I can never tell what I'm doing when I'm in the middle of publication because I have no confidence. I have terrible self-esteem, along with boundless narcissism.

Two things put me in the spirit to give. One is that I have come to think of everyone with whom I come into contast as a patient in the emergency room. I see a lot of gaping wounds and dazed expressions. Or, as Marianne Moore put it, "The world's an orphan's home." And this feels more true than almost anything else I know. But so many of us can be soothed by writing: think of how many times you have opened a book, read one line, and said, "Yes!" And I want to give people that feeling, too, of connection, communication.

I got a lot of things that society had promised would make me whole and fulfilled - all the things that the culture tells you from preschool on will quiet the throbbing anxiety inside you - stature, the respect of colleagues, maybe even a kind of low-grade fame.

These are pictures of the people in my family where we look like the most awkward and desperate folk you ever saw, poster children for the human condition.

Mattie sat at the table, obsessing, orbiting around herself. She was sick of her worried, hostile mind. It would have killed her long before, she felt, if it hadn't needed the transportation.

Frequently, as so many poets and psalmists and songwriters have said, the invisible shift happens through the broken places.

You can get the monkey off your back, but the circus never leaves town