Skin (review)

"I have to do something," thinks a frightened Donnie about his anorexic older sister. "She's getting so small." In fact, the opening scene has already revealed that Karen eventually dies of her disease, and the book then goes back to trace, through Donnie's viewpoint, the year leading up to her death. There are some high spots in the year, such as Karen's friendship with new neighbor Amanda, and the summer vacation wherein Donnie, Karen, and Amanda are a close and happy trio; mostly, though, the year is dominated by the bitter, repeated battles between the siblings' parents, by Karen's enduring resolve to restrict her food intake, and by Donnie's descent into miserableness and, ultimately, self-erasure at school and at home. This is probably the most subtle and emotional portrayal of an eating disorder in young adult literature, made all the more effective for being not a problem novel per se but a depiction of a family in a whole spectrum of agony. There's no reductive causality here—Karen's parents have histories that make their unhappiness valid, and it's clear Karen's disorder has a momentum of its own separate from her parents' problems. Yet the book is really about Donnie, not Karen, and about the way his life is being silently eaten away as hers is being starved away; its redemptive promise lies in the fact that he finally manages to find his way out of deprivation when she couldn't. Sharply observed in matters small and large, this is a poignant and heartbreaking portrait of familial and individual distress.