David Small grew up crushingly lonely, rendered mute from cancer surgery and largely ignored by his distant father, his even more distant mother and his cruel, possibly insane, grandmother.

His mother was a closeted lesbian and was in constant poor health. His father, a doctor, probably caused his son's cancer by exposing him to high levels of radiation in an attempt to cure his asthma. His grandmother terrorized him and tried to murder her husband. None of this was ever discussed, not even the cancer -- young David underwent two surgeries but was never told why.

Imagine the bitter and accusatory memoir that he could have written. What he has produced, instead, is a remarkable work of art.

"Stitches" is not a traditional written narrative, but is told through powerful pen-and-ink illustrations. With just a few lines and a splash of ink wash, he conveys much, each panel suffused with the emotions and images of childhood: the blank flash of his mother's glasses; the backs of his father's legs walking away; the cold bathroom floor where David sprawls, alone, after his grandmother deliberately scalds his hands.

Small survived by retreating into his imagination and his art. Eventually, he became an illustrator of children's books and winner of the Caldecott Medal and the E.B. White Award. "Stitches," his first book for adults, is mesmerizing and chilling. The narrator is wounded, yet not bitter. These are deeply damaged people, all of them, but in young David's face you see hope, a spark that tells you he will survive.

LAURIE HERTZEL