"Blood and Guts in High School" is a novel by Mary Gaitskill that explores the complexities of adolescence through the eyes of a teenage girl named Ruth. The story delves into themes of identity, sexuality, and the struggles of growing up, often using dark humor and surreal elements to convey its messages. The book is known for its unconventional narrative style and graphic imagery, which challenge traditional storytelling. It has garnered attention for its candid portrayal of teenage angst and the emotional turmoil that accompanies the transition into adulthood, making it a significant work in contemporary literature.