James wakes up, throws up three times, and goes to the lounge where he reads The Big Book of Alcoholics Anonymous. He is convinced that believing in AA is just exchanging one addiction for another. He cleans the toilets thoroughly and vomits twice more. He feels no sense of accomplishment and vows not to clean them again. Returning to his room, he finds a copy of the Big Book and the Bible on the nightstand. He throws them out the window. He goes to the bathroom and tries again to look into his own eyes, but fails. In the shower he realizes that he is responsible for his own loneliness. He also thinks of Michelle from junior high school, his only friend. James helped her to lie to her family about a date she was going on with a high school student. While on the date, the car Michelle was riding in was struck by a train, killing her instantly.

James goes to bed and has a dream in which he finds a loaded gun under a bag of cocaine and puts the barrel of it in his mouth. As he pulls the trigger, he wakes up. He goes to the bathroom and vomits. Warren and James’s new roommate, the Bald Man, are in the bathroom. Warren holds James while he vomits. When Warren tries to get some help, James refuses. Warren loans James one of his shirts because James’s is covered in vomit. James is moved by the gesture. At breakfast James fills his plate and eats voraciously. Looking around the dining room, he notices divisions between the poor, the middle class, and the wealthy, and he sees a further division between the “wussies” and “the hardcore.” Leonard sits with him and tries to make conversation, but James doesn’t feel like talking. He leaves, gets more food, and eats again. He leaves the table and sees Lilly. He is struck by her beauty.

After lecture, Ken takes him to a meeting with Dr. Baker, who tells James that he’s done so much damage to his body that he will die the next time he uses drugs or has a drink. James has suspected this for a long time, so the news brings a strange kind of relief. He goes back to his room and sees that someone has put the copies of the AA book and the Bible back on his bed. James stuffs them into the garbage can. He decides that he is going to kill himself during lecture after dinner. Roy and Lincoln walk into the room, and Roy claims that James did not clean the toilets, leaving them filthy. James says that he cleaned the toilets that morning. He and Lincoln have a standoff.

After lecture, Roy and another man graduate from the facility. James gets ready to leave. He puts a note in the jacket that Hank loaned him, thanking Hank for his kindness and friendship. He folds Warren’s shirt and leaves a note. Leonard comes to join him, but James tells him, “Have a nice life,” and then leaves. On the way out he spots Lilly through the glass corridor separating the men from the women. He stares at her and takes in her beauty. At lecture Leonard tries to talk to him again, but James ignores him. James walks out of lecture and out the doors of the facility. Leonard follows him out and tries to convince him to try again. James attacks Leonard, grabbing his Adam’s apple, but Leonard refuses to let him go. James agrees to twenty-four more hours. The two return to the facility.


James is confronted with the Alcoholics Anonymous method of recovery several times in this chapter and quickly decides that it is a crutch, a wimp’s way out. As life at the facility continues and the Twelve Step program continues to pervade lectures, classes, and group therapy sessions, James is forced to either find a way to accept the Twelve Steps or find something of his own to believe in. His own growing humanity provides a handy outlet to this. To this point, James has never thrown up in front of others, but Warren and the Bald Man are on hand this time, and James is forced to finally show others just how sick he is. The vomiting worries Warren enough that he wants to call a doctor, but James won’t allow him to. Warren is forced to settle for helping James by loaning him a clean shirt, even if it’s one that James would never wear himself. In fact, it’s such a nice shirt that James feels strange wearing it. Still, he accepts the shirt, much as he did Hank’s offer of a jacket. He is learning to take help from others. He can no longer pretend that he is living in a vacuum. Other people exist, and he must interact with them.

Every morning James stares at himself in the mirror, looking for the person he thinks lives under the scars and the black eyes, but he cannot bring himself to confront whoever that is. The only person he can really talk to and face isn’t even alive. This is Michelle, his friend from middle school who died in an accident. He says that he believes he may die soon and that he hopes to see her wherever they end up, but then he comments that he doesn’t believe that she’s in a better place or that there is a heaven or a God, which reveals some conflict of faith. He believes that they’ve both been wronged as far as her death goes—he was blamed for her death while the boy she was actually with got away scot-free, and she didn’t deserve to die. He shows a strong sense of self-righteousness, deserved or not, and exposes the fact that he seems to feel as if life has dealt him a rough hand despite his loving family and privileged upbringing. James shows a fairly profound selfishness here—his friend died in an accident, and yet the person he feels sorry for is himself.

Dr. Baker’s assessment that James will die if he ever uses again seems to release James from what he certainly feels is a pointless existence. After he hears his “death sentence,” he is considerably more honest and open. He takes some time to really consider who he’s become in the past decade, and his full inventory is one filled mostly of blackouts, arrests, and people he’s hurt or left behind. It’s not a picture that James is proud of, and his decision to kill himself reflects that. Despite all this, the reader is reminded during James’s intended “last meal” that he has fond memories of his parents and brother, and of functioning as a family unit together with them. It’s a scene that he describes wistfully, and he clearly wishes he could go back and change how he’s done things.

He is bolder in his interactions with Leonard after the meeting with Dr. Baker. Although he doesn’t say too much, he does reveal to Leonard that he’s “coming to terms with some [things] .” And in what he believes will be his final encounter with Lilly, he stares openly at her, transmitting to her the very clear message that he finds her beautiful.