joy that comes not only from the majestic, nuanced language and tale well told, but the joy that you get from reading tales of pure unadulterated courage, like Joshua Chamberlain's courage at the Battle of Little Round Top.

This book has its critics, I know. Ignore them. "Autobiography of a Face" is a masterpiece.

If you're like me, there aren't many magazine articles that haunt you for fifteen years or more. There aren't many stories that shine a torchlight into your eyes so brightly that it takes you fifteen years to find the courage to pick up the book that came after.

I'm 58 years old. It so happens that my wife used to own a children's bookstore and has subsequently been a "young adult" librarian. That's why I've read a lot more "young adult" books than the typical geeky fellow of my age. I've read perhaps 100 "YA" books. But I can't recall ever reading anything has better reminded me of what it felt like to be 9 years old, 10 years old, 11, 12. . . through early adulthood than "Autobiography of a Face."

I'm not going to go over the story told in this book; it's been more than adequately covered in hundreds of other reviews here and elsewhere.

But the subject of this book, which I thought apparent, seems to have escaped many readers, so I would like to offer a comment or two on that, viz, what this book is really about.

As Grealy herself stated, the subject of the book is (I'm paraphrasing), what is a self and how does one arrive at an understanding of what it is to be oneself?

Other writers have of course addressed this question. Among living writers who deal with this question, the cognitive scientist and computer scientist and linguist and philosopher of language Douglas Hofstadter is my personal favorite. But lots of writers have looked into this simple but deceptively deep question. Dante and Ginsberg, obviously. Plato, not so much, but Aristotle, absolutely. Augustine. Montaigne. Henry Miller. James Joyce. And perhaps topping the list, Shakespeare.

But as the saying goes (as far as I can determine, originating in Frank and Ernest cartoon) "Ginger Rogers did everything Fred Astaire did, only backwards in and high heels". I won't say that Lucy Grealy did "everything" that Shakespeare, Aristotle, Dante, Ginsberg et al did. Her opus is (like Ralph Ellison's), small. But "Autobiography of a Face" belongs in the same discussion with Hamlet, with Howl, with Inferno. Moreover, much of what she did (observing, experiencing, thinking), she did as a child from a broke, dysfunctional family, who had a form of cancer with a 5% expected survival rate. And the rest of what she did (writing her book) she did as a woman who had endured decades of pain, humiliation, ostracism, fear, surgery, poverty, ridicule, self-destructive excess, bigotry and cruelty. If that's not "backwards and in high heels" I don't know what is.

I've read thousands of books. Of them, "Autobiography of a Face" is one of the ten or twenty that I'm pretty sure will stick with me forever.

[Kevidently · Rating 4 out of 5]

What is identity? How much of who we are is dependent what we look like? What sort of person can we be when our appearance never stays the same?

These were questions I first wrangled with when reading Ann Patchett's book Truth & Beauty about her best friend Lucy Grealy. My friend Tracey suggested I read Patchett's book before delving into Grealy's own account of her life, as it would make Lucy easier to approach. Patchett's take on Grealy isn't especially sympathetic; sentimental, sure, because these were friends who loved each other. But Patchett's memory of Lucy is often spiky, always unflinching. Lucy Grealy had flaws that would haunt her for the rest of her life, and to what degree that had to do with the state of her face is a matter of perspective.

If anything, Grealy's own memories - which intersect only briefly with Patchett's - let us see the constant turmoil behind the self-destruction. And it's dire, sure, but it's also not off-putting, not in the way you'd think it would be. One of the most fascinating things about this book is Lucy's long, arduous decision to not see herself as others see her. For a long while, it's not a conscious decision. Because of the cancer that necessitated removing her jaw, Lucy has to suffer through chemotherapy; during the moments she's not in the hospital, she thinks people only gawk at her because she's bald. That's a malady that makes sense, something she can control easily with a hat. She either refuses to acknowledge or honestly can't acknowledge the face below the bald head.

There are all these way stations in Lucy's life that force her to see herself for who she is. Once, trying on a dress in store, she looks at the mirror and really sees herself - asymmetrical, and in her opinion, ugly. A wig that's been gifted to her by a well-meaning friend becomes something of a family joke, right until the moment it isn't. Closer to the end, her face constructed as well as it ever will be, Lucy has to reckon with the idea that her face can't be a crutch anymore; that she, as a whole person, is responsible for being loved and loving in return.

That being loved thing is really at the heart of this book. Having the foreknowledge of Ann Patchett's thoughts on this, we know Lucy was probably a sex addict, using it to make herself feel wanted and loved and lusted after. Consistently, she required not only the love of friends and family, but of men who would make her feel desired, if not attractive. Knowing her later issues with drugs puts an early sequence involving pain pills in a starker light; a foreshadowing for a future this book doesn't know about yet.

