A poet and author recounts her nine-year struggle with a rare autoimmune disease in this spare and unsparing memoir of illness and recovery. At twenty-one, just as she was starting to comprehend the puzzles of adulthood, Sarah Manguso was faced with another: a wildly unpredictable disease that appeared suddenly and tore through her twenties, paralyzing her for weeks at a time, programming her first to expect nothing from life and then, furiously, to expect everything. In this captivating story, Manguso recalls her struggle: arduous blood cleansings, collapsed veins, multiple chest catheters, the deaths of friends and strangers, addiction, depression, and, worst of all for a writer, the trite metaphors that accompany prolonged illness. A book of tremendous grace and self-awareness, The Two Kinds of Decay transcends the very notion of what an illness story can and should be. Praise for The Two Kinds of Decay A New York Times Book Review Editors’ Choice Best Book of the Year, San Francisco Chronicle and Time Out Chicago “Moving . . . a fiercely truthful memoir.” —The Boston Globe “Hers is not a day-by-day description of this grueling time, but an impressionistic text filled with bright, poetic flashes. . . . Many sick people learn to live in the moment, but the power of Manguso’s writing makes that truism revelatory.” —The Washington Post Book World “Sarah Manguso has miraculously elevated the act of memory. She has found honesty, fear, longing and beauty in every moment of her young life, giving this book an intensity found nowhere else. You put it down panting with wonder and grief, but never with pity. A breakthrough in the memoir, and in writing.” —Andrew Sean Greer