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Am J Psychiatry 1997;154:1774-1789.
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The books for this month are a holiday gift list: books to broaden the library and the mind, to provide pleasure and enjoyment, to give to oneself and others.

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Angela's Ashes: A Memoir, by Frank McCourt. New York, Simon & Schuster, 1996, 364 pp., $24.00; $13.00 (paper).

A century has passed since Leo Tolstoy wrote the first line to Anna Karenina: "All happy families are alike but an unhappy family is unhappy after its own fashion." Today, the word "dysfunctional" is often used to describe the unhappy family. However, as a clinical descriptor this term is sadly imprecise and trendy. Unlike a true medical diagnosis, it is a conveniently blurry label that sweeps across a broad array of human experience and clinical findings, suggesting an emotionally chaotic family lacking love, attention, and nurturing. At the most pathological extreme, psychiatrists encounter such families wrought in the chaos of addiction, physical and sexual abuse, and premature death. Angela's Ashes looks through a child's eyes at a family crippled by alcoholic havoc. In the second paragraph, the author recalls, "When I look back on my childhood I wonder how I survived at all. It was, of course, a miserable childhood: the happy childhood is hardly worth your while." An unnerving beginning, don't you think?

Frank McCourt is the oldest son in a family collapsed in poverty, gut-wrenching hunger, squalor, and paternal alcoholism. His was virtually a childhood where nightmares walked in daylight.

The story begins a month after Black Tuesday, the beginning of the Great Depression. The place is Brooklyn, New York. A young Angela Sheehan arrives by ship from Ireland and soon, at a neighborhood party, meets Malachy McCourt. Frank McCourt describes him as having a hangdog look from the 3 months he had just spent in jail. Angela is attracted to the hangdog look, and the reader soon recognizes that life with Malachy McCourt will never be plain vanilla. After what the author calls a "knee-trembler," a child is conceived; there is a walk up the middle aisle, and drunkenness, debt, destitution, and more children follow.

Four years into the marriage, there are five children. Then the youngest dies. The cause seems multifactorial: infectious disease, malnutrition, parental ignorance, and neglect. Angela's relatives know she is married to a man beyond control and recommend the family return to their native land. The immigrant dream has failed. Money is sent from Ireland for the family to return.

What follows is a chronicle of a family barely holding on to a rim of survival in Limerick, Ireland, from roughly 1934 to 1948. Malachy McCourt seems never to hold a job more than 3 weeks. His alcoholism, even by the tolerant norms of early twentieth-century Irish society, is "beyond the beyonds." Addictive irresponsibility creates unpredictable havoc for his family. Destitution and the deaths of two more children result. At age 10, the author is hospitalized with typhoid for more than 3 months in the Fever Hospital at the City Home. While hospitalized, the young Frank McCourt meets 14-year-old Patricia Madigan, who is dying of diphtheria, and is introduced to poetry and Shakespeare. He tells Patricia that Shakespeare's words are like having jewels in your mouth. It seems the author never forgets the cadence and prose of eloquent language. Some of this book's most touching incidents occur outside the family setting, when the author is hospitalized, at school, or during moments of early love.

Pride and whiskey are a bad blend, and Malachy McCourt had too much of both. He was a selfish, shameless alcoholic who, when either righteously sober or pub-crawling-gutter-gliding drunk, intimidated his wife and children, demanding "dignity and respect." Habitually, after drinking the paycheck or charity dole, he would return home to a hungry family with the kiss of whiskey on his lips, singing melancholic Irish ballads and awakening the children to have them swear they'll "die for Ireland." He was an idler who chased the love of whiskey and sang of the sufferings of Ireland without ever incorporating the connections. A mindfulness to the Gaelic proverb: Is milis d ¢l é ach is searbl d ¡oc e (It is sweet to drink but bitter to pay for) would have served his family better.

What unfolds, in an appallingly predictable way, are the effects of Malachy's severe alcoholism underpinned by ironclad character pathology. His world is painted in black and white with clear, egosyntonic, categorical absolutes. His hatred for the English, his perceived ancient foe, reaches back 800 years. He possesses a fondness for delivering final judgments. Malachy's pontifications are forever bold, but his deeds are wanting. When he speaks, his words often reek with the garlic we label axis II. (It appears that only when sober and with his children is he capable of transcending himself. He becomes the genuine Irish storyteller and spinner of tales that would make Scheherazade wink.)

Young Frank McCourt likens his father to the Holy Trinity—a man with three identities: the one who quietly reads the newspaper in the morning, the one who tells the stories at night, and the bad one with the smell of whiskey. Freud had awareness of the likes of Malachy McCourt when he commented that the Irish were the only people who could not be helped by psychoanalysis (1).

The author is a writing teacher at Stuyvesant High School in New York City. Angela's Ashes is his first book; it earned him the Pulitzer Prize. At the time of this writing, the book has stood solidly on the New York Times Book Review bestseller list for a year. It is more than a memoir of alcoholic devastation in a family; it also provides, in astonishing detail, an accurate portrayal of the lives of the poor in the Ireland of the 1930s and 1940s. This is an Irish story without blarney or impish shenanigans. The author deftly ties together everyday family life and neighborhood happenings. His attention to detail is impeccable, and his language forges strong images.

The narrative uniqueness of Angela's Ashes is the point of view. It is a continuous, present-tense tale told from the viewpoint of a small child growing to young adulthood. Emotionally seared memories are retold in the echoing voice of a child who stood invisibly, watching attentively—much like a psychiatrist. The tone is conversational, and the language is forthright, unvarnished, and captivating. This is a memoir that reads like a well-crafted novel.

Angela's Ashes is also available on audiocassette. The audio version is slightly abridged without omitting important incidents. The cassettes are ideal for psychiatrists wishing to listen while commuting, and they provide a slightly lesser alternative for those with little time who want to experience the essence of the book. The cassettes offer the advantage of hearing the author narrate his own story in a buoyant Irish lilt.

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