But: BUT. I have to assert that this book feels optimistic. Throughout her surgeries and self-re-assessments, Lucy sees herself as honestly as she can. She doesn't always like herself, but she wants to like herself, and that's the crucial bit that stops this book from feeling like a slog of body horror. Even knowing what happens later, one can't help but come to the end of this book hoping that Lucy will find peace within herself, and within the world. She certainly earned it.

[Ciara · Rating 3 out of 5]

possibly i made a big mistake by reading this & then immediately reading truth & beauty by ann pratchett (as well as some of suellen grealy's choice comments about how ann pratchett never should have written truth & beauty). my immediate thoughts on this book were something along the lines of, "not bad. she really touches a nerve about the power & perception of beauty in women. she seems to have some demons, but has to be incredibly strong to go through everything she has gone through." (the book is a memoir about grealy's relationship with her face stemming from a diagnosis of earwig's sarcoma when she was nine years old. to treat the tumor, doctors had to remove a significant portion of her jawbone, & she proceeded to undergo almost forty surgeries to reconstruct her face over the next 25 to 30 years, none of which was successful. she spent years in hospitals, eventually becoming addicted to painkillers & street narcotics--though this aspect of the story is only hinted at in . as she enters adolescence, she is teased mercilessly by the other kids at school--mostly boys--& learns to think of herself as ugly & unlovable. she spends most of her life waiting for the surgery that will restore her face so that she can suddenly begin her life, but that surgery never happens. grealy died of a drug overdose in her 30s, six years after this book was published.)

in the afterword, pratchett suggests that the reader peruse this book at least a couple of times to inure herself against the drama of grealy's story, & to fully digest her power as a writer. i did not do that. i infrequently reread books. too many books, too little time. grealy is certainly a capable writer. at no point was i jerked out of the narrative by a clunky phrase or strange word choice. she is also a poetic writer (she considered herself a poet first & a memoirist not at all). which is probably my problem. i'm not big on atmosphere. this book has a lot of atmosphere, for lack of a better word. much as grealy waited for her face in order to start her life, i waited for a coherent narrative before i invested in this book, but it never really gelled. this is purely a matter of personal taste. i prefer writing that is a little bit more concrete than grealy's writing. & because truth & beauty gave me some perspective on how much of grealy's story was edited & shaped & pruned to portray a self-reflection that grealy preferred...well, all writers who write about themselves do this (or should), but something about grealy's choices rubbed me the wrong way. there was a self-conscious kind of self-mythologizing that grated a little.

but this is definitely one of those books that i think people should read & then decide about for themselves. i certainly don't think anyone would regret reading this book.

[Kristen · Rating 5 out of 5]

I went into Autobiography of a Face expecting this book to be mostly about cancer, and although Grealy does go into detail about the period of time between her diagnosis and treatment, the substance of the book takes place after she is cancer free and finally has the room to wrestle with how cancer affected her physical appearance, and therefore her identity and sense of self. Since the age of 9, it seems Grealy spent more time in hospitals than out of them thanks to her cancer treatment and many subsequent facial reconstruction procedures. The toll that takes on a person is hard to understand, but I think this memoir does a great job of giving us a sense of what that was like. It was hard to hear about Grealy getting procedure after procedure, and even more disheartening to know that she has since died at a relatively young age.

The writing felt super authentic and vulnerable, and I think all readers could relate in some capacity to Grealy’s struggle with confidence, defining her identity and sense of self, and feeling unlovable/seeking validation from external partnerships.

I also listened to the audiobook, narrated by Grealy, which I would recommend.

[Lily · Rating 5 out of 5]

“I used to think truth was eternal, that once I knew, once I saw, it would be with me forever, a constant by which everything else could be measured. I know now that this isn't so, that most truths are inherently unretainable, that we have to work hard all our lives to remember the most basic things”

This work really touched me. Lucy Grealy writes so beautifully here, and many times I was struck by all the things that she describes that I myself could never quite form into words. Or, by the very act of description and sharing her own most vulnerable thoughts, she eases the burden of the reader’s own shame for those thoughts. Of course, her story is an especially difficult one, but despite the sadness baked into here, there were so many little moments that felt almost uplifting. I’m thinking now of the way she described her relationship with her horse, and her love for animals in general. There’s something here of the grace and elegance with which she tried at various points to view the world around her. Moreover, she depicts the pain she went through with such vividness, emotional and physical. It’s really a testament to her talent.

