Memoirs don't come any lovelier than Truth & Beauty, novelist Ann Patchett's account of her long friendship with writer Lucy Grealy. Grealy, who died in 2002, was best known for her 1994 ''Autobiography of a Face,'' the delicate, devastating tale of growing up missing a portion of her face. At 8, Grealy was the cute tomboy daughter in a big Irish-American family; at 9, she was diagnosed with Ewing's sarcoma and doctors removed a chunk of her jaw. Radiation destroyed most of her teeth, and successive, gruesome attempts at reconstructive surgery failed. Needless to say, her adolescence -- ''Hey, girl, take off that monster mask'' was a favorite schoolyard taunt -- had the earmarks of a nightmare. But like most memoirs of traumatic experiences, ''Autobiography'' suggested that the troubles were firmly in the past and the author had found some measure of serenity. Wasn't the cool, wise, and accomplished book you were reading evidence of that?
Well, not exactly, according to ''Truth & Beauty,'' which makes an unsettling companion piece to Grealy's work, as well as a powerful stand-alone portrait of a fascinating, understandably tormented woman -- and of a great friendship. Patchett and Grealy met in college, and became fast friends at the Iowa Writers' Workshop when they were both in their 20s. ''Iowa City in the eighties was never going to be Paris in the twenties,'' Patchett writes, ''but we gave it our best shot.'' Grealy and Patchett drank gin and tonics, exercised to the Jane Fonda video, and talked about books and boys. ''Whenever I saw her,'' Patchett writes, ''I felt like I had been living in another country, doing moderately well in another language, and then she showed up speaking English and suddenly I could speak with all the complexity and nuance that I hadn't even realized was gone.''
That's a pitch-perfect definition of a certain type of relationship. But while Grealy and Patchett spoke the same language, they were hardly similar. Effervescent and exhibitionistic, Grealy was fond of dancing in gay bars (where her looks weren't an issue) and beginning every conversation by asking, ''Will I ever have sex again?'' She picked up men on the street, ignored her bills, and rarely prepared for the classes she taught, coasting instead on her charm. But racked by insecurity and loneliness, she also fell into severe depressions -- they could be triggered by something as simple as seeing the happy, handsome couple in ''Peggy Sue Got Married'' -- and she turned constantly to Patchett for support.
She couldn't have chosen a more suitable confidante. Modest and reserved, Patchett -- who treated writing a novel ''like a factory job'' -- cleaned up Grealy's household messes, paid her bills, and reassured her that yes, she was talented, and yes, of course, she would have sex again. Patchett doesn't idealize their friendship: Grealy was needy and unreliable, while Patchett could be judgmental. Toward the end of Grealy's life, Patchett grew snippy and impatient with her friend's drug use. (Grealy's death was attributed to a heroin overdose.) But their dynamic, frustrating friendship blazes forth in all its original glory in this remarkable book: While Grealy is the glittering, tragic star, it is Patchett's voice -- perfectly modulated, lucid, and steady -- that makes it both true and beautiful.