A Celebration of
Great Opening Lines
in World Literature

Launched: January 1, 2022

This website is dedicated to the memory of John O. Huston (1945-2022)

Genre:  Medicine & Health

Result set has 62 entries.
Kevin F. Adler and Donald W. Burnes (with Amanda Banh and Andrijana Bilbija)
When We Walk By: Forgotten Humanity, Broken Systems, and the Role We Can Each Play in Ending Homelessness in America (2023

Everyone is someone’s somebody.

When I first read these opening words, I felt as if I’d been slapped on the side of the head. Like a new meme that had taken occupancy in my mind, the impossible-to-forget first sentence reverberated in my thoughts for days.

The words come from senior author Kevin Adler, who was thinking about his uncle Mark—a man who died at age fifty after spending over three decades struggling on and off the streets of Santa Cruz, California.

The haunting first sentence—and the rest of the book that followed—not only profoundly affected the way I viewed homeless people on the streets in my town, it inspired me to take some proactive steps I’d never taken before.

In a review of the book, Publisher’s Weekly said: “It’s a must-read for anyone interested in solving the problem of homelessness.” I was also pleased to include Adler’s first sentence in my Smerconish.com post on “23 of the Best Opening Lines of 2023” (to be seen here).

Gregg Allmann (with Alan Light)
My Cross to Bear (2012)

I was sitting up talking, and I just kind of nodded off. But I didn’t nod off: I was Code Blue. I was bleeding inside, and I was drowning in blood.

These are the first words a reader sees after opening the book, and they appear on an enigmatic page that is simply titled “September 2001” (the words appear in italics in the book). After opening with this impressive “hook,” Allman also began the formal Prologue to the book quite memorably:

“It should have been the greatest week of my life, but instead I hit an all-time low. The Allman Brothers Band, the band my brother started, the band with our name on it, was inducted into the Rock and Roll Hall of Fame, and I flat-out missed it. I was physically there, but otherwise I was out of it—mentally, emotionally, and spiritually. You might say that I had the experience but missed the meaning. Why? The answer is plain and simple—alcohol. I was drunk, man, just shitfaced drunk, the entire time.”

Dave Barry
“A Journey Into My Colon—and Yours,” in The Miami Herald (Feb. 22, 2008)

OK. You turned 50. You know you’re supposed to get a colonoscopy. But you haven’t. Here are your reasons: 1. You’ve been busy. 2. You don’t have a history of cancer in your family. 3. You haven’t noticed any problems. 4. You don’t want a doctor to stick a tube 17,000 feet up your butt.

One of Barry’s most effective opening line strategies was to begin with a preposterous exaggeration, but one that—at least on some level—felt vaguely true. Barry continued:

“Let’s examine these reasons one at a time. No, wait, let’s not. Because you and I both know that the only real reason is No. 4. This is natural. The idea of having another human, even a medical human, becoming deeply involved in what is technically known as your ‘behindular zone’ gives you the creeping willies.”

Catherine Belling
A Condition of Doubt: The Meanings of Hypochondria (2012)

Hypochondriacs have two significant beliefs; that their bodies contain something that will kill them, and that, if they could only read their bodies closely enough, they should be able to find that lurking threat before it is too late.

Belling continued: “If a doctor examines such a patient and announces that no evidence of disease can be found, the patient (who would love to be able to believe the doctor) is not finally convinced. The patient concludes that this particular doctor is just not good enough to have found the horror that must—surely?—be hidden somewhere within.”

Elizabeth Berg
Talk Before Sleep (1994)

This morning, before I came to Ruth’s house, I made yet another casserole for my husband and daughter. Meggie likes casseroles while Joe only endures them, but they are all I can manage right now. I put the dish in the refrigerator, with a note taped on it telling how long to cook it, and at what temperature, and that they should have a salad, too.

Great opening lines don’t necessarily bowl readers over, they simply provide subtle hints about what’s been happening and where the story is going. Another casserole? All I can manage? Her own family taking second priority to time at Ruth’s? Talk Before Sleep turns out to be a moving story about a friendship between protagonist Ann Stanley and her cancer-stricken friend Ruth Thomas.

Rutger Bregman
Humankind: A Hopeful History (2019)

This is a book about a radical idea.

An idea that’s long been known to make rulers nervous. An idea denied by religions and ideologies, ignored by the news media and erased from the annals of world history.

At the same time, it’s an idea that’s legitimized by virtually every branch of science. One that’s corroborated by evolution and confirmed by everyday life. An ideal so intrinsic to human nature that it goes unnoticed and gets overlooked.

If only we had the courage to take it more seriously, it’s an idea that might just start a revolution. Turn society on its head. Because once you grasp what it really means, it’s nothing less than a mind-bending drug that ensures you’ll never look at the world the same again.

So what is this radical idea?

That most people, deep down, are pretty decent.

Frank Bruni
The Beauty of Dusk: On Vision Lost and Found (2022)

They say that death comes like a thief in the night. Lesser vandals have the same MO. The affliction that stole my vision, or at least a big chuck of it, did so as I slept. I went to bed seeing the world one way. I woke up seeing it another.

In 2017, New York Times columnist Bruni woke up one morning with significantly blurred vision in his right eye, the result of a stroke that had cut off the blood supply to one of his optic nerves. Rendered functionally blind in that eye, he soon learned that he was in danger of losing sight in the left eye as well. In the memoir’s second paragraph, Bruni continued about the life-altering event:

“I went to bed believing that I was more or less in control of my life—that the unfinished business, unrealized dreams and other disappointments were essentially failures of industry and imagination and could probably be redeemed with a fierce enough effort. I woke up to the realization of how ludicrous that was.”

Melvin Burgess
Junk (1996)

A boy and girl were spending the night together in the back seat of a Volvo estate car. The car was in a garage. It was pitch black.

With these simple—but highly evocative—words, we are introduced to Gemma Brogan and David “Tar” Lawson, both fourteen years old and on the verge of escaping their highly dysfunctional home environments. Little do they know at this point of their journey that an even more dismal future awaits.

Burgess’s dark and gritty tale about teenage drug addiction went on to win the 1996 Carnegie Medal, awarded annually by England’s Library Association for the outstanding children’s book by a British writer. In 2007, on the 70th anniversary of the Carnegie Medal, Junk was named one of the Top Ten winners of the award. In 1997, the book was published in America under the title Smack, yet another slang term for heroin.

