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A few years ago, Adam and I went through the process to become licensed foster parents. Every Monday night we attended class and basically learned how many different ways parents can go wrong while raising a child. Each week as we drove home, we marveled that anyone could survive childhood at all without being screwed up for life.

Beyond imparting an understanding of the experiences kids in foster care have gone through, our instructor also insisted we make connections between those experiences and the resulting behaviors. Why, for example, a child who has experienced food insecurity might hoard snacks under his bed or gorge herself at meals. Why a teenager who has endured sexual abuse might recoil from physical affection or, conversely, try to gain attention from adults in inappropriate ways. Our experiences in life, especially in childhood, play a large part in determining who we are, and to be a successful foster parent, you need to understand the reasons behind the behaviors you see. From the outside a suffering child may look defiant or withdrawn or aggressive, but those behaviors are a disguise, a suit of desperate armor over the pain.

Those classes, and the year we spent as foster parents afterward, kept surfacing in my mind as I read A Little Life. Jude St. Francis and his friends Malcolm, JB, and Willem are college roommates who form a lifelong bond. They share in each other's triumphs and commiserate over losses and failures, but Jude always keeps them at a distance. Even after years and years, none of them knows much of anything about Jude's life before he arrived at the university, and not from a lack of interest. The three of them can make assumptions—about why he wears long sleeves even in hot weather, or why he never shows interest in dating, or why he walks with a limp—but their imaginations are limited by their own relatively happy, stable childhoods. The reality of Jude's first fifteen years of life is bleaker than any of them could guess.

While I'm normally impatient with long books, what makes A Little Life tolerable is its very length. It's definitely a time commitment at over 700 pages, but those pages provide Yanagihara enough space to dole out the details of Jude's suffering in manageable pieces. Revelations come one at a time, interspersed between sections focusing on Jude's remarkably functional adult life. The more that is revealed, the more sense his occasionally self-destructive behavior makes. Sometimes his friends and loved ones don't know how to reach him, how to help him see himself as they see him, but we as readers can see that every single one of his behaviors can be connected with a straight line to a scene in his past—and the past can never be changed or erased, only accommodated.

So why read this book, now that I've made clear how wrenching it is? How can a book about a terrible childhood be anything but blatantly manipulative? I admit there were moments when I wasn't sure I wanted to keep reading, when I thought it might be better to save my heart from the vicarious pain of Jude's life. But there was always something that pushed me onward, some desire to bear witness even to this fictional life, because I know there are lives that resemble it closely that are not fictional, not in the slightest. And while I knew I wasn't guaranteed a happy ending—what would a happy ending even look like, for someone who has lived a life like Jude's?—I wanted to know the ways in which he would persevere, and to see how those who love him would help him do so.

A Little Life is a difficult read in every sense of the word, but like most difficult things, it's worth the effort.

With regards to Doubleday and NetGalley for the advance copy. On sale March 10.