Gripped by haunting magazine images of starving refugees, Elsa has dreamed of becoming a nurse since she was a teenager. Of leaving her humble working-class Boston neighborhood to help people whose lives are far more difficult than her own. No one in her family has ever escaped poverty, but Elsa has a secret weapon: a tube of lipstick she found in her older sister’s bureau. Wearing it never fails to raise her spirits and cement her determination. With lipstick on, she can do anything --- even travel alone to war-torn Afghanistan in the wake of 9/11. But violent nights as an ER nurse in South Boston could not prepare Elsa for the devastation she witnesses at the small medical clinic she runs in Bamiyan.

Marya Hornbacher tells her story through scenes of astonishing visceral and emotional power. She takes us inside her own desperate attempts to counteract violently careening mood swings by self-starvation, substance abuse, numbing sex, and self-mutilation. How Hornbacher fights her way up from a madness that all but destroys her, and what it is like to live in a difficult and sometimes beautiful life and marriage -- where bipolar always beckons -- is at the center of this brave and heart-stopping memoir.