When the novel came out in a 25th Anniversary edition in 2021, the Guardian’s Julia Eccleshare wrote about it: “Melvin Burgess’s ground-breaking Junk remains the best book about teenagers and drugs to this day.”

Kelly Corrigan
The Middle Place (2008)

The thing you need to know about me is that I am George Corrigan’s daughter, his only daughter. You may have met him, in which case just skip this part. If you haven’t, I’ll do what I can to describe him, but really, you should try to meet him.

Norman Cousins
Anatomy of an Illness: As Perceived by the Patient (1979)

This book is about a serious illness that occurred in 1964. I was reluctant to write about it for many years because I was fearful of creating false hopes in others who were similarly afflicted. Moreover, I knew that a single case has small standing in the annals of medical research, having little more than “anecdotal” or “testimonial” value.

In many non-fiction works, the best beginnings are often simple and straightforward—and that is certainly true with Cousins’s account of his famous attempt to treat a serious connective tissue disease with massive amounts of Vitamin C and systematic viewing of episodes of the TV-show Candid Camera (a method he called “laugh therapy”).

Cousins continued: “However, references to the illness surfaced from time to time in the general and medical press. People wrote to ask whether it was true that I ‘laughed’ my way out of a crippling disease that doctors believed to be irreversible.

Michael Crichton
“Cadaver,” in Travels (1988)

It is not easy to cut through a human head with a hacksaw.

Crichton is best known for his novels—so many of which have been adapted in classic American films—but he was also a skilled non-fiction writer, as he demonstrates in this “hook” he wrote for a piece on his experiences as a student at the Harvard Medical School.

Gavin de Becker
The Gift of Fear: Survival Signals That Protect Us from Violence (1997)

He had probably been watching her for a while. We aren’t sure—but what we do know is that she was not his first victim.

These opening words look a lot like the beginning of a suspense thriller, but they actually opened a non-fiction book that has become a classic in the literature on violence against women.

In his book, de Becker went well beyond the cliche of learning to trust one’s “gut instincts” by pinpointing a number of key warning signs—he called them pre-incident indicators, or PINS—that were precursors to violence.

Louise Dean
Becoming Strangers (2004)

Before he’d had cancer he’d been bored with life. Since he’d taken dying seriously, he’d been busy; he was occupied with understanding the disease and training his body to resist it.

In a Feb. 20, 2004 review in The Guardian, critic Julie Myerson offered a thorough and thoughtful analysis of this opening. She began by writing: “The opening lines of Louise Dean’s quite exceptional first novel may not be much of a laugh, but they stopped this reader in her tracks. It rarely takes me more than a page or two to sense whether a novel’s going to take me somewhere worth going. In Dean’s case, those first 17 words were enough. My heart raced and I sat up. I knew.“

Myerson went on: “It’s not just the bald, frank darkness of those two opening statements, nor the ache of truth they contain. And it’s not just about the rise-and-fall rhythm of the words either, the pleasing arc that the collision of the two sentences somehow creates. No, most of all, I think, it’s what the writer makes you feel—instantly—about this mystery ’he’: a wave of naked curiosity. Who on earth is this man, whose life has been so vivified by death?“

Joan Didion
The Year of Magical Thinking (2006)

Life changes fast.

Life changes in the instant.

You sit down to dinner and life as you know it ends.

The question of self-pity.

Those were the first words I wrote after it happened.

The “it” here was the 2003 death of Didion’s husband John Gregory Dunn—from a sudden heart attack while the couple were seated at the dinner table in their home. The remainder of the book chronicled Didion’s attempts over the next year to live and function without a man she’d been married to for nearly forty years. The book went on to win the 2005 National Book Award for Nonfiction.

Didion’s coping efforts were severely affected by the illness of her adult daughter, who was lying unconscious—from a serious case of pneumonia—in a New York hospital at the time of her father’s death (she died of pancreatitis in 2005). Didion wrote about the loss of her daughter in yet another book of mourning and grieving, Blue Nights, published in 2011.

Larry Dossey
The Extraordinary Healing Power of Ordinary Things: Fourteen Natural Steps to Health and Happiness (2007)

There is an old saying: If you want to hide the treasure, put it in plain sight. Then no one will see it.

We’ve seen many times in these pages how effective it is to open a book—especially a non-fiction book—with a powerful quotation, biblical passage, or proverbial saying, and Dossey demonstrates that very nicely here. He continued in the second paragraph: “In the pages that follow, we will explore things that are in plain sight, but whose healing power and ability to add to life’s fulfillment have been overlooked or forgotten.”

Larry Dossey
The Power of Premonitions (2009)

Sometimes things grab hold and just won’t let go.

Dossey continued in the first paragraph: “That’s what it’s been like with premonitions for me. I’ve been wrestling with them for a long time, unable to detach, rather like Jacob’s struggle with the angel in the Old Testament. The main difference is that Jacob’s brawl lasted only one night. My tussle with premonitions has persisted for more than three decades and shows no signs of ending.“

Larry Dossey
Reinventing Medicine: Beyond Mind-Body to a New Era of Healing (2009)

During my first year of medical practice, I had a dream that shook my world.

Go ahead, with the book in your hand, read this opening sentence—and try not to read on.

Larry Dossey
“Spirituality, Healing and Science,” in Ervin Laszlo and Kingsley L. Dennis, The New Science and Spirituality Reader (2012)

What is spirituality? I consider it a felt sense of connectedness with something higher, a presence that transcends the individual sense of self.

Dossey continued: “I distinguish spirituality from religion, which is a codified system of beliefs, practices, and behaviors that usually take place in a community of like-minded believers. Religion may or may not include a sense of the spiritual, and spiritual individuals may or may not be religious.”

Caitlin Doughty
Smoke Gets in Your Eyes: And Other Lessons from the Crematory (2014)

A girl always remembers the first corpse she shaves.

Doughty is a California mortician, a YouTube celebrity (“Ask a Mortician”), and a passionate advocate for funeral industry reform. In 2006, at age 23, she began working in a San Francisco mortuary, and her description of an experience from her very first day on the job ultimately ended up as a spectacular opening line (in truth, it’s hard to imagine a better way for a female mortician to begin a book about her work). In the book, Doughty continued:

“It is the only event in her life more awkward than her first kiss or the loss of her virginity. The hands of time will never move quite so slowly as when you are standing over the dead body of an elderly man with a pink plastic razor in your hand.”