I didn’t know much about Lucy Grealy before picking up this book, having only read the synopsis a couple of years ago and saved it to my shelf, so I wasn’t aware that she had passed until finishing. I sat a while today thinking about both her book, which ends on a semi-optimistic note, or at least on the theme of acceptance, and her early death. We can learn a lot from other people’s lives, but no one’s life can truly fit into any narrative. I was reminded of my favorite quote from the last novel in the My Brilliant Friend series, about life inclining toward obscurity, not clarity. And of course, the quote I added to the top. We spend our lives striving to understand ourselves, feel more content with ourselves, but it’s like walking a tight rope, and again and again, we have to rebalance, with all the hopelessness and anxiety that comes with that, because we just keep forgetting and relearning what’s essential. I can’t decide if this is hopeful or depressing to me. Regardless, a story worth reading.

This is only half a review of the book, half just me rambling. My bad. I’d give this a 4.5.

[Dianne · Rating 4 out of 5]

Exquisite memoir by poet and novelist Lucy Grealy. Diagnosed with Ewing’s Sarcoma at aged nine, Lucy had half of her jawbone removed and spent the next three years undergoing constant radiation and chemotheraphy treatments. The brutal toll that the damage and subsequent reconstructive surgeries took on her face and psyche is the focus of the book, which covers the time between her diagnosis and early adulthood.

Grealy is an intelligent and gifted writer and her thoughtful examination of her disfigurement is transfixing. I found myself wondering how she could remember so clearly discussions and events from when she was so young. Apparently I am not the only person who wondered, because Grealy was asked that very question at a book reading. Her response was, I thought, very telling – “I didn’t remember it, I wrote it.” This isn’t a black-and-white retelling of events and strictly factual information; it is her musings, perceptions, and interpretations. It is a sublime and beautiful piece of literature.

Immediately after reading this, I read Ann Patchett’s “Truth and Beauty,” which is the story of Ann Patchett and Lucy Grealy’s friendship. Ann (The Magician’s Assistant, Bel Canto, State of Wonder) and Lucy met in college at Sarah Lawrence, became roommates at the Iowa Writer’s Workshop when they were in their twenties, and stayed close friends until Lucy’s death in 2002 at age 39. Ann’s book is remarkable in its own way and allows the reader a perception of Lucy from another’s viewpoint. If you do read “Autobiography of a Face” and want to know more about Lucy Grealy, I recommend following it with the Patchett book.

[Sandra · Rating 4 out of 5]

I am interested in writing memoir or at least creative non-fiction so I was excited to read this book. Certainly autobiography is self-centered by nature and one should not be surprised to find the subject's conciousness to take center stage. Grealy somehow manages to almost completely immerse us in her thoughts and feelings for the eighteen years between her diagnosis with Ewing's sarcoma and the writing of the book. Her honesty is unflinching and totally politically incorrect at times. There are times when we find her heartless--her lack of sorrow at her fathers death--which she herself admits as strange. She also doesn't seem to understand what poverty is when she has health insurance and all these operations and her family can still afford to keep a horse, but for the most part I found her story very engrossing and not at all pitiful. I'm ready to read Truth and Beauty now though I hear her twin does not approve of Ann Pratchett's telling of her sister's story. One does crave the rest of the story though and an understanding of her demise at 42 after living through cancer at 10.

[Madison · Rating 3 out of 5]

I'm not saying this is the year I finish the Rory Gilmore Reading Challenge, but it should be because this is where Gilmore Girls ends, so.

[robyn · Rating 5 out of 5]

4.5/5. in love with grealy’s voice; at once gregarious, kind, intelligent, unpretentious, thoughtful. always haunting to carry the knowledge of an author’s very untimely death (she was only 8 years older than i am now!) while reading a book in which they are so vital and present, and parts of this - grealy’s casual recounting of her teenage codeine addiction, the paragraph where she contemplates being an age she never actually reached - really made that hit home for me. but very very good on its own terms also

[Patty · Rating 3 out of 5]

About 20 years ago, I read an essay by Grealy in a book about women and their bodies. (I can't figure out what that book was titled.) I was so impressed by her story that when Grealy's memoir was published, I read it immediately. I could not imagine being so honest about one's body and self image. I found Grealy's story fascinating and very forthright.
Then, I encountered Truth and Beauty by Ann Patchett. This is the story of her friendship with Grealy. It wasn't until I picked up Patchett's memoir that I realized Grealy had died. Although I had liked both books, I had put them out of my mind - I can't remember everything.
Then one of the women in my book group showed up with Autobiography of a Face as her pick for this year. I seconded the recommendation and here I am, revisiting Lucy Grealy's incredible life.

I believe the book has held up well. Given that Grealy has been dead for ten years and her memoir is 18 years old, it speaks well for her abilities as an author that the book is still read.

It is an affecting story, not only for her ability to see herself, but also for the mirror she has held up to society. I suspect our ability to deal with disability has not improved in all these years.

I recommend the book to those concerned with self-image, to readers who want to know more about what it is like to be "other" and to anyone who reads memoirs. This is an especially good read paired with Patchett's Truth and Beauty.