The woman Tom describes, “wallowing” in self-pity and unable to decide what the world should do about it, is exactly the woman I grew up afraid of becoming. I knew better—we all, it seems, knew better—than to become one of those women who plays victim, lurks around the sickbed, hands her pain out like a business card. What I’m trying to say is, I don’t think this was just me. An entire generation, the next wave, grew up doing everything we could to avoid this identity: we take refuge in self-awareness, self-deprecation, jadedness, sarcasm. The Girl Who Cried Pain: she doesn’t need meds; she needs a sedative.

And now we find ourselves torn. We don’t want anyone to feel sorry for us, but we miss the sympathy when it doesn’t come. Feeling sorry for ourselves has become a secret crime—a kind of shameful masturbation—that would chase away the sympathy of others if we ever let it show. “Because I had grown up denying myself any feeling that even hinted at self-pity,” Grealy writes, “I now had to find a way to reshape it.”

Reshape it into what? Into faith, sexual promiscuity, intellectual ambition. At the pinnacle: into art. Grealy offers this last alchemy, pain-to-art, as possibility but not redemption. It seems likely that for all her wound has given her—perspective, the grit of survival, an insightful meditation on beauty—Grealy would still trade back these wound boons for a pretty face. This confession of willingness is her greatest gift of honesty, not arguing that beauty was more important than profundity, just admitting that she might have chosen it—that beauty was more difficult to live without.