In a 2015 PsychologyToday.com article (“The Truth About Cremation”), psychologist Susan K. Perry wrote, “If you delight in a one-of-a-kind writer’s voice…I doubt that you have ever read a first sentence like this one.”

Caitlin Doughty
Will My Cat Eat My Eyeballs: Big Questions from Tiny Mortals About Death (2019)

No, your cat won’t eat your eyeballs. Not right away, at least.

Doughty’s entire book consists of her answers to questions about death and dying posed by children. It opens with this creepy-but-adorable answer to a question that also served as the title to Chapter One: “When I Die, Will My Cat Eat My Eyeballs.” About the book, reviewer Terri Schlichenmeyer (“The Bookworm Sez”) wrote: “There’s serious science here, but also cultural lessons in death and dying, a little history, and a touch of gruesomeness wrapped in that shroud of sharp, witty humor.“

Nora Ephron
“The O Word,” in I Remember Nothing (2010)

I’m old.

I am sixty-nine years old.

Really old is eighty.

But if you are young, you would definitely think I’m old.

No one actually likes to admit that they’re old.

The most they will cop to is that they’re older. Or oldish.

Michael J. Fox
Lucky Man: A Memoir (2003)

Gainesville, Florida—November 1990

I woke up to find the message in my left hand. It had me trembling. It wasn’t a fax, telegram, memo, or the usual sort of missive bringing disturbing news. In fact, my hand held nothing at all. The trembling was the message.

In the opening words of his memoir, Fox finds a creative as well as a memorable way to describe the appearance of his very first Parkinson’s Disease symptom—a twitching of the pinkie finger on his left hand. It occurred just after waking up that morning, and his first thought was that he had slept on it wrong. After trying to shake it out, however, he couldn’t make it stop, and the twitching intensified as the day progressed.

It would be almost another year before Fox was formally diagnosed, but he found what he described as a “serviceable metaphor” to describe that day: “That morning—November 13, 1990—my brain was serving notice; it had initiated a divorce from my mind. Efforts to contest or reconcile would be futile; eighty percent of the process, I would later learn, was already complete.”

Ty Gagne
The Last Traverse: Tragedy and Resilience in the Winter Whites (2020)

James Osborne is on the precipice, barely holding on to the frayed rope of advanced life support. The hospital’s technology and medications are working to protect him from falling into the abyss, but just how long the fragile anchor system can keep him aloft is uncertain.

GUEST COMMENTARY from David J. Hartson, Ph.D. a retired North Dakota psychologist who lived and practiced for many years in Littleton, New Hampshire. Dr. Hartson writes:

“These dramatic first lines capture a medical team’s tense struggle to save the life of James Osborne, an outdoorsman who hours earlier was rescued half-alive and more than half-frozen while on a winter hike in the White Mountains of New Hampshire. One of the world’s most beautiful places in the summer, it is one of the most treacherous in the winter, with routine low temperatures of -20 F, wind velocity of 75-95 mph, wind chill at -53 F, and visibility of zero. Gagne’s book is a moving tribute to the medical team’s efforts to save Osborne’s life, and to the First Responders who brought him out alive.”

The exceptionally high quality of Gagne’s writing continued in the remainder of the first paragraph: “As the life struggle rages on, he swings helplessly back and forth through a spectrum of amorphous dreams and disruptive stimuli. His primitive brain is on alert, working behind the scenes in support of the intervention it senses being undertaken by forces unknown. This is because his analytic brain, the cortex, did an emergency bailout over a day ago and hasn’t been heard from since.”

Lisa Genova
Inside the O’Briens: A Novel (2015)

Damn woman is always moving his things. He can’t kick off his boots in the living room or set his sunglasses down on the coffee table without her relocating them to “Where they belong.” Who made her God in this house? If he wants to leave a stinking pile of his own shit in the middle of the kitchen table, then that’s where it should stay until he moves it.

Where the fuck is my gun?

“Rosie!” Joe hollers from the bedroom.

Inside the O’Briens is a dramatic fictional portrayal of the onset and development of Huntington’s Disease in a Massachusetts police officer named Joe O’Brien. In a beginning note to the reader, Genova briefly described the disease and concluded about it: “It has been called the cruelest disease known to man.”

John Green
The Fault is in Our Stars (2012)

Late in the winter of my seventeenth year, my mother decided I was depressed, presumably because I rarely left the house, spent quite a lot of time in bed, read the same book over and over, ate infrequently, and devoted quite a bit of my abundant free time to thinking about death.

The opening words come from 16-year-old Hazel Grace Lancaster, who continued: “Whenever you read a cancer booklet or website or whatever, they always list depression among the side effects of cancer. But, in fact, depression is not a side effect of cancer. Depression is a side effect of dying. (Cancer is also a side effect of dying. Almost everything is, really.) But my mom believed I required treatment, so she took me to see my Regular Doctor Jim, who agreed that I was veritably swimming in a paralyzing and totally clinical depression, and that therefore my meds should be adjusted and also I should attend a weekly Support Group.

A review in The Manila Bulletin said about the author’s opening: “Just two paragraphs into the work, and he immediately wallops the readers with such an insightful observation delivered in such an unsentimental way that it’s hard not to shake your head in admiration.“

We soon learn that Hazel uses sarcasm and dark humor as a way of coping with her own diagnosis of terminal cancer (about which, she says, “thyroid originally but with an impressive and long-settled satellite colony in my lungs”). While attending the support group, she meets a fellow patient named Gus, and their unfolding story becomes totally engrossing. In a Time magazine review, Lev Grossman recalled Hazel’s observation that “Cancer books suck” to write that this particular cancer book “does not suck. In fact, it is damn near genius.”

In 2014, the novel was adapted into a terrific movie, starring the enormously talented Shailene Woodley as Hazel. In a New York Times review, A. O. Scott wrote: “The film sets out to make you weep—not just sniffle or choke up a little, but sob until your nose runs and your face turns blotchy. It succeeds.“

Rachel E. Gross
“Half the World Has a Clitoris. Why Don’t Doctors Study It?” in The New York Times (October 17, 2022)

If there was one thing Gillian knew, it was that she did not want a hole punch anywhere near her genitals.

