"This poem begins where Bulimia ends

or maybe, just maybe, when it started. Where

the differential diagnosis is confused

by decades of self-made violence. Poverty,

colonialism, god, all prisms that will shatter

one day, if not now..."

Part self-interrogation, part confession, part hospital diary, the intense, heartbreakingly frank poems in Brandi Bird's second collection detail the author's ongoing struggles with eating disorders and depression, conditions that disproportionately afflict Indigenous girls, women, and two-spirited persons. These challenging poems investigate the relationship between sexuality and eating disorders as well as how the voyeurism of religion (the idea of being eternally watched) intersects with both of those spheres. They also raise questions about body shaming and body sovereignty-a failed sovereignty in this case, as "sovereignty" itself is a communal concept. In the tradition of poets like Amy Berkowitz (Tender Points) and Hannah Green (Xanax Cowboy), the poems in Pitiful also lay bare the way patriarchy, medical sexism, and bigotry have not only sabotaged the treatment of such conditions but often make them worse.