As an adult his migraines occur with alarming regularity, and his repeated attempts at self-medication send him over and over to the emergency room. He knows that to visit twice is to risk being institutionalized as a suicide risk. So, following each trip to the hospital, he draws upon his skill as a petty forger, and reinvents a new identity for himself.
The Contortionist's Handbook is about the lengths people will go to in order to protect themselves from others and ultimately from themselves.
...ContinuaInscribed by the author, "Becky--Thanks for, among other thing, the job. Soon enough, Craig Clevenger."