In the world of journalism, a great opening line is commonly called a lede, and they don’t get much better than this first sentence of Gross’s story about a registered nurse’s medical misadventures after her gynecologist recommended a vulval biopsy.

Pete Hamill
The Drinking Life: A Memoir (1995)

This is a book about my time in the drinking life. It tells the story of the way one human being became aware of alcohol, embraced it, struggled with it, was hurt by it, and finally left it behind. The tale has no hero.

John Irving is widely quoted as saying, “Whenever possible tell the whole story of the novel in the first sentence,“ and Hamill proves in the opening words of his book that the advice applies equally well to memoirs and autobiographies.“

When I first read Hamill’s memoir, I had two major reactions to the opening paragraph. The first was to view it as an absolutely remarkable way for a recovering alcoholic to begin a memoir about his time in the drinking life. The second was to think to myself, “The tale may not have had any heroes, but I’m sure there were plenty of victims.“

J. Patrick Henry
“Syringe,” in The Remembered Arts Journal (June 28, 2016)

Freda kept losing her husband.

In five simple words, the goal of all great opening lines is achieved—the reader feels compelled to read on to see where the story is going. In the second paragraph, the narrator continued:

“There were many times when she thought she’d lost him, but he would rally, surprising her and the other family members who, at the urging of his doctor, had joined her at bedside to say goodbye. Freda’s emotions were whipsawed by these false alarms to the point where her heart became numb, and the man in the hospital bed, the man she’d met and married thirty-two years before, appeared as if a stranger.”

When I learned that the author was alive today because of a lung transplant in 2015, I believed his short story might have autobiographical elements. Henry confirmed my suspicions with this reply to my query:

“The story is a small mystery that centers around a batch of composition notebooks that Freda’s late husband used to communicate when on a hospital ventilator or tracheal tube. It was based loosely on my own experience—five months in hospital post-transplant. I still have the seven notebooks I filled during the weeks I couldn’t speak.”

Christopher Hitchens
Mortality (2012)

I have more than once in my time woken up feeling like death. But nothing prepared me for the early morning in June when I came to consciousness feeling as if I were actually shackled to my own corpse.

So begins a book of deeply personal essays—all originally written for Vanity Fair—that chronicled Hitchens’s battle with a fast-growing esophageal cancer that ultimately took his life at age 62 on December 15, 2011. In his opening paragraph, Hitchens continued:

“The whole cave of my chest and thorax seemed to have been hollowed out and then refilled with slow-drying cement. I could faintly hear myself breathe but could not manage to inflate my lungs. My heart was beating either much too much or much too little. Any movement, however slight, required forethought and planning. It took strenuous effort for me to cross the room of my New York hotel and summon the emergency services.”

Shere Hite
The Hite Report: A Nationwide Study on Female Sexuality (1976)

Women have never been asked how they feel about sex.

This is the frank and unequivocal first sentence of a book that exploded on the national scene in 1976. Building on the work of Kinsey and, after him, Masters & Johnson, Hite was a previously unknown sex researcher who brought a feminist perspective to human sexuality—and who famously concluded that women didn’t need sexual intercourse, or even men, to experience sexual gratification. A 2020 New York Times obituary wrote about her: “However obvious her conclusions might seem today, they were seismic at the time.” An international bestseller, her book went on to sell nearly 50 million copies. In her opening paragraph, she continued:

“Researchers, looking for statistical ‘norms,’ have asked all the wrong questions for all the wrong reasons—and all too often wound up telling women how they should feel rather than asking them how they do feel.”

As the years passed and more controversial books followed, questions about the quality of Hite’s research—and her life—fueled a conservative backlash that made her life in America so miserable that she ultimately renounced her U.S. citizenship in 1995 to formally became a German citizen.

John Irving
A Prayer for Owen Meany (1989)

I am doomed to remember a boy with a wrecked voice—not because of his voice, or because he was the smallest person I ever knew, or even because he was the instrument of my mother’s death, but because he is the reason I believe in God; I am a Christian because of Owen Meany.

These powerful opening words come from narrator John Wheelwright, who, along with his best friend Owen Meany, grew up in a small New Hampshire town in the 1950s. John described Owen as remarkable young man who saw himself as God’s instrument on earth, and as fulfilling a role that had been prophesied for him. The novel is generally regarded as an homage to Günter Grass’s The Tin Drum. Grass, along with Charles Dickens, was an enormous influence on the adolescent Irving, and it can hardly be a coincidence that Owen Meany has the same initials as The Tin Drum’s protagonist, Oskar Matzerath. In a 2007 New York Times article (“A Soldier Once”), Irving formally acknowledged that the Meany book was written in “homage” to Grass.

In a 2019 Book Chase blog post, reviewer Sam Sattler identified his three favorite opening paragraphs, this one from Owen Meany, another from Larry McMurtry’s Lonesome Dove, and a third from Peter Dexter’s Spooner. About them, he wrote: “A good first paragraph is one of the most important tools an author has available to grab my book-browsing attention—usually quickly and in less than 100 words. I can learn more about the style and readability of an author from an opening paragraph than I will ever gather from a canned dust jacket summary or some blurb from a fellow author of the writer’s that I wouldn’t believe in a million years anyway.”

Molly Ivins
“Who Needs Breasts, Anyway,“ in Time magazine (Feb. 18, 2002)

Having breast cancer is massive amounts of no fun. First they mutilate you; then they poison you; then they burn you. I have been on blind dates better than that.

Ivins retained her irreverent sense of humor even while struggling with the cancer that would take her life—at age 62—in 2007. She continued: “One of the first things you notice is that people treat you differently when they know you have it. The hushed tone in which they inquire, ‘How are you?’ is unnerving. If I had answered honestly during 90% of the nine months I spent in treatment, I would have said, ’If it weren’t for being constipated, I’d be fine.’ In fact, even chemotherapy is not nearly as hard as it once was, although it still made all my hair fall out.”

Tracy Kidder
Mountains Beyond Mountains (2003)

Six years after the fact, Dr. Paul Edward Farmer reminded me, “We met because of a beheading, of all things.”

