"The Reason You're Alive"

For anyone who saw military service during the Vietnam War “The Reason You’re Alive,” by Matthew Quick, will strike like a blunt instrument. For those who were in combat, it will hit like a hatchet, and I don’t recommend they read it.

The term “Post-Traumatic Stress Disorder” is used nowadays for anything from lingering anxiety after a minor accident to a truly disabling disorder stemming from a close brush with death. To this reviewer/psychiatrist, a more accurate diagnosis as it’s used here would be something like “Permanent Brain Damage Due To Exposure to Indescribably Horrendous Events.”

David Granger suffers from this disorder, and his problems are worsened when he crashes his BMW and sustains a severe head injury. During surgery for the latter, neurosurgeons discover a chimeric finding deep in his brain: a mass of… something… with hair and three tiny teeth.

In Granger’s words, “I absorbed a twin when I was in my late mother’s womb back in 1944.” Granger finds this absurd, but in reality these are not that unusual. Its significance to the story was never clear to me, however.

The over-arching emotion in this intense novel is rage, which blows out in all directions at unpredictable times: his wife Jessica learns not to touch him in the midst of a screaming night-terror, having found herself on the floor with his razor-sharp combat knife at her throat. He has carried the knife and a pistol since Vietnam, beneath the combat fatigues he wears compulsively.

Granger meets his beloved Jessica in a house where he has gone to check on a fellow combat vet whom he is concerned about. “We keep track of each other, make sure everything’s okay.” It turns out to be a drug house full of teenage girls attracted by the menu of mind-altering chemicals provided by his friend.

In the midst of the “party” he hears screaming from upstairs and walks in on an appalling scene with another vet and two teenage girls, one of whom he has raped and is pointing his pistol at. Granger’s uncontrollable rage explodes and leads him to hit the man, unknowingly killing him.

He and the girl leave and spend the rest of the night cruising in his beloved GTO and by the time they end up on an ocean beach early the next morning, he has fallen in love with her. Before they get home, Jessica reveals that she is pregnant by the rapist, does not want an abortion, and has decided her only way out is suicide, killing herself and the unborn child.

Granger forcefully turns her away from this, insists on marrying her, and rears the child Hank as his own. This is never revealed to Hank, and Granger finds little to love or admire in him, “a girly-man.” Jessica, it turns out, has been a nationally recognized artist beginning in high school, and Granger nurtures her as much as he can. These two facts plus Jessica’s recurrent, ever-worsening psychotic depression, present most of the structure of the book.

From the first, we get the sense that Granger is relating his story to an unseen and unspoken examiner of some sort, and the reason for this mechanism becomes clear in the unexpected, satisfying denouement.

As I’ve indicated, this is an extremely powerful book, depicting the crushing damage the Vietnam War inflicted on a generation of many of our best young men. It’s well worth reading, but it’s not for the faint of heart or the combat vet of any war. As a psychiatrist in the USAF from 1968 to 1970 (in a non-combat role, thank God) I can attest to this book’s accuracy. If anything, it soft-pedals the reality.