This is not an easy book to read. It is a very good book, and worthwhile reading, but it is not a pleasant book.

Nate Powell brings us into the world of Ruth and Perry, a teenaged brother and sister who live in a fairly normal family somewhere in the South. Their parents are loving, if a bit exasperated and distant at times; their house is small and not particularly nice; and as the story opens, their seriously ill grandmother is arriving to spend her dying days (which turn into years) lying on their couch.
 
On the surface, this family looks normal, but that’s what makes the hallucinations so striking. Both Ruth and Perry see things that aren’t there, and the things they see control their lives. Perry’s vision is simple: A wizard who sits on the end of his pencil and commands him to draw. Ruth’s is more complicated: She sees insects, a multiplicity of creatures who pile in through gratings and windows or simply buzz around her as she walks. She fills jars with specimens of different bugs and arranges and rearranges them as a way of exerting control over the world.
 
One of the things that makes this book so compelling is the way the hallucinations mix in with ordinary life. Ruth and Perry help with the dishes, go to class, sit with their ailing grandmother, but all the time they are accompanied by these odd manifestations. Sometimes they slip in public, talking back to the hallucinations within earshot of outsiders, but the bond between Ruth and Perry is built from the understanding that only they have, the shared family secret of things that aren’t there. As the book goes on, their grandmother reveals that she, too, has had visions. Memaw may be old and sick, but she is sharp enough to see what is going on.
 
The great advantage of the graphic novel form is that Powell can use visuals not only to depict the hallucinations but also to show the inner states of his characters. Most of his pages are dark, the characters and settings hidden in heavily hatched shadows, but when Ruth begins taking antipsychotic medications, the shadows drop away and the drawings become bright and clear.
 
While Perry’s hallucinations stay more or less under control, Ruth’s grow stronger, and she submits to them more and more. It would be easy to be heavyhanded about this, but Powell continues to interweave Ruth’s inner demons with the ennui of everyday life. Some of her actions, such as stealing a stuffed frog from a museum, seem clearly “crazy,” but when she stands up to a teacher’s clumsy racist joke, it’s hard not to sympathize.