So begins Kidder’s biography of Paul Farmer, a renowned physician and infectious-disease specialist whose motto was “the only real nation is humanity.” Nine years earlier, in 1994, Kidder was on assignment in Haiti, reporting on the 20,000 American troops who had been sent to restore the nation’s democratically-elected government after it had been toppled by a military junta three years prior.

Anne Dillard had the opening line—and more—in mind when she said the book “unfolds with the force of a gathering revelation.“

Wally Lamb
I Know This Much Is True (2008)

On the afternoon of October 12, 1990, my twin brother Thomas entered the Three Rivers, Connecticut Public Library, retreated to one of the rear study carrels, and prayed to God the sacrifice he was about to commit would be deemed acceptable.

In a 2023 Guardian article, Irish writer Liz Nugent included this opener in her list of “The Top Ten First Lines in Fiction,” writing:

“The first part of this sentence points to an average man on an average day. The second part indicates something huge is about to happen. Thomas is no average character. Who chooses a library to make a sacrifice? Reading it today, one might suspect Thomas to be a suicide bomber, but in 1998, when I first read it, that didn’t enter my mind. Even if it had, I would have been wrong. What sacrifice is about to be made? Why the library? What’s going on between Thomas and his twin brother?”

In 2020, the novel was adapted into an HBO-TV miniseries, with Mark Ruffalo playing the roles of both twin brothers, Dominick and Thomas Birdsey.

Anne Lamott
Hard Laughter (1979)

My family lived for fifteen years in a castle built more than a century ago by an eccentric man who wanted his Rhine-born wife to feel at home when he brought her to live in California.

Any mention of an American castle is certain to arouse interest, but especially when the opening sentence is so crisply and cleanly written. In Lamott’s debut novel, inspired by her own father’s battle with brain cancer, the narrator is a 23-year-old writer and part-time housecleaner named Jennifer. She continued: “It was a monstrous rock construction two hundred feet above San Francisco Bay, surrounded by cypress trees, two stories of rock with a trapdoor underneath the kitchen table and two caves in the back of the house, one of which was said to have led to the beach during bootlegging days.“

Anne Lamott
“It’s Good to Remember: We Are All on Borrowed Time,” in The New York Times (October 30, 2023)

Getting older is almost like changing species, from cute middle-aged, white-tailed deer, to yak. We are both grass eaters, but that’s about the only similarity.

In the opening paragraph, Lamott—writing at age sixty-nine—continued:

“At the Safeway sushi bar during lunchtime, I look at the teenage girls in their crop tops with their stupid flat tummies and I feel bad about what lies beneath my big, forgiving shirts but—and this is one of the blessings of aging—not for long.”

Andrew Leland
The Country of the Blind: A Memoir of the End of Sight (2023)

I’m going blind as I write this.

These are the stark—and startling—opening words of a memoir that seemed to come out of nowhere in the middle of the year and ended up on numerous “best books of the year” lists. Leland continued in the opening paragraph:

“It feels less dramatic than it sounds. The words aren’t disappearing as I type. I’m sitting comfortably in the sunroom. The sun is rising like it’s supposed to. I can plainly see Lily sitting next to me, reading in her striped pajamas. The visible world is disappearing, but it’s not in a hurry.”

Leland—a Massachusetts writer, teacher, editor, and audio producer—has retinitis pigmentosa (RP), a progressive eye disease that slowly but inexorably leads to blindness. When the book was published, he could see only about six percent of what a person with normal vision sees.

I was so impressed with Leland’s opening sentence that I included it in my annual Smerconish.com post on “23 of the Best Opening Lines of 2023” (see the full list here).

Daniel J. Levitin
Successful Aging (2020)

The poet Dylan Thomas wrote that one should not go gently into that good night, that old age should burn and rage at close of day. As a younger man reading that poem, I saw futility in those words. I saw aging only as a failing: a failing of the body, of the mind, and even of the spirit.

Levitin, a neuroscientist who authored four previous New York Times bestsellers, turned his attention to aging in this latest book, also a bestseller. He continued: “I saw my grandfather suffer aches and pains. Once agile and proudly self-sufficient, by his sixties he struggled to swing a hammer and was unable to read the label on a box of Triscuit crackers without his glasses. I listened as my grandmother forgot words, and I cried when eventually she forgot what year it was.”

Clancy Martin
How Not to Kill Yourself: A Portrait of the Suicidal Mind (2023) A Portrait of the Suicidal Mind (2023)

The last time I tried to kill myself was in my basement with a dog leash.

It’s a grisly first sentence, true, but it’s hard to imagine a better opening line for a nonfiction book addressed to people who are attempting to cope with suicidal thoughts. After his “hook” has been implanted in readers, Martin—a philosophy professor with a long history of failed suicide attempts—reels them in with the following explanation:

“As usual, I didn’t write a note. I carried down a green leather and wood chair from my office while my dog watched from the stairs. She’s afraid of the basement. I took the heavy blue canvas leash, looped it over a beam, made a noose by snaking the leash through the handle, latched it, and checked it for strength. Then I kicked the chair away like the gentle old institutionalized suicide Brooks Hatlen does toward the end of The Shawshank Redemption.”

I was delighted to include Martin’s first sentence in my end-of-year Smerconish.com post of “23 of the Best Opening Lines of 2023” (see the full list here).

Robert McCrum
Every Third Thought: On Life, Death and the End Game (2017)

No one will ever know exactly what happened inside my head on the night of 28 July 1995, but probably it went something like this. First, for reasons that remain mysterious, a surreptitious clot began to form in one of my cerebral arteries, cutting off the blood supply to the one organ in the body that, after the heart, is most greedy for blood.

This is a dramatic opening, and that haunting phrase about being most greedy for blood kept returning to my mind. McCrum continued: “Eventually, perhaps some hours later, like a breaking dam, the clot burst into the right side of my brain, causing an uncontrolled ‘bleed’ that would achieve irreversible destruction of cerebral tissue deep inside my head, in the part of the cortex known as the basal ganglia.”

You might also be interested in knowing that McCrum borrowed the title of his memoir from a Prospero line in Shakespeare’s The Tempest: “Every third thought shall be my grave.”

