Mattilda Bernstein Sycamore’s third novel—Sketchtasy—locks us in the head of Alexa, a queen in early her 20s who’s trying to survive life in mid ’90s Boston. Random Bostonians subject her and her queer friends, along with the black and brown people in her neighborhood, to daily acts of violence. Alexa can’t even walk to the laundromat without some frothing heterosexual trying to drop a cinderblock on her head. She’s also dealing with “incest flashbacks.” Her father molested her as a child, and when we meet her she’s in the process of preparing to confront him. Meanwhile, her parents have cut her off financially for dropping out of college. To pay for rent, vegan food, and tons of drugs Alexa starts turning tricks for cash—again. And, of course, all of this is happening during the AIDS crisis.

All of that sounds heavy, and it is. But Alexa greets each new threat of violence, each traumatic flashback, and every betrayal the way she treats everything else: like another god damn thing she’s got to deal with. Her nonchalance and humor aren’t evidence of some kind of willful obtuseness. They’re the tools she needs to stay resilient in this compelling story of survival.

Much of the book is a line by line, pill by pill, john by john account of life in Boston’s gay club scene. I cannot understate how often characters snort lines of coke or pop pills in this book. Many pages read like laundry lists—straightforward descriptions of the drugs done, the bars crawled, and the after-hours hosted. While Sycamore risks monotony with Alexa’s mesmerizing monologue, she also getting a lot of mimetic mileage out of it. You’re supposed to feel the boredom of doing all these drugs. Sycamore isn’t glamorizing anything here—except for good hair and great dancing—she’s trying to put you in the room.

This almost bland accounting also allows Sycamore to make sharp, surprising turns toward humor and sentimentality. The humor often works. Alexa pulls herself out of a funk, for example, after getting a little too emotionally close to a client with this dark zinger: “Really I just need to have hot sex with someone I actually care about, but then Polly passes me the dollar bill and I do a line and yes, it’s a great day at the office.” You laugh, you cry, you nod your head. You’ve been there even if you haven’t exactly been there. And did you just read a hot sex scene involving sex work that treated the characters as real people and not 2D avatars for grittiness? You did! Sycamore’s turns toward sentiment, however, rely too heavily on the literary convention of appreciating the way light looks, and so those gestures aren’t as successful as the jokes.

Aside from contributing to a fully immersive reading experience, Alexa’s singular, all-consuming voice gives Sycamore the opportunity to bury emotional landmines throughout the book. You wouldn’t expect something as common as the announcement of a character’s age to make your heart gush with grief, but after 153 pages of intense drug journaling, of watching characters negotiate more violence and pain in an afternoon than privileged people have to negotiate in a lifetime, a line about someone’s 21st birthday will make you put the book down and take a walk.

Alexa’s story is fictional, but it reads like a first-person historical account of queer survival, one that accurately portrays the struggle of a person trying to build a community outside of a society that constantly rejects her. There are no answers here, and no detailed blueprint for how to build that community. But there are glimmers, clues, hopes, sketches of an idea.