I Know This Much Is True

I Know This Much Is True is a 1998 novel by Wally Lamb set in Three Rivers, Connecticut, and follows the lives of twins Dominick and Thomas Birdsey. Thomas suffers from paranoid schizophrenia. His medication helps to keep the psychotic episodes at bay, and for the most part Thomas is able to function normally, holding down a job at a coffee stand. Occasionally, though, he has severe episodes that incapacitate him.

On October 12, 1990, Thomas seeks to make a statement against the Gulf War that threatens to break out between the United States and Iraq by cutting off his own hand in the public library as a form of protest. When questioned about his actions later, he says that he believes God requires a sacrifice in order to spare the lives of others and prevent further bloodshed. After committing the act, he is sent to a state hospital and committed for observation.

Dominick is the younger of the twins and a former high school teacher. After the death of his baby daughter and the subsequent failure of his marriage, he now paints houses for a living. After hearing of his brother’s hospitalization, he seeks to have him transferred from the maximum security building to a less intense environment. His brother’s new social worker offers a helping hand in this matter. A British-educated psychologist from India, Dr. Rubina Patel commiserates with the twins and proves to be an ally to Dominick.



Dominick’s difficult upbringing, unresolved grief over the loss of his wife and child, and continued problems with his irresponsible girlfriend, Joy Hanks, serve to further complicate his life. Flashbacks reveal that Thomas and Dominick’s mother was Connie Tempesta. Unmarried at the time, she gave birth just a few months after the death of her autocratic father, Domenico Tempesta, Dominick’s namesake.

Connie struggles as a single mother until she meets and marries Navy veteran Ray Birdsey, a pipe fitter at the local shipyard. Ray soon proves himself to be a violent man. Connie does everything in her power to maintain the peace, even after Ray breaks her arm. Dominick quickly masters Ray’s most important lesson: Never show weakness. Thomas, on the other hand, is bullied more often because he is hypersensitive, cries, and will not stand up for himself. While Connie remains a mild and loving presence in her sons’ lives, she is essentially passive.

In 1986, Connie develops breast cancer, and on her death bed Dominick promises her that he will look out for Thomas. When Dr. Patel asks for his assistance gathering background information on Thomas, Dominick begins to meet with her regularly. She believes that the intimate details Dominick knows about his brother will be the key to helping him. She soon realizes that Dominick is fighting his own battles, and ends up serving as a counsel to them both.



In 1969, Thomas, Dominick, their friend Leo Blood, and Ralph Drinkwater, held summer jobs together on a city work crew. Dominick decides to room with Leo during the next term, even though he and Thomas had previously roomed together. Dominick now regrets that he pushed Thomas away in favor of the others and that he decided to room with Leo. He admits to Patel that he feels guilty that his brother is the one who is ill. His guilt continues to manifest itself in disturbing dreams.

That same summer, Dominick met Dessa, and three years later they got married. The couple desperately wanted to have children but found that it was difficult for them, eventually seeking the help of a fertility specialist. Their only child died at three months of age; Dominick found her body stiff in the crib. Distraught, the parents found they could not communicate about their grief. On what would have been his daughter’s first birthday, Dominick underwent a vasectomy so that he could not be hurt again, but he neglected to discuss his decision with his wife, who wanted another child. Heartbroken, she decided to leave him. Dessa now works in a hospital where she comforts dying children.

In the midst of this, Dominick is also reading the autobiography of his grandfather, Sicilian-born Domenico Tempesta, which discloses details about the legacy of twins in their family. By learning about his grandfather, Dominick uncovers more about himself and his mother. At the same time, he learns that his live-in girlfriend, Joy, has been seeing another man on the side, her bisexual half-uncle. She is also HIV-positive, having contracted it from said secret lover. She asks Dominick to raise her baby if she dies. At first he resists, but later, after having found his way back into a relationship with his ex-wife, Dessa, they decide to remarry each other and adopt Joy's daughter. The book ends with Dominick coming to terms with the considerable loss, failure, and sorrow in his personal and family history.