Ida Mae is so passionate about her work as a filmmaker, her intensity lands her in the hospital after a heart attack. Her mother, Edna, whose ghost takes up residence in Ida Mae's hospital room, appears as Ida Mae's spirit leaves her body and shoves it back in. "You think because I'm dead, I don't know things? I'm your mother. I know everything." Lisa, Ida Mae's mirror image twin, lives a perfect life with a perfect husband, and the sisters' resentment of each other, which began simmering when they were children, has now reached its boiling point.
Fern, the psychiatrist who is called in to evaluate Ida Mae, battles with her own demons, specifically, her mother and food. Within minutes of meeting anorexic-looking Ida Mae, "[t]he flat foot of inadequacy reaches up and kicks her in the behind, its heel sinking into thirty extra pounds of cellulite." Fern regards Ida Mae as "an egocentric, frizzy-haired, sarcastic bitch who uses every opportunity to build up her own self-esteem by trying to tear down others," but writes, "Patient is in denial about cause of arrest. Claims starvation was for 'artistic' reasons. Exhibits hostility to authority. Suspect rivalry with sister, Lisa."
If you're thinking, "Yikes," you're already inside Ida Mae's head, and you've only read 8 pages of one of the most alternately terrifying and hilarious novels ever written. I will not spoil your enjoyment further, except to urge you to set aside a chunk of time before you open the cover, because you will not be able to stop reading once you've begun.