Sherwin Nuland
How We Die: Reflections on Life’s Final Chapter (1993)

Every life is different from any that has gone before it, and so is every death. The uniqueness of each of us extends even to the way we die.

Meghan O’Rourke
The Invisible Kingdom: Reimagining Chronic Illness (2022)

The stories we tell about illness usually have startling beginnings—the fall at the supermarket, the lump discovered in the abdomen during a routine exam, the doctor’s call. Not mine. I got sick the way Hemingway says you go broke: “gradually and then suddenly.”

A time-honored way to open a book is to invoke the famous words of a famous author, and in this case the quoted saying applies as well to the new topic under discussion as it did to the original one. I was delighted to honor O’Rourke’s opener in my compilation of “The Best Opening Lines of 2022” on Smerconish.com (see the full list here).

A finalist for the National Book Award for Nonfiction, O’Rourke’s meticulously-researched book was described by Esquire magazine as “At once a rigorous work of scholarship and a radical act of empathy.” It also made The New Yorker’s list of “The Best Books of 2022.”

In her highly-praised work, O’Rourke—a poet, writer, and creative writing teacher—also cleverly tweaked one of the most famous opening lines of all time, writing: “And so it is a truth universally acknowledged among the chronically ill that a young woman in possession of vague symptoms like fatigue and pain will be in search of a doctor who believes she is actually sick.” The original opener, from Jane Austen’s Pride and Prejudice (1813), may be seen here.

Peter Olsson
Janusian Days: Memoirs of an Almost-Old Psychiatrist (2019)

My passion for medicine dawns in the realm of childhood idealism and spiritual innocence. I am ten years old and picture myself as a medical missionary like Albert Schweitzer or Tom Dooley.

Olsson continued: “Mom reads me books about these famous missionary doctors. I pledge to selflessly help African natives with cures of bodies, minds, and souls. I go with Mom to weekly Bible study and missionary prayer meetings at our Baptist church. I pray for missionaries in Africa, China, and India. I help box up clothes, canned goods, bandages, and medicines for shipment to them. My church community embraces such efforts to help others. Mom smiles. I feel love and importance.“

Randy Pausch
The Last Lecture (2008; with Jeffrey Zaslow)

I have an engineering problem.

While for the most part I’m in terrific physical shape, I have ten tumors in my liver and I have only a few months to live.

I am a father of three young children, and married to the woman of my dreams. While I could easily feel sorry for myself, that wouldn’t do them, or me, any good.

So, how to spend my very limited time.

Few people would describe imminent death from cancer as an “engineering problem,” but Randy Pausch was hardly a typical person. As a book, The Last Lecture was an expanded version of a literal “last lecture” that Pausch delivered to students at Carnegie Mellon University on Sep. 18, 2007 (the lecture’s formal title was “Really Achieving Your Childhood Dreams”).

Earlier in the year, Pausch had been invited to deliver a hypothetical “final talk,” a lecture in which professors were asked to imagine what they would say to students if they could deliver only one more lecture. In 2006, Pausch had been diagnosed with pancreatic cancer, and he and his doctors were aggressively fighting it. A month before the lecture, though, he learned that he had only a few more months to live.

On the night of the lecture, over 400 students and faculty members—fully aware of the situation—gave Pausch a prolonged standing ovation before the lecture. When he finally said, “Make me earn it,” and motioned for the audience to sit down, a voice from the crowd shouted out, “You did!” His inspirational lecture that evening became a immediate YouTube sensation, and Hyperion Books soon offered him a 6.7 million dollar book advance. Pausch was 47-years-old when be died on July 25, 2008, but he lived long enough to see his book make The New York Times bestseller list. It remained on the list for 85 consecutive weeks, ultimately selling over five million copies.

Dolen Perkins-Valdez
Take My Hand (2022)

Memphis 2016

A year never passes without me thinking of them. India. Erica. Their names are stitched inside every white coat I have ever worn.

After these few, brief words, we’ve already grasped the essence of the story to come and find ourselves in full agreement with the Bookpage reviewer who wrote: “There’s nothing better than settling down to read a novel and immediately sensing that you’re in the hands of a gifted storyteller.” I was delighted to honor this beautiful opener in my compilation of “The Best Opening Lines of 2022” on Smerconish.com (see the full list here).

As the opening paragraph continues, we don’t yet know if the narrator is a doctor or a nurse, but the words are haunting:

“I tell this story to stitch their names inside your clothes, too. A reminder to never forget. Medicine has taught me, really taught me, to accept the things I cannot change. A difficult-to-swallow serenity prayer. I’m not trying to change the past. I’m telling it in order to lay those ghosts to rest.”

Jodi Picoult
House Rules (2010)

Everywhere I look, there are signs of a struggle. The mail has been scattered all over the kitchen floor; the stools are overturned. The phone has been knocked off its pedestal, its battery pack hanging loose from an umbilicus of wires. There’s one single faint footprint at the threshold of the living room, pointing toward the dead body of my son, Jacob.

The first paragraph is a classic hook. As soon as readers take the bait, the next two paragraphs begin to reel them in:

“He is sprawled like a starfish in front of the fireplace. Blood covers his temple and his hands. For a moment, I can’t move, can’t breathe.

Suddenly, he sits up. “Mom,” Jacob says, “you’re not even trying.”

Richard Powers
The Echo Maker (2006)

Cranes keep landing as night falls. Ribbons of them roll down, slack against the sky. They float in from all compass points, in kettles of a dozen, dropping with the dusk.

It’s always nice to see a novel begin with a beautiful description, but this one also contains the interesting tidbit that a flock of cranes may also be correctly called a kettle (technically, a kettle is a gathering of any group of soaring birds—including cranes and vultures—that utilize circular updrafts of warm air to gain elevation).

In the opening paragraph, the narrator continued: “Scores of Grus canadensis settle on the thawing river. They gather on the island flats, grazing, beating their wings, trumpeting: the advance wave of a mass evacuation. More birds land by the minute, the air red with calls.”

Mary Roach
Stiff: The Curious Lives of Human Cadavers (2003)

The way I see it, being dead is not terribly far off from being on a cruise ship. Most of your time is spent lying on your back. The brain has shut down. The flesh begins to soften. Nothing much new happens, and nothing is expected of you.

