Lucy Grealy tells a story about not fitting in, unbearable pain that takes up residence in one's head as loneliness and confusion, questioning what things mean, being scared and lost in your family, enduring intense physical pain, and most importantly, figuring out who you are. Lucy had no idea she might die, even though the survival rate for Ewing's sarcoma was only five percent. She does not present her parents as overly afraid for her life, either. Her autobiography is not a story about the fear of death, but about such courage and anguish.

Lucy shows how she falls under the spell of her disability, allowing it to control her life and dictate her future to a greater extent than it would otherwise. Having a disability means that sometimes you have to say 'I'm disabled, therefore I can't... .' , but as Lucy finally learns, it also means sometimes saying 'I'm disabled, but I can!" Through her traumatic tale of misfortune, she has sifted out truths about beauty, the public, and self-concept. Lucy's description of her early disease is particularly upsetting. Her family, overwhelmed by financial and emotional turmoil because of the stress of her illness, is not as visible as the part they actually played. Lucy's mother was a somewhat blurred figure who seemed to disappear by the middle of the book and portrayed her father as a particularly vague individual.

However, the day-to-day trappings of illness force her to rely on her mother, whose relationship is one of the most disturbed, and moving. Early on she comments that when she was a child she didn't understand that her mother's anger was caused by depression, but she never elaborates on this observation. Her mother compares being brave with being good, and says: 'At a time when everything in my family was unpredictable and dysfunctional... here I had been supplied with a formula of behavior for gaining acceptance and, I believed, love. All I had to do was perform heroically and I could personally save my entire family." Her words to Lucy to be brave, not to cry and not to give in to suffering and pain, only added to Lucy's burdens.

Yet, one feels deeply sad for her simply because she is a mother with five children, a job, and constant money problems. She was a victim of depression even before Lucy's illness, driving into the city five days a week for Lucy's chemotherapy and radiation treatments, watching her child suffer day after day. A strong sense of satisfaction came when Lucy describes the joy and delight she felt on the fourth day following her weekly chemo treatments. With all her suffering, Lucy was awakened to all the glories of living to which we remain unaware of so much of the time. Lucy also exhibits a sensible, mature understanding of her father. She realizes he left her alone during her terrifying and traumatizing treatments with a completely heartless and hateful physician only because of his own inability to deal with and accept the type of pain his own daughter was experiencing.

Through these extraordinary events, the family, overwhelmed by shock and shame, abandoned Lucy emotionally. The cruelty of children is something we all can relate to, but under the circumstances Lucy was experiencing, it was outright inexcusable. From the boys in the lunchroom, to the drunken men in the railroad dining car, and the 'how'd you get so ugly', these instances contributed directly to Lucy's self-perception. At school her disfigurement causes her to be constantly harassed and she is forced to eat her lunch alone in the career guidance counselor's office. 'I felt safe and secure in that office, but I also felt lonely, and for the very first time I definitively identified the source of my unhappiness as being ugly." Once after one of her many operations, she has a conversation with a woman who is having a mastectomy. At first, Lucy felt unsympathetic because she saw a breast more hidden than a face.

Lucy eventually realizes the woman's suffering and says, 'Her feelings of ugliness consumed her as much as mine consumed me... but there was no doubt she was beautiful. Her problems lay in her perception'. At 10, she began to mature emotionally at a rate uncommon to children facing a catastrophic loss. She tells of receiving solace and understanding more from a seriously ill asthmatic boy from a troubled family than from her own family. The years of cruel school taunting and reconstructive surgeries finally took their toll.

Brilliantly explaining the pain of being rejected by her classmates and the secret desire to feel special, Lucy openly captures the pain and heartache of a girl growing up wanting nothing more than for others, as well as her self, to get past her physical flaws and love her for who she is on the inside. Other patients who suffered similarly by disfigurement and handicaps play a more prominent role in Lucy's experiences. From them she gathered the courage and strength that made it possible for her to survive. Lucy wonders early on "how do we go about turning into the people we are meant to be?" For years, the answer didn't come to her because of what she saw, or what she didn't see when she couldn't attempt to look in the mirror.

However, a change in Lucy's perceptions starts to occur when she realizes that she has fallen victim to society's perception of appearance and stereotyping. Until this point, she has accepted that she "is" her face that is too ugly to go to school and doomed by her appearance to a life with no possibility of love. She only saw a life devoted to trying to 'fix' herself, rather than to loving and accepting herself. People staring, name-calling, the emphasis of beauty in advertising, sharing a room with a woman having cosmetic surgery, and even literature filled with physically beautiful women all relentlessly bombarded Lucy with the message that beauty is the only key to a woman finding happiness and love. In conclusion, "Autobiography of a Face" shows how Lucy identified herself with her face above everything else around her.

The autobiography of Lucy Grealy has become the autobiography of her face because for eighteen years of her life Lucy was nothing more than a face, or at least it seemed so and it is also how she perceived herself. Doctors, fellow students, family members, and complete strangers saw not a woman with a disfigured face; they saw a disfigured face. The book's title portrays that it was just her face that suffered, but in all actuality her body also took a pounding to her years of chemotherapy and the numerous facial surgeries. Whether it was years of chemo making her ill to the point that she never fully grew, or her hair falling out, she was undoubtedly self-conscious about her physical flaws.

The multiple operations used skin grafts taken from her back, legs and stomach, and bone grafts from her hips. All of the transplanted tissue always dissolved away completely in her face, so she experienced pain and accumulated scars for nothing. On contrary, Lucy went on and did well at college and gained a reputation for being a great poet, but one last chance operation comes up near the end of the book and her response is moving, she says, 'How could I pass up this chance... to fix my face, fix my life, my soul?' This statement alone reveals the belief that the extent of an illness can change ones life forever. All in all, I believe that Lucy Grealy did finally understand and learn to accept herself for who she is with confidence, but not without buying into the popular cultural belief of beauty and happiness..