It gets harder and harder for Raina to function at school though, and she spirals in and out of panicking about if someone near her can get her sick. Lauren asks Raina to talk about why she is there, and at first it is hard, but Lauren is patient and tells her to try. One day, Raina’s mother takes her to a therapist named Lauren. Raina starts to miss too much school and her parents are concerned. She does not sleep all night and the next day is exhausted at school. The next day when Raina comes home from school she sees her brother is sick on the couch, and panics and runs outside.

Jane tries to take her to the school nurse but Raina is too grossed out, and when she returns to class Michelle mocks her. During the presentation though, Raina freezes and runs to the bathroom. Raina and Jane work together and decide to present on Girl Scouts. Abrams announces they will be doing LDIs or Lecture, Demonstration, or Instruction on topics the students want to pick. Soon Raina starts fifth grade, with her friends, and Michelle in her class, and a teacher she has had in another grade, Mr. Fourth grade ends as Raina thinks about how hard it is to get privacy, and the bathroom was the only place she could get it sometimes. Her mother takes her to the doctor who says she is healthy, but this does not explain why she feels scared. That night she thinks she will throw up again, the images depicting her spiraling and falling in green, but she does not, but she still knows something is wrong.

Raina and her friends talk about their food at lunch, Michelle making fun of Jane, while Raina explains her family’s particular and picky habits. At school, another kid throws in the yard at recess and all the kids stare, and when the kid comes back everyone calls him pencil puke.

The book starts as Raina wakes in the middle of the night, and goes to the bathroom to throw up, with her mother there beside her. For the purposes of this guide, the memoir is broken into six sections. There are no explicit chapter titles, but the author splits sections with an entire left side page filled with just an image and no words or page numbers - such as on pages 32, 70, 128, 140, 156, 166, 178, 184, and 194. The following version of this book was used to create this study guide: Telgemeier, Raina.

Raina guts