Illness is like love in that it is paradoxically a general phenomenon and also a specific, intensely individual experience. Shelby Smoak — a sensitive, unpretentious young man from a loving family who was born with hemophilia and contracted HIV from a blood transfusion at age 11 — is a similar contradiction: an archetypal young American who is also totally unique. “Bleeder,” his often painfully beautiful account of living in the shadow of a stigmatized illness, begins when he’s 18, and his health care provider is required to tell him his status. From then on, he feels set apart from the rest of his world.

This memoir, which takes us to the advent of the miraculous protease inhibitor drugs, is remarkable for being utterly, brilliantly ordinary. Memoirs of illness are often praised for their lack of self-pity, but Smoak also avoids the pitfall of swagger. He never pretends to be anything but a well-loved young man who is reasonably frightened by what he’s going through.

A young man who “goes to the hospital like other people go to the mall,” Smoak finds that his strength as a writer is his ability to closely observe — and thus elevate — the mundane aspects of life. Set in and around the North Carolina coast, “Bleeder” takes place in an America of mid-scale food franchises, long car rides down fairly unremarkable roads and the deceptively bland environs of hospital waiting rooms. Yet Smoak is more connected to the Earth and the landscape than many a so-called “nature writer” from far more dramatic places. In his early 20s, rundown and lonely, he winds up working at the classic “in-between” job for young people with “only” a bachelor’s degree — a bookstore — while living in a tiny apartment in Chapel Hill. Smoak describes its powder-blue carpets and shadowed back yard so that they manifest his own fragile, exhausted state: “outside, stout evergreens fence my home and their dark boughs block out light. The cell of pine and the blue carpet that covers the floors. … I am encoffined by this shade.”

Tired and depressed, Smoak watches his weight and T-cell count fall dangerously low, but he refuses to quit work or trying to live a “normal” life. Here’s where his unaffected eye for detail serves him best, turning the commonplace stark and original: When his worried mother stares out the kitchen window: “as the spring sun descends … [she] spins her mug in her hands. Her wedding ring clinks against the porcelain handle as she drums her … fingers against the cup.” The clink of metal in the silence, a worried woman’s face; against an unspoken life-or-death backdrop, these snapshots acquire a dark radiance.

Like that scene, Smoak himself is at once emblematic and unique. In one sense, he’s an average young American, experiencing all the first loves, victories and losses typical of his age. Even his HIV, in its own terms, runs a fairly usual course, but Smoak’s eye and ear, his lack of artifice, make him a true original. “Bleeder” is suffused with sweet sharpness, like the light coming through your mother’s window.


Emily Carter is a writer in Connecticut and author of “Glory Goes and Gets Some,” published by Coffee House Press.