Science writers are not noted for a sense of humor, but in her debut book, Roach proved from the outset that it’s possible to write a serious science book that is also world-class quirky and laugh-out-loud funny. In the book’s Introduction, Roach continued by describing how cadavers have played an integral, even essential, role in human history—albeit in their own deathly quiet way.

In the remainder of the book, Roach proved herself to be an Opening Lines master, beginning almost every chapter in a way that would have garnered an A-plus from any college professor of Creative Writing. For example, in Chapter One (titled, “A Head Is a Terrible Thing to Waste”), here’s how she began a chapter on a Face-Lift Refresher Course for Plastic Surgeons:

“The human head is of the same approximate size and weight as a roaster chicken. I have never before had occasion to make the comparison, for never before today have I seen a head in a roasting pan. But here today are forty of them, one per pan, resting face-up on what looks to be a small pet-food bowl. The heads are for plastic surgeons, two per head, to practice on.”

Later chapters open in an equally impressive manner, and here are three examples. In Ch. 3 (“Life After Death”), Roach began: “Out behind the University of Tennessee Medical Center is a lovely, forested grove with squirrels leaping in the branches of hickory trees and birds calling and patches of green grass where people lie on their backs in the sun, or sometimes the shade, depending on where the researchers put them.”

In Ch. 4 (“Dead Man Driving”), Roach opened with: “By and large, the dead aren’t very talented. They can’t play water polo, or lace up their boots, or maximize market share. They can’t tell a joke, and they can’t dance for beans. There is one thing dead people excel at. They’re very good at handling pain.”

And in Ch. 8 (“How to Know If You’re Dead”), she began: “A patient on the way to surgery travels at twice the speed of a patient on the way to the morgue. Gurneys that ferry the living through hospital corridors move forward in an aura of purpose and push, flanked by caregivers with long strides and set faces, steadying IVs, pumping ambu bags, barreling into double doors. A gurney with a cadaver commands no urgency. It is wheeled by a single person, calmly and with little notice, like a shopping cart.”

Mary Roach
Spook: Science Tackles the Afterlife (2005)

I don’t recall my mood the morning I was born, but I imagine I felt a bit out of sorts. Nothing I looked at was familiar. People were staring at me and making odd sounds and wearing incomprehensible items. Everything seemed too loud, and nothing made the slightest amount of sense.

Roach’s opening paragraph may not have much to do with life after death, but it’s an intriguing way to begin any book, especially a science book.

Mary Roach
Bonk: The Curious Coupling of Science and Sex (2008)

A man sits in a room, manipulating his kneecaps. It is 1983, on the campus of the University of California, Los Angeles. The man, a study subject, has been told to do this for four minutes, stop, and then resume for a minute more. Then he can put his pants back on, collect his payment, and go home with an entertaining story to tell at suppertime.

Manipulating his kneecaps? Where on earth could this be going? It all becomes clear—and delightfully so—as Roach continues in her opening paragraph: “The study concerns human sexual response. Kneecap manipulation elicits no sexual response, on this planet anyway, and that is why the man is doing it: It’s the control activity. (Earlier, the man was told to manipulate the more usual suspect while the researchers measured whatever it was they were measuring.)”

About Bonk, writer A. J. Jacobs (The Year of Living Biblically) said: “I would read Mary Roach on the history of Quonset huts. But Mary Roach on sex? That’s a godsend!” As we saw earlier with Roach’s Stiff book, many of the opening lines of other chapters in Bonk are also inspired. Let me cite a few examples. In Ch. 2 (“Dating the Penis-Camera”), Roach began: “Let me state it simply. Women came into Masters and Johnson’s laboratory and had sex with a thrusting mechanical penis-camera that filmed—from the inside—their physical responses to it.”

Ch. 6 (“The Taiwanese Fix and the Penile Pricking Ring”), opened this way: “A man having penis surgery is the opposite of a man in a fig leaf. He is concealed face-to-feet in surgical sheets, with only his penis on view. It appears in a small, square cutout in the fabric, spotlit by surgical lamps.”

And in Ch. 12 (“Mind Over Vagina”), Roach’s opening paragraph began: “The human vagina is accustomed to visitors. Even the language of anatomy imbues the organ with an innlike hospitality, the entrance to the structure being named the ‘vaginal vestibule.’ Take off your coat and stay awhile.

Jacqueline Rose
On Violence and On Violence Against Women (2021)

It is a truism to say that everyone knows violence when they see it, but if one thing has become clear over the past decade it is that the most prevalent, insidious forms of violence are those that cannot be seen.

Peter Schjeldahl
“The Art of Dying,” in The New Yorker (Dec. 16, 2019)

Lung cancer, rampant. No surprise. I’ve smoked since I was sixteen, behind the high-school football bleachers in Northfield, Minnesota. I used to fear the embarrassment of dying youngish, letting people natter sagely, “He smoked, you know.” But at seventy-seven I’m into the actuarial zone.

Four months earlier, Schjeldahl, the longtime art critic for The New Yorker magazine, was driving to his country home in the Catskills when he received a phone call from his oncologist. The lung cancer was indeed rampant, and he would soon learn that his Memorial Sloan Kettering team was giving him six months to live. In the essay’s second paragraph, he continued:

“I know about ending a dependency. I’m an alcoholic twenty-seven years sober. Drink was destroying my life. Tobacco only shortens it, with the best parts over anyway.“

Gail Sheehy
Passages: Predictable Crises of Adult Life (1976)

Without warning, in the middle of my thirties, I had a breakdown of nerve.

Sheehy’s opening line refers to an event that is known in the history of Northern Ireland as “Bloody Sunday.” As a reporter for New York magazine, she was covering a civil rights march by Catholic citizens of Derry when a rifle shot from a British soldier struck a young Irish boy directly in the face. As he fell, no longer recognizable, he fell on top of Sheehy. Over the next harrowing minutes, as other Derry citizens were felled around her, she crawled to safety as bullets reigned all around.

In her opening paragraph, Sheehy continued: “It never occurred to me that while winging along in my happiest and most productive stage, all of a sudden simply staying afloat would require a massive exertion of will. Or of some power greater than will.”

Passages went on to become one of the most popular books of the era, on The New York Times Best-Seller list for three years and selling more than ten million copies. Sheehy’s groundbreaking exploration of the “predictable passages of life” had such an impact on contemporary thinking that The Library of Congress hailed it as one of the ten most influential books of modern times.

