The narrator, Sonny's brother, asks him why he uses heroin. It is hard for this older brother, the upstanding sibling who has made a life for himself as a public school teacher, to understand why Sonny uses such a destructive drug.
At first Sonny says it is to feel confident and in control. As his brother probes, however, asking if heroin is what he needs to be successful at his music, Sonny says he is not sure that it is. What he is sure of is that he uses heroin:
"... to stand it, to be able to make it at all. On any level." He frowned and smiled: "In order to keep from shaking to pieces."
As his brother continues to try to understand, Sonny admits that plenty of people he has known have, in fact, shaken to pieces from heroin use. He confides that it is "repulsive" to him how much people have to suffer—even if it makes their art deepen. The narrator then asks Sonny if there is, realistically speaking, any way to avoid suffering. Sonny responds by saying:
"I believe not," he said and smiled, "but that's never stopped anyone from trying."
Sonny is caught between using heroin to try to escape the suffering that comes from being a black man trapped by racism in the Harlem slums and his desire to be clean. But he also admits that, on some level, it is the suffering that infuses his music with meaning. While he sometimes feels overwhelmed, he assure his older brother that:
"I won't," he said flatly, "die trying not to suffer."