James wakes up on a plane with a broken nose, four missing teeth, a hole in his cheek, and eyes swollen nearly shut. What is worse is that he has no idea how he got there, what happened to him, or where he is going. He discovers that he fell down a fire escape face first; a friend contacted his parents, telling them their son needed to get some help. His parents meet him in the Chicago airport and they drive to their cabin in Michigan. James is unable to make the trip without the benefit of alcohol and cigarettes, and his mother is especially distraught at his plight. They have arranged for their son to enter a rehabilitation clinic in Minnesota, and they pick up an older brother on their drive there. Despite the bottle of vodka he has consumed, James is afraid but understands he needs to make a drastic change after this traumatic incident.
Once he is admitted and his family leaves, James suffers from the inevitable effects of detoxification and withdrawal. He sees bugs and shadows and bright lights; he knows they are not real but cannot help reacting. In meetings with his doctor (who rebroke his nose and put forty-one stitches in his cheek) and Ken, his Unit Recovery Advisor, James admits he is addicted to alcohol and cocaine (though he will use anything), a habit he began at the age of ten. He is taking drugs at the clinic to counteract the symptoms of withdrawal; they make him numb and allow him to sleep. In line for his meds, he meets Lilly, a fellow patient. They talk for a few moments, but any interaction with those of the opposite gender is against the rules. James is warned. He is taken to his new home in the rehab center, a unit called Sawyer, where he meets his three roommates. When he meets with Ken, he freely admits to outstanding criminal charges (ranging from DUI to assault) in multiple states and to dealing drugs for a living. Ken asks him if he is “willing to do whatever it takes,” and eventually James answers, “I don’t know.” For the first time in his memory, he is actually aware of going to sleep rather than blacking out at night.
The clinic arranges for him to meet with a dentist, but first he must do his assigned chore. He cleans the group bathroom, only to violently vomit into one of the toilets for some time afterward. What he expels, besides blood and bile, appears to be pieces of his stomach. This is a typical morning experience for James. At the dentist’s office, he realizes by the reactions of those around him that he must look hideous. James tries to concentrate on some of the lectures he is required to attend but is struggling. Like so many of the others, “the Addicted without their addictions,” James is not convinced he will be able to conquer the demons that plague him. He talks to his parents and is amazed that they could still love him. He attends lectures and is skeptical that he will ever really recover. He is unable to meet his own eyes in the mirror; one day when he can do so, he knows he will be able to recover. James assesses his problem succinctly: “It’s always been the same, I want more and more and more and more.” He briefly recalls a young girl from his college days with great regret. On his fifth day of rehab James has an incident. After waking up from a “User Dream” and retching violently once again, James is cleaning the group toilets. One of his fellow residents attacks him verbally, and something in him snaps. There is a fight, some restraints, and finally a needle.
The next day he wakes in the medical ward and then leaves to get his dental work done. The van driver, Hank, is kind to him and gives him a warm jacket to wear. It is an excruciating experience because patients in treatment are not permitted to have any painkillers. He has one cavity filled, two caps put on, and two root canals—all without anything to dull the pain. He survives but wishes he had not. James understands who he is: “I am an Alcoholic and I am a drug Addict and I am a Criminal.” If nothing changes, he will die as an alcoholic, an addict, and a criminal.
As James continues his pattern of vomiting and craving, he recalls a young friend from eighth grade. Michelle was his only friend. She was a popular and successful student and no one bothered her about her friendship with James, an angry and rebellious young man. She got asked out on a date but was not allowed to go; instead, she lied and said she was going to the movies with James. Michelle and her date were killed when a train hit their car on some railroad tracks. Everyone blamed James, and James blames himself.
