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)