When Greg Bottoms runs into an old friend from high school, neither man is sure if it's worth starting their first conversation in over a decade. As teens, they had run with a rough crowd-standard hooligans, in Bottoms' mind, until his friend became cruel in his violence, exhibiting "pure, gleeful meanness.” Years later, as they cross paths at an ATM in their hometown, the friend can't believe Bottoms went to college, grad school, is a writing professor with a wife and kids. The friend has been in and out of prison for drugs and drunken brawls, has a son with a black eye waiting in his truck. Such is the juxtaposition between Bottoms and many of his childhood acquaintances. In a southern town with starkly drawn class lines, crime was not uncommon. What Bottoms finds, though, is not so much a matter of social standing or economic opportunity, but the tragedy of untreated mental illness and its often deadly impact on anyone near the afflicted. Pitiful Criminals takes a close look at the author's hometown to examine twelve cases of violence committed by those who were too young, too intoxicated, or too mentally unstable to truly know any better. Bookending these pieces is the story of Bottoms' own brother, who, in a spiraling schizophrenic episode, set fire to the house with his sleeping family inside, convinced the home would be purged of his demons if he could just burn them out.