At twenty-one, just as she was starting to comprehend the puzzles of adulthood, Sarah Manguso was faced with another: a wildly unpredictable autoimmune disease that appeared suddenly and tore through her twenties, paralysing her for weeks at a time, programming her first to expect nothing from life and then, furiously, to expect everything. In this captivating story, Manguso recalls her struggle: arduous blood cleansings, collapsed veins, multiple chest catheters, depression, the deaths of friends and strangers, addiction, and, worst of all for a writer, the trite metaphors that accompany prolonged illness. A book of tremendous grace and humour, The Two Kinds of Decay transcends the very notion of what an account of illness can and should be.