Thomas Larson packs tons of emotion into this tiny memoir, and I went from being repelled by glimpses of his life I didn’t need to know about, to being moved almost to tears as I read while sitting on a very hard stool in a very crowded Apple Store, waiting for my appointment at the Genius Bar. Highlighting almost every paragraph, wondering how socially inappropriate it would be to cry about a memoir to a tech support guy–The Sanctuary of Illness had me like this so many times, but then always took things a little too far, causing me to reel from its total disclosure and turn away from sad, brilliant insight Larson free associates onto the page.

Larson is a man doomed, by that perhaps least onerous but most prevalent condition in the U.S. today. His father died of heart disease at sixty-one, and his older brother died of heart disease at forty-two. The book opens with Larson’s first heart attack, which he realizes is upon him as he’s teaching a class. Anyone who has ever been devastatingly ill in any way, from a panic attack to the stomach flu to a migraine to a heart attack like that which strikes Larson, can relate to his attempts to maintain social norms despite a failing body. What makes Larson’s writing so memorable is that this isn’t memoir filtered, this isn’t someone after the fact trying to put a bright spin on things. He portrays everything, and we’re there with him in the bathroom, we’re there with him as he’s mildly delusional, telling his class he has to leave, somehow driving himself to the hospital, blinking through random glimpses of emergency angioplasty. This isn’t illness, minus the ugly parts, less the endless indignities that might make the reader want to squirm. This is Larson exposed, at his most vulnerable, his heart literally failing as he watches.

This complete openness is also, to be quite unfair, what I disliked about The Sanctuary of Illness, as sometimes I wished for more filter between author and reader. Larson’s concerns about impotence early in the memoir are answered later with vivid glimpses of his sex life, fueled by Viagra, that still haunt me. A few sentences stand out as inappropriately, awkwardly much too pornographic for the rest of the book (disturbing all its reviewers, it seems). His explorations into therapy with his wife illustrate how devastating heart attacks can be for a significant other, and how deep the fear of death really goes in a rift between a couple, but again, this is really intimate stuff. And perhaps that is why we don’t talk about heart disease more in our society, as that leading killer which can strike from nowhere unannounced, lightning in illness form. Heart disease has such a brilliant and clear connection with death, looking at it straight on almost hurts.

But maybe we should. Heart disease is the leading cause of death for both men and women in the United States, and Larson’s story is a not only an explanation of the disease itself, and his struggle through it, but also an examination of all the various quirks and curiosities that surround it in our society: why men who feel like they’re dying choose to get in a truck and drive, alone, rather than seek help; the delicate and every-mysterious line, post-diagnosis, between angina and anxiety, heartburn and heart attack; talking about heart disease while eating out at a restaurant with friends, all of them made uncomfortable by what is or isn’t on their plates. The Sanctuary of Illness presents everything about heart disease, whether the reader would like to see it or not. Larson, in all his unglamorous over-exposure, trudges as an explorer, on a path so many of us seem fated to follow but few of us seem able to discuss.

The Sanctuary of Illness by Thomas Larson on Amazon.com/Powell’s.com/Indiebound.org