by Rachel Simon (2002). Published in paper back by Penguin in New York, USA and Hodder in Sydney, Australia. Price: $15.00

This is a great book that at first glance tells the story of the relationship between two sisters, one of whom has intellectual disability and spends most days riding the buses, chatting with the drivers and annoying the other passengers. However, the book not only engages the reader with a brilliant narrative but also portrays a vivid picture of the everyday experiences of of a woman with intellectual disabilities who struggles with the inherent dilemmas of self determination and community inclusion. The book's strength is its capacity to convey the reality of intellectual disability and the tensions experienced by our society in making current policy visions a reality. This book is a far easier and much more enjoyable to read than many texts that adopt a more formal and scholarly approach to unraveling these issues.

The book is Rachel's reflection on the birthday gift she gave to her sister - a year spent joining Beth in her daily occupation of riding buses. This gift of "time" to Beth provides the opportunity for Rachel to reframe her perceptions of Beth's life and relationships, which leads to an exploration of how both she and the community understand and respond to people with "mental retardation." During their time together, Rachel begins to recognize her sister's capabilities and the value she derives from her chosen lifestyle, as well as the hurt so frequently inflicted on her by intolerant members of the community. Beth's streetwise sense and ability to get by are a revelation to Rachel. They are brilliantly illustrated by the description of Beth's comprehensive knowledge of shops, café's and buildings that have "accessible" toilets to a traveller such as she is.

Through description of Beth's everyday interactions with bus drivers and their passengers, the book delves into that grey area, too often described as manipulative behaviour in people with intellectual disability, and explores the finely grained differences between purposeful manipulation, personality traits and the impact of low cognitive capacity on the everyday lives of people with intellectual disability. Thinking about the technical definition of intellectual disability Rachel has recently found, and her own responses to her sister's behavior sometimes Rachel says:

"Indeed, anger is a foolish and pointless response when I should actually expect limitations. Especially when I factor in her stubborn personality. And even more especially when I consider that she's in a society that careens between bullying her and seeing her as a perpetual child¹⁵¹."

For me, the descriptions of various paid workers from the disability services involved in Beth's life, and Beth's responses to them, illustrates two critical issues about the nature of family relationships. First, the limited understanding that siblings can have of the nature of intellectual disability, the workings of the service system and its philosophies - knowledge which too often professionals take for granted. The second issue is a recognition of the fundamental differences between professional and family relationships. For example, the case manager reflects on the difficulties of supporting clients to make health decisions that may involve short term pain or discomfort, but are likely to have longer term benefits that are however, perhaps poorly comprehended by clients. Her practice is driven by agency accountability and risk management that can sometimes leave less than life threatening conditions untreated. Explaining her potential response to Beth's reluctance to undergo medical intervention, the case manager says;

"as a professional if I had been there in the hospital, and Beth had wanted to run away, I would have said, "Okay". And if Beth had said she didn't want the shot, there is no way I would have gotten beside her and pushed²¹³."

In contrast, confronted with Beth's understandable apprehension about the final step of a pre-operative procedure, Rachel, without hesitation, simply heaved her onto her side and stayed with her whilst the shot was given. Her response as a sister is less fettered by questions of ethics and is driven instead by unconditional love. No wonder there can be such a gulf between professionals and families.

I have focused on the reflections about intellectual disability I took from this book. There is, however, another side to the book that illustrates peoples' wisdom and empathy. It shows, too, that a sense of community can be found in unlikely places. These qualities coexist with ignorance and intolerance, which form one of the greatest barriers in the quest for inclusion of all minorities in any community. This book will be an enjoyable read for practitioners and a great introduction to intellectual disability for readers from all walks of life.

Christine Bigby, PhD
School of Social Work and Social Policy
LaTrobe University, Victoria, Australia