Skin opens with eighth-grader Donnie discovering his sister’s lifeless body. She has died from anorexia, and in flashbacks, Donnie recalls the journey that brought Karen—and his family—to this point. Their parents’ fragile and often volatile relationship bonded Donnie and Karen through much of their childhood. Karen’s illness—or awareness of it—comes on gradually, over the course of a year in which their parents’ marriage falls apart completely. Soon it takes over their lives. Each member of the family displays a different response to Karen’s downward spiral: denial, confrontation, paralysis. Eventually it becomes clear that her anorexia is a result of how Karen copes with the disintegration of her already dysfunctional family. Donnie’s method of coping, marked by withdrawal and self-sabotaging social interactions at school, have also become more pronounced. Feeling enormous pressure to keep tabs on just how much Karen is or isn’t eating, Donnie worries constantly that she will end up dead. When she does, it is bitter and painful. But for Donnie, it is also a turning point, and in the haze of his despair, he begins to assert his voice. (Age 12 and older)

I'M TELLING YOU THIS BECAUSE YOU DIDN'T ASK. I'VE GOT IT ALL HERE, GROWING LIKE A TUMOR IN MY THROAT.

I'm telling you because if I don't, I will choke on it. Everybody knows what happened, but nobody asks. And Elvis the EMT doesn't count because when he asked, he didn't even listen to me answer because he was listening to my sister's heart not beat with his stethoscope. I want to tell. It's mine to tell. Even if you didn't ask, you have to hear it.

Fourteen-year-old Donnie's older sister, Karen, has always been the one person in his life on whom he could totally depend. But as Karen slowly slips away in the grip of an eating disorder, Donnie finds himself alone in facing the trauma of his parents' faltering marriage and his new life as an outcast at school.

Donnie makes it his responsibility to cure his sister's illness and fix his parents' issues, letting every part of himself disappear in the process. It is more important -- and somehow easier -- to figure out if today is a day when Karen is eating, or to know if Dad and Mom are sleeping in the same bedroom, than to deal with his own problems. In the end, though, Donnie must decide whether to float through life unnoticed, or to claim his rightful place as a member of his family and of the world. This powerful story from a brilliant new talent introduces a memorable boy in Donnie, who, from his funny and painfully honest point of view, describes a harrowing year that leaves both him and his family forever changed.