Benjamin Spock
The Common Sense of Baby and Child Care (1946)

You know more than you think you do.

These are among the most famous opening words in the history of non-fiction books (from a first chapter titled “Trust Yourself”). At the time, Spock was a 43-year-old practicing pediatrician who was vigorously opposed to a then-popular “scientific parenthood” movement that urged new parents to put their faith in “experts.” Spock’s goal was to reassure young mothers that they were already up for the challenge of parenting, and his first words couldn’t have been more perfectly phrased.

The book was an immediate—and spectacular—success, selling 500,000 copies in the first six months after publication. It went on to become one of the most influential books of the twentieth century, revolutionizing child-rearing methods for a generation of women born after WWI and now looking at a whole new post-WWII world. The book was ultimately revised ten times and has sold more than 50 million copies in forty different languages.

Sharon Stone
The Beauty of Living Twice (2021)

I opened my eyes, and there he was standing over me, just inches from my face. A stranger looking at me with so much kindness that I was sure I was going to die. He was stroking my head, my hair; God, he was handsome. I wished he were someone who loved me instead of someone whose next words were “You’re bleeding into your brain.”

In the opening paragraph of her best-selling memoir, Stone found a tantalizing way of describing a 2001 medical emergency that, at age forty-three, threatened her career and almost took her life. She continued: “He stood there gently touching my head and I just lay there knowing that no one in the room loved me. Knowing it in my guts—not needing my bleeding brain to be aware of the ridiculous slap-down of my now-immobilized life. It was late September 2001. I was in the ER at the California Pacific Medical Center in San Francisco. I asked Dr. Handsome, ‘Will I lose my ability to speak?’ He said it’s possible.”

Cheryl Strayed
The Torch (2005)

She ached. As if her spine were a zipper and someone had come up behind her and unzipped it and pushed his hands into her organs and squeezed, as if they were butter or dough, or grapes to be smashed for wine. At other times it was something sharp like diamonds or shards of glass engraving her bones.

Putting medical symptoms into words can be difficult, but the narrator finds an ingenious metaphorical way to describe the pain being experienced by Teresa Rae Wood, the 38-year-old host of a local talk-radio show.

The narrator continued: “Teresa explained these sensations to the doctor—the zipper, the grapes, the diamonds, and the glass—while he sat on his little stool with wheels and wrote in a notebook. He continued to write after she’d stopped speaking, his head cocked and still like a dog listening to a sound that was distinct, but far off.”

In a San Francisco Chronicle review, Reyhan Harmanci wrote about Strayed’s debut novel: “The book opens with [a] diagnosis of rapidly metastasizing spinal cancer. Told at the age of 38 that she will go from healthy to dead in less than a year, Teresa does the best she can…. But this isn’t Teresa’s story. Strayed is more interested in the effects of death on the living.”

William Styron
Darkness Visible: A Memoir of Madness (1990)

In Paris on a chilly evening late in October of 1985, I first became aware that the struggle with the disorder in my mind—a struggle which had engaged me for several months—might have a fatal outcome.

Elizabeth Vargas
Between Breaths: A Memoir of Panic and Addiction (2016)

I don’t know if I was born an alcoholic, but I was definitely born anxious. The alcoholism came to me later in life, after years of drinking to ease stress and worry, and to fend off panic.

In a first chapter that Vargas titled “Chasing the Glow,” the popular television news personality continued: “But the anxiety? It was there from the start. My earliest memories are infused with it. It was a steady theme throughout my childhood, and it is the background music of my adult life.”

Jim Wahlberg
The Big Hustle (2020)

I’d been in fights all my life. I’d been pummeled by the toughest guys you’d ever not want to meet. I’d been beaten up, knocked unconscious, whacked in the head with a crowbar, and thrashed by a prison guard. But far and away the worst gut punch I ever took was when I discovered that my son was on drugs.

Wahlberg, the fifth child in a Dorchester, Mass. family of nine children that included Donnie (8th) and Mark (9th), was an ex-con and former addict who finally got his life together and dedicated his life to the recovery movement. After a successful marriage that produced three wonderful children, he wasn’t prepared for the next crisis in his life. He continued: “Daniel was sixteen years old. His behavior had been off, his energy seemed low, but we attributed that to recently losing his best friend to cancer.”

David Waltner-Toews
On Pandemics (2nd ed.; 2020)

Until a few years ago, many scientists had banished words like “threat” and “danger” from our vocabulary. In an attempt to be more rigorously quantitative and less emotional, we began to write about risks. Our response to danger was called “risk management.”

Waltner-Toews continued: “A risk is a threat or a danger that you can put into a box. Then you can count boxes, and manage them. The assumption in risk management is that you can quantify danger. This is only partially true.”

Hans Zinsser
Rats, Lice, and History (1935)

This book, if it is ever written, and—if written—it finds a publisher, and—if published—anyone reads it, will be recognized with some difficulty as a biography.

Zinsser, a prominent American physician and bacteriologist, may have been the first person in history to write a biography about a thing rather than a person—and he directly addressed that issue in the opening words of his book on typhus (the formal subtitle was: Being a Study in Biography, Which, After Twelve Preliminary Chapters Indispensable for the Preparation of the Lay Reader, Deals with the Life History of Typhus Fever).

Biographical writing was enjoying great popularity in the early decades of the 20th century, and it seems clear that Zinsser was hoping to capitalize on the trend. A bit later in his Introduction, he wrote: “The subject of our biography is a disease,” and he went on to add: “We shall try to write it in as untechnical a manner as is consistent with accuracy. It will of necessity be incomplete, for the life of our subject has been a long and turbulent one from which we can select only the high spots.“ Zinsser’s attempt to capitalize on the interest in biographical writing appears to have been successful, as his book became the 8th bestselling nonfiction book of 1935.

In the Preface to his work, Zinsser also offered some memorable opening words, and they provide a hint as to why he chose to frame the book as a biography: “These chapters—we hesitate to call so rambling a performance a book—were written at odd moments as a relaxation from studies of typhus fever in the laboratory and in the field. In following infectious diseases about the world, one ends by regarding them as biological individuals which have lived through centuries, spanning many generations of men and having existences which, in their developments and wanderings, can be treated biographically.”