On a Scale of One to Ten

Tamar is admitted to Lime Grove, a psychiatric hospital for teenagers with a variety of issues. She’s asked endless questions. But there’s one question she can’t. . . or won’t answer: What happened to her friend Iris? As Tamar’s past becomes more and more clear to her, she’ll have to figure out a path toward forgiveness and find a way to live.

Tamar tells her own story which allows her self-hatred, guilt, and desire to die take center stage. While readers may not understand Tamar’s struggle, she is a sympathetic character who isn’t sure how to take control of her life. While in the psychiatric hospital, Tamar does little to help herself and she describes most of the hospital workers in a negative light. The staff members are either incompetent or too worn out to expend any energy on the patients. When a psychiatrist sees Tamar, his lack of compassion makes the sessions useless. While in the hospital, Tamar continues to try to harm herself and even attempts to end her life. Even though the story has a hopeful conclusion, the reason that Tamar is beginning to heal is unclear.

On a Scale of One to Ten is difficult to read because of Tamar’s graphic descriptions of her suicide attempts and her self-hatred. Tamar often refers to herself as a murderer because of Iris’s death. The constant reminders of Iris create suspense, but the circumstances of Iris’s death aren’t revealed until the very end. The reasons that led to Iris’s suicide are unrealistic and horrifying. When a girl sets Iris’s hair on fire, Tamar does nothing to help Iris, which is one of the reasons Tamar feels guilt. Tamar’s lack of empathy for Iris and her own despicable behavior is heartbreaking.

In the end, Tamar is on the path to recovery, and she realizes “there isn’t a cure. Except me: I am the cure.” On a Scale of One to Ten gives readers insight into one girl’s struggle with mental illness; however, the story doesn’t include how Tamar is finally able to cope with her guilt and suicidal thoughts. On a Scale of One to Ten excellently depicts Tamar’s emotions and gives insight into teens who struggle with mental health. Mature readers who want to delve into another book that explores mental illness should add Turtles All the Way Down by John Green to their must-read list.

Sexual Content

• Tamar wonders if a charity shop is “a front for drugs, kidnapping, or prostitution.”
• Tamar goes to a party at Toby’s house. While there, “I feel his face close to mine even though my vodka-brain is swirling my vision and Rihanna bursts on. . . I brush my lips against his and I don’t think it lasts for more than a few seconds.” Later, Tamar describes the “burnt taste of weed on his lips.”
• Tamar, who is wearing a dress, wonders if the “person in the street is looking at me weirdly. . . [is] planning to stalk and rape me.”
• After Tamar gets out of the hospital, she begins dating. Kissing is involved.

Violence

• To get the bad thoughts to stop, Tamar hits her head against the wall. “If you slam your forehead hard enough, then it bleeds under the skin and the bruises are swollen and sore, but at least the thoughts disappear for a third of a second.”
• Tamar cuts herself. “I make three thin scratches on my thigh, watch to see which one draws the most blood.” She then gets in the bath and, “I stretch out my arm in front of me and press down, slice the blade across the skin. I watch it split, blood starting to ooze out. . . I’m slashing, wildly gashing deeper, deeper into my undeserving body. . .” She is taken to the hospital and given stitches.
• While in Dr. Flores’s office, Tamar begins “shouting and swearing every swear word in the English language. I’d . . . hurled the books with the hardest covers I could find at him. . . He’d swerved just as the Holy Bible smashed into his computer.” When the nurses tried to restrain Tamar, she “tried to bite them as they held my squirming body. . .”
• Tamar tries to drown herself. She fills the bathtub and then “plunging below the surface, water burning nostrils, dancing into lungs that in equal measure try to accept and reject in confusion the muddy flood that prances into them.” The scene is described over two and a half pages.
• Again, Tamar tries to kill herself. She talks about “how tight the noose felt as it dug into my soft flesh, how my eyeballs felt like they were going to burst out of my sockets, and I could feel my brain swelling against my skull . . .”
• Ellie, one of the patients in the psychiatric hospital throws a fit. “She thumps on the corridor walls outside the bedroom, dashing and darting away from nurses who want to inject her. . . I don’t look out the window or my door, but I’m sure if I did, I would see the chairs that I heard land, flying across the corridor and slamming into walls. . .”
• Iris is a new girl at Tamar’s school. One day, Iris, Tamar, and Mia (Tamar’s friend) go outside to smoke. “Mia lifted the lighter to Iris’s red hair. Iris’s face said it all before the flames did, and her hair billowed into a smoking russet plumage. Someone. . . engulfed Iris’s head in a blazer.” There were “sheens of crimson lining her scalp. Shiny tracks of peeled skin running across her forehead.” The paramedics treated her burns. Neither Tamar, nor Mia was punished.
• Iris and Tamar go to a dam and get wasted. When Tamar leaves, Iris “put her boots back on and filled them with stones. . . [she] jumped into the surging pool below. For a few minutes her body was tossed around as if all her bones had been removed. . .” Her death is described over one-third of a page.

 Drugs and Alcohol

• Tamar and her friend, Iris, were drinking and smoking after school. Both girls got extremely drunk.
• Tamar and her friends smoke cigarettes often. Once, Tamar “smoked half the pack of cigarettes out of my window, curled up into my curtains. It made me feel sick . . .”
• While in the psychiatric hospital, the teens are given a variety of medications such as risperidone, lamotrigine, and fluoxetine. For example, Tamar is given a sleeping pill.
• Tamar describes her dad as “beer-guzzling.”
• In the ER, a man is given acetaminophen.
• A girl in the hospital says her “mother overdosed on heroin in front of her when she was three.”
• Tamar ’s friend gives two guys money and assumes they will buy “a can of Budweiser and a packet of Royals.”
• While on a home visit, Tamar goes to a party where the teens wait “for tipsy to kick in.” Tamar drinks “one shot, then drink the rest of the bottle single-handedly, like it is water. . .until the room swirls. . .” Tamar was so drunk she was taken to the ER and didn’t remember it in the morning.
• When Tamar tries to kill herself, she is taken to the hospital and given antidepressants, antipsychotics, and mood stabilizers.

Language

• Profanity is used frequently. Profanity includes bullshit, damn, fuck, hell, piss, and shit.
• A girl says, “my mum was a whore.”

Supernatural

• None

Spiritual Content

• While in the hospital, Tamar hears “Patient A” freak out. Then, “Distressed Patient A prays to God for it all to end, fractured cries between weeping. God doesn’t hear.”
• At one point, Tamar is in so much pain that she prays, “Oh, God. Please make it end.”