At age 24, Janet Buttenwieser moved to Seattle with a résumé devoted to public service and fantasies of single-handedly ending poverty. But within a year she’d developed an intestinal illness so rare she wound up in a medical journal. Janet navigated misdiagnosis, multiple surgeries, and life with a permanent colostomy. Like many female patients her concerns were glossed over by doctors. She was young and insecure, major liabilities in her life as a patient. How would she advocate for low-income people when she couldn’t even advocate for herself?  Janet’s model for assertiveness was her friend Beth. She was the kind of friend who’d accompany you to the doctor when you got dysentery in Ecuador, nonchalantly translating the graphic details of your symptoms into Spanish. Throughout Janet’s illness Beth took care of her; then she developed brain cancer and their roles reversed. Eventually Janet recovered, but Beth’s condition worsened. At the age of 38, Beth died. To cope, Janet competed in endurance events, becoming a triathlete with a colostomy pouch.

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“Blunt, eloquent, piercing, honest, witty, heartaching, startlingly funny, and beautifully, refreshingly unique. Can you read a book about pain while grinning and trying not to cry and not being able to think of a single book that’s anything like it? Yup. This one. Guts.” 

— Brian Doyle, author of Mink River

“A beautiful and honest portrait of resilience and emotion along the winding path of a friendship woven with long-term health issues. Janet Buttenwieser writes with a keen eye not only about medical challenges but also places these challenges in their rightful place among the supports of friendship, love, career, and community. Buttenwieser’s clear prose shares confidences like a friend, and I found this book difficult to put down.”

— Sonya Huber, author of Pain Woman Takes Your Keys and Other Essays from a Nervous System

“GUTS is a fearless memoir about the limits of the body and the strength of the spirit. Janet Buttenwieser’s journey through chronic illness, infertility, and loss will resonate with anyone who’s ever wondered why bad news always comes in waves. Her grit and sense of humor make this an unforgettable story.”

— Leigh Stein, author of Land of Enchantment

“You’ll be hooked from the very first scene, intrigued by the story’s promise: a woman’s decisive, tenacious journey through illness and loss. This book is about friendship, family, and the challenge to accept—and survive—the events in our lives beyond our control.”

— Nicole Hardy, author of Confessions of a Latter-day Virgin