If Wally Lamb had stuck to telling the story of the sibling relationship between Dominick and Thomas, I'm certain the novel would have been much better and a lot shorter. There are entirely too many plot lines within this novel (i.e. Dom's relationship with Dressa, Joy's AIDS dilemma, the crazy Italian grandfather, etc.). Much of the novel could have been condensed with the help of a good editor. The ending was also out of left field. I didn't believe for one minute that Dominick and Thomas were part black, Indian, or whatever. Wally Lamb has about three or four novels going on within "I Know This Much is True." My suggestion is that he tell the Ralph Drinkwater story. This character seemed much more interesting that the Dominick Birdsey's throughout most of the novel.