Stitches by David Small is an illustrated memoir of incredible power. As a child he received the gags that narcissistic and bitter parents apply. More interested in their own lives, their own attempts to escape themselves and each other, his parents treated Small and his brother as less than afterthoughts, more than annoyances.

Treated as a baby by his father, a radiologist, with X-rays for a breathing difficulty, Small later developed cancer in his throat when a teenager. The tumor, ignored to the point that he lost half his vocal cords and therefore his voice, was finally removed. The surgery gave him a line of stitches from his ear to the top of his sternum, and left him as silent as his parents had always wished him.

Through this experience he developed a love of art, literature, and escape. He withdrew into his drawings and fantasies, acted out at schools until expelled, and finally found his way into the chair of a therapist with the honesty and heart to tell him his mother didn’t love him.

Stitches has been reviewed and talked about extensively. It was reported on in The New York Times and USA Today. Publishers WeeklyStitches. WW Norton rightfully provided heavy promotion, and people noticed and talked about it. A book doesn’t become a National Book Award finalist if its not being talked about.

Much of the discussion centered on who the audience was; there was debate on whether it should have been nominated as an adult non-fiction book rather than in the young people’s literature category. What is its place? Who is reading it? Small’s own hope for the book seemed to center on helping adults see their own childhoods with objectivity, to parent without repeating the mistakes made upon them.

Through all of this discussion ran the question of whether the graphic nature of the story was too strong for young readers. There are the elements of his treatment, his mother’s sexuality (she was a lesbian; something Small discovered when he walked in on her and another woman one afternoon), and the scarring psychological impact of his treatment that concerned some. Response to these concerns included the argument that young people are exposed to some horrible conditions. Thankfully, few children undergo the levels of parental torture and neglect that he experienced. Painfully, too many children will suffer comparable fates.

Missed in both these views is a recognition of how Stitches presents itself. Is it a story of overcoming odds? In one sense, yes, of course. Small overcame his horrible childhood and the mutilation of his self-expression by finding other means of expressing himself. He is an artist of incredible talent, and his career as a childrens’ book illustrator and author was impressive before Stitches arrived. To hold the book in your hands is to hold proof that he survived, thrived, achieved levels of talent and expertise few people can or will. Yet, it is worth asking this question: is that what the book is about? Is it about a rise from the ashes?
 
Stitches (I mean here the physical sutures themselves, not the book) are a prelude to healing. They are also a prelude to scarring. To have stitches is not to undo hurt, but to build upon and past it, to incorporate it into you in a way that cannot be removed. The injury is hidden, perhaps, but not undone. The ending of Small’s beautifully illustrated memoir, while magnificent, does not vanquish the pain of what came before any more than reading it vanquishes the uneasy connection we make to the extreme suffering he endured. The connection we make to him, the place we find for ourselves on the scale of suffering, captivates us in our reading.

In the Publishers Weekly pictorial essay, Small tells why he wrote the book. The drive to tell the story was turning him into a monster, but early work on it, particularly about his mother, released a rage he couldn’t face. So he didn’t. He turned inward.

He depicts himself as a Frankenstein creation. He terrorized his wife and self-medicated with alcohol. One evening he rushed into a restaurant bathroom and realized his neck was swelling in the same place that the tumor had been, that his corked rage was turning on him, that it would kill him, as the cancer would have if it hadn’t been taken out. Stitches is the result. He had to release the rage.

The book does not exemplify rising above, it exemplifies the continuing, life-long struggle to release the toxic histories we drag around with us. His survival is unquestionable, and so too his ascent out of self-pity or denial, but to claim the book illustrates his flight away from pain is to misunderstand its content. Small did not illustrate his successes, here, he illustrated his bruises. This isn’t a book about rising from the ashes, it’s the story of recognizing that rising is possible, but more likely a dream, and that walking on the ashes is far more likely.