I Know This Much Is True by Wally Lamb
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Summary
At 40, Dominick Birdsey's entire life has been compromised and constricted by anger and fear: by the schizophrenic twin brother he both deeply loves and resents, and by the past they shared with their adoptive father, Ray, a spit-and polish ex-Navy man and their long-suffering mother, Concettina, a timid, self-conscious woman.