Part 1 is written in the past tense, and the first chapter begins with a “maddening, claw-at-your-skin, keep-you-up-at-night” itch that Suleika Jaouad can’t ignore (3). No one knows why she itches, and she tries to stop scratching, but the itch and scratching only deepens and spreads, creating “oozing nicks, thick scabs, and fresh scars [...] [b]loody harbingers of a mounting struggle taking place inside of me” (3). Herbalists and doctors recommend creams, tinctures, tonics, and bitter teas. To hide the sores and scars, Jaouad wears jeans and tights no matter the weather and has sex in the dark.

Suleika is a senior at Princeton and is exhausted, taking hours-long naps each day. She expresses this to friends and hears that everyone is tired. They all pull all-nighters for partying and studying to take advantage of their final weeks together. Suleika’s itch and exhaustion worsen. She thinks her fatigue might be different, deeper, and more concerning. After Suleika graduates, she moves to New York City and starts an internship. She shares an apartment with nine other people, and this isn’t the life she imagines for herself. She dreams of being a correspondent in North Africa, where her father is from and where she lived for a while as a child.