When James sees the doctor to get his medical assessment, the news is as bad as he had expected. There is substantial damage to every major organ in his body, and the prognosis is dire: he will likely die if he ever takes another drink or does another drug. At the age of twenty-three, James Frey is given a death sentence. He determines to leave the Clinic, which he is perfectly free to do at any time, and go somewhere, anywhere, to end his life. While at lecture that night, he steps outside in the rain and begins walking. One of his fellow addicts, an older man named Leonard, follows him. Leonard is the only one in the house who is not put off by James’s boorish attitude and behavior, and he tells James he has the resources to search him down and bring him back if he carries through with his plan to leave. His eyes tell James he means it, that he will use his mysterious resources to find him. James sees in his eyes that Leonard will do what he says and that he believes James can recover. Twenty-four hours is all James gives Leonard; Leonard gives James a hug. He is scared beyond measure, but he will try.
James anticipates that the twenty-four hours he promised Leonard will be difficult for him, but he keeps his word. He inexplicably pulls out the stitches from his cheek, has breakfast with the persistent Leonard who tries to explain why he wants to help James, and has his first visitors. His brother and two old friends come and bring him some very basic things that seem like priceless treasures to him. Lilly’s grandmother is also visiting and is kind to him. James makes some phone calls to friends who have inquired after him. His parents want to come to a special class for parents of addicts, but he is clear with them: “I don’t want you here.” He talks to a friend who fills in a few of the gaps about the night of his fire-escape fall; none of it is a real surprise to James, and none of it is good. One of James’s roommates thinks he has offended him and tries to give James his daughter to make up for it. At dinner, James continues a pattern of filling the need he feels inside with food until he has to go expel it all because there is not enough room in his stomach to hold it. James falls asleep with a smile on his face. He has made it through the twenty-four hours he promised Leonard, and it was one of the best days he has had in a very long time.
The next morning begins unlike the rest; although James stops in his usual place at the toilets to expurgate what is roiling inside him, he feels no need to vomit. After being sociable at breakfast for the first time since arriving, he meets with a counselor to discuss his psychological evaluation. The diagnosis is that he is an angry addict, something he already knows. James is adamant that no twelve-step program will help him and refuses to even entertain the idea. Later in the day, though, he is walking around the grounds and has a kind of epiphany. He cries and decides to stay, to fight, and to live.
The following morning, however, begins the same as all the others. During another morning walk, James again feels his rage and anger build; he starts to rip and tear savagely at a small pine tree in front of him. From behind him comes a voice; it is Lilly, and suddenly all he wants is to lean on her and cry. He does so, soaking both of them in his tears. It has been a long time since James has felt so vulnerable or so touched by a woman.
Leonard tells him more of his story, and James again remembers the girl from college, whom he obviously loves. Lilly passes him a note at mealtime asking him to meet her at their clearing later. James is moved to a room with only one roommate, Miles, who is a State Supreme Court Judge and plays the clarinet. As Miles plays one night, James begins reading the Tao Te Ching, one of the books his brother brought him, and it helps give him some perspective on his life. The tenets do not ask anything of him, they simply are truths by which he believes he can live. James admits he is tired of being hard (angry, even furious) all the time; he wishes he were soft, but it does not seem likely for him:
I’m wanted in three states. I’m addicted to alcohol and crack. I’m unemployed, unemployable and completely broke. I’ve blacked out every night for as long as I can remember and my time in here is the longest stretch of sobriety I’ve known since I was ten years old. I am out of control.
He and Lilly meet as planned, and James is as honest with her as he has been with anyone, knowing he can trust her to not hurt him or use what he says against him. He even talks of the girl he met and still loves in college. They make plans to meet again despite the Clinic rules prohibiting it.
Life is a little better for James. He realizes he has a few friends, a few weeks of sobriety, and a few possessions—none of which he had when he arrived. Although he is a happier man, his consistent morning vomiting is a reminder that his body is still suffering the effects of a lifestyle that nearly killed him. “I’m not happy, but I’m not unhappy.” The one thing he is still fighting is the Alcoholics Anonymous program the Clinic wants him to adopt. In his mind, it is simply a replacement addiction.
Despite his insistence that he does not want them here, James’s parents are flying in from Tokyo to participate in the family program....
(The entire section is 4131 words.)