Study Guide

I Know This Much is True Rules and Order

By Wally Lamb

Rules and Order

Trying to help a relative or friend with mental illness is hard enough because of their illness, but then there's all the bureaucracy and red-tape to deal with. It's almost impossible to get an accurate diagnosis. And once that happens, you have to deal with doctors, institutions, social workers, and, if things get really bad, the police. All this is enough to drive everyone else crazy, and we get an up close look at this side of mental illness in I Know This Much is True thanks to Dominick.

Questions About Rules and Order

  1. How would Thomas's illness be treated differently if the book was set in the 1950s? Or set today? Why?
  2. If Dominick had followed the rules, and not tried to appeal for Thomas's release, would Thomas still be alive? Dig into the text to support your claim.
  3. Does anyone at Hatch actually have Thomas's best interests at heart, or is everyone just looking for what's best for Dominick?

Chew on This

Dominick wants to break the rules for Thomas because he thinks he knows better how to care for him than the doctors and social workers.

Breaking the rules (by blackmailing the hospital) ends up freeing Thomas, but it also ends up killing him. It's difficult to say whether Thomas would get better if they stuck to the rules or not.