How do you convey something so maddeningly inconceivable? How do you make someone understand a disease that so frequently evades science, medicine, the very people who suffer?

In Wintergirls (Viking, 2009), young adult author Laurie Halse Anderson tilts a prism of ice, splintering the light of eating disorders, self-injury, and the girls trapped in unimaginable self-destruction.

Wintergirls opens as eighteen-year-old Lia learns of her former best friend Cassie’s death. (We’ll later find out with Lia that Cassie died as a result of the horrific consequences of chronic bulimia.)  Lia, who has spent two stints in eating disorder treatment, is already holding tight to the anorexia she believes keeps her safe. Cassie’s death – and the thirty-three calls from her that Lia ignored the night before – catapult Lia through the increasing cold of New England’s late fall/early winter. And then Cassie’s ghost comes to haunt Lia, and we walk away unsure if Cassie’s truly there or if she’s become an internal persona attached to Lia’s disordered thoughts.

I like to think of myself as a connoisseur of sad-girl books: teen-girl novels, grown-woman novels, memoirs (so many memoirs).  Teen-girl novels are problem novels. Girl has problem; girl fixes problem. The problem is the story, and that’s that.  Grown-woman novels are frequently memoirs in disguise.  And memoirs are digested – information spun during years of therapy and refashioned into a charming survival narrative.  The brutality of the moment has been cut, sanded, and stained – the difference between a tree and your dining room table.

This, though, this is beautiful and right there.  The little thoughts of guilt over Cassie or moments in Lia’s past break through the paragraphs.  Each breakaway, each cross out, puts us closer and closer to Lia’s thoughts. The school nurse hands Lia a cup of orange juice. “I take the cup from her. My throat wants it my brain wants it my blood wants it my hand does not want this my mouth does not want this.” Or, “I inscribe three lines, hush, hush, hush, into my skin. Ghosts trickle out.” Lia and her family are all richly dynamic characters, leaving the problem as a result of the characters – rather than the characters a result of the problem.

The very power of the book is also its greatest danger. For almost every food Lia eats, she gives us the calorie count. Her designated post-hospital “healthy” weight still leaves her at an underweight BMI. (Intended or not by Anderson, low discharge weights frequently end in relapse.) Lia visits pro-anorexia websites, snippets from which are included in the text. Critics have discussed the hazard of this material (which I’ll argue is so beyond easy to find on the Internet that reading it in a book is a moot point) and also how, as the novel progresses, it’s so easy to fall into Lia’s thought patterns. Everything she says seems logical. On a narrative level, this means Anderson succeeded admirably at her job. Don’t break the dream, right? She slams us right into it and holds us there. It hurts.

So there’s the big question: should an author keep secrets? The most brutal parts of us, the spider-web thoughts that confuse us, that help us understand each other, are so quickly taken for the damage they do. If one girl falls over the ledge between thought and action after reading a book like Wintergirls, is that one too many for the good the book might do? What if it brings one girl back? Or helps a mother understand her little girl?  We know how much the disorder is hurting Lia both physically and emotionally. She sprints, limps, and then crawls her way right to that line between the living and the dead where she’s forced to make a decision about her recovery because no one else can do it for her. We also know how much her suffering hurts her family, especially her younger stepsister. By novel’s end, we are reminded of the very illogic of Lia’s logic.

What happens to writing if we write with our fingers wrapped in the fear of liability?  What of any topic we want polished, polished, polished, so that we might only acknowledge the good? Gender, race, sexuality, class, religion, any of it. All of it.  We so often take discussion and disclosure as tacit endorsement for the very thoughts that scare us the most. We say help us understand, but we so very rarely seem to actually want what understanding entails. And that maybe hurts the most.