I Know This Much Is True

I Know This Much Is True is the second novel by Wally Lamb, published in 1998. It was featured in Oprah's Book Club for June 1998. Plot summary The novel takes place in Three Rivers, Connecticut, in the early 1990s. Dominick Birdsey's identical twin Thomas suffers from paranoid schizophrenia. With medication, Thomas is able to live his life in relative peace and work at a coffee stand, yet occasionally has severe episodes of illness. Thinking he is making a sacrificial protest that will stop the Gulf War, Thomas cuts off his own hand at a public library. Dominick sees him through the decision not to reattach the hand, and makes efforts on his behalf to free him from the inadequate and depressing hospital for the dangerously mentally ill. In the process, Dominick contemplates his own difficult life as Thomas's brother, his marriage to his ex-wife, their only child dying of SIDS, and his hostility toward their stepfather. Dominick displays classic symptoms of PTSD as a result of stressors in his adult life. First in Thomas's interests, and then for his own sake, he sees therapist psychologist Rubina Patel, employed by the hospital. She helps Dominick come to understand Thomas's illness better and the family's accommodations to it. In the course of Thomas's treatment, Dominick is covertly informed of sexual abuse taking place in the hospital and helps to expose the perpetrators. He succeeds in getting his brother released but Thomas soon dies, apparently by suicide. After Thomas's death, Dominick discovers the identity of their birth father; part African American and part Native American. All a secret their mother had shared with Thomas but not him.