Joan Didion could never make a baby, but she sure has made a lot of books. They just keep shooting out of her—out of those giant hands. The writing in her earliest nonfiction books (1968's Slouching Towards Bethlehem, 1979's The White Album, 1992's After Henry) is so powerful, it's as if nature made it, as if it came from the sky, as if it's part lightning.

But being a mother didn't come nearly as naturally. In 1966, a baby was handed to her, was adopted, and was raised "as a doll," Didion admits in her new memoir, Blue Nights. Quintana Roo, named after a place Didion and her husband saw on a map, was an eccentric kid who grew up troubled, with various diagnoses of mental illness and possibly a drinking problem, and by her late 30s was in and out of hospitals, falling into comas, seized with septic shock, stricken with acute pancreatitis—a freak-show cascade of medical crises that figures into the background of Didion's 2005 memoir, The Year of Magical Thinking. The main event of that book is Didion's husband falling over dead at the dinner table. Quintana, in the background, constantly coming to in one hospital or another and forgetting everything, is so out of it that she has to be told three separate times that her dad has died.

Quintana was still alive by the time Didion finished The Year of Magical Thinking, but she was dead before the book tour. According to Blue Nights, Didion placed her dead 39-year-old daughter's ashes in a marble wall, the same marble wall she'd placed her husband's ashes in, and a week later—when any human being would beg off public appearances, citing the need for privacy—Didion set out on a 10-city publicity whirlwind, including a trip to Seattle, where she stood fixedly at a podium and gave a reading without taking off her purse.

Obviously, privacy has never been a big thing for her. This is the woman who, in The White Album, published the text of her own psychiatric report. With The Year of Magical Thinking, an unexpected best seller and it's-about-time award-winner, she went from being someone graduate writing students adore to someone your mom has heard of. "With Magical Thinking, suddenly people were speaking to me in airports, and usually they had some really terrible thing that had happened," is how she put it in a recent interview I found on YouTube.

Good thing the public's appetite for dark, embarrassing stories about well-known people is unquenchable, because the older she gets (she turned 77 this week) and the more well-known she's become, the more her life has filled with dark embarrassments. There's the scene in Blue Nights where Didion collapses on the street before Quintana's wedding and, while being "transfused for an unexplained gastrointestinal bleed," is told by the doctors she has to swallow a very small camera. "Since I had never in my life been able to swallow an aspirin it seemed unlikely that I could swallow a camera," she writes. "In the end, I did swallow the very little camera, and the very little camera transmitted the desired images, which did not demonstrate what was causing the bleed but did demonstrate that with sufficient sedation anyone could swallow a very little camera."

There's a scene where she describes her vision being blocked by what looks like "black lace" that turns out to be blood, and another scene where she's in a folding chair, unable to move, unable to get up, and begins to panic.

Most distressingly, there's the scene that begins with her on the street, walking home from dinner, and the next thing she knows she's

on the floor of my bedroom, left arm and forehead and both legs bleeding, unable to get up. It seemed clear that I had fallen, but I had no memory of falling, no memory whatsoever of losing balance, trying to regain it, the usual preludes to a fall. Certainly I had no memory of losing consciousness. The diagnostic term for what had happened (I was to learn before the night ended) was "syncope," fainting, but discussions of "syncope," centering as they did on "pre-syncope symptoms" (palpitations, light-headedness, dizziness, blurred or tunnel vision), none of which I could identify, seemed not to apply.

I had been alone in the apartment.

There were thirteen telephones in the apartment, not one of which was at that moment within reach.

I remember lying on the floor and trying to visualize the unreachable telephones, count them off room by room.

I remember forgetting one room and counting off the telephones a second and a third time.

This was dangerously soothing.

I remember deciding in the absence of any prospect of help to go back to sleep for a while, on the floor, the blood pooling around me.

This is a scene you can't imagine in the voice of any other writer. (Also hard to imagine: 13 telephones.) But it has to be said that most of the book is not like this: Most of the book consists of Joan Didion walking around her apartment pulling open drawers and looking into closets and recalling things. As Didion has started to come apart physically, her famous rhetorical strictness has started to come apart a bit, too. Gone is that sharp cerebral sting you used to get at the end of a great Didion tear, like your brain was at the business end of a cracked whip. What she might have done as an essay before is now book-length, padded out with increasingly elliptical and diffuse material, tangents that don't always add up, almost like she perpetually can't remember what she was about to say. Blue Nights is an assortment of fragments.

And for a writer who used to wield bluntness like a bazooka, she's uncharacteristically roundabout on certain topics. I had to read in a book review of Blue Nights, after reading Blue Nights myself, that the book deals with Quintana's drinking problem, because it is discussed only once in all 188 pages, as I found when I read it a second time. Here is the entire discussion of it: "She was depressed. She was anxious. Because she was depressed and because she was anxious she drank too much. This was called medicating herself. Alcohol has its well-known defects as a medication for depression but no one has ever suggested—ask any doctor—that it is not the most effective anti-anxiety agent yet known." That's it.

Maybe it's just the subject matter. As Didion writes elsewhere: "Quintana is one of the areas about which I have difficulty being direct." In lieu of directness, we get a spray of brand names and place names and celebrity-friend names, a whole litany of incidents and icy understatements and bitchy comebacks. Many of the points she makes fall into one of two camps: self-laceration (she doesn't think she was a good mother) or defensiveness (she tries to smack around people who say Quintana grew up privileged, even though Quintana clearly grew up privileged). The narrative may lack the old force, but within the fragments are multiple scenes of wry, aggressive, vintage Didion doing that thing her readers love to watch her do, which is dress down idiots—paragraphs that basically go: Something, something, fuck you, something, something, shove it, something, something. She's still got it. She may have lost her husband and her daughter and her physical strength, but she has not lost her mind. She's alive. She's living. She lives.