As Bill Clinton discovered while penning his memoirs, writing an autobiography is a painful experience. The author has to dredge up old memories—many better left undisturbed—examine them from every angle, and try to repackage the events so that the audience can relate.

Novelists can churn out a dozen or more books. They aren't bound by events except in the broadest sense. Writers of fiction brazenly recycle earlier material into later narratives; change geography, chronology, and perspective; and kill off characters when they get bored with them. Memoirists have more shallow wells to draw from, and consequently tend to author fewer volumes. Each installment is expected to break new ground, setting the facts of one's life straight for posterity—a balancing act that is lousy with difficulties. Unless they're deranged, it's not easy for autobiographers to kill off the bores.

So I began reading Jim Knipfel's third memoir, Ruining It for Everybody, wondering if he hadn't run this particular well dry. Knipfel's first memoir, Slackjaw, with its brutal bring-on-the-pain honesty and pitch-perfect prose, was a critical and commercial success. Quitting the Nairobi Trio, a more focused story about his time in a mental ward after a suicide attempt, was also worth reading but fell into the sequel trap: not quite up to the original. Why even bother with a third installment now, with the author only in his thirties?

Knipfel—who published a novel, The Buzzing, between his second memoir and the new one—says that he needs the money, but there's also something else. In the intro, he goes out of his way to spell out his maladies—his creeping blindness, his epilepsy, his well-marinated liver and smoke-clogged lungs, the scars and kidney failures ...