Beth, who lives in an unspecified Pennsylvania city, suffers from mental handicaps. She is not employed but has created a social life for herself by riding the city buses all day. She has cultivated relationships with a dozen or so bus drivers, whose routes she knows by heart and rides regularly. The author, Rachel Simon, a workaholic whose social life had shrunk almost to nothing, is Beth's sister. She had recently become separated from her husband when Beth asked her to ride the buses with her. Rachel agreed to ride the buses with Beth approximately once a week for a year.

This book is an account of that time. Rachel gets to know Beth's friends, the bus drivers. She attends Beth's plan of care meetings, meets the team of social workers who work with her sister, and learns that self-determination is their goal in providing services to Beth. Rachel works through some of her exasperation and other less than charitable feelings towards her sister and learns much more than she had previously known about her condition. The memoir intersperses Beth and Rachel's encounters with various bus drivers with Rachel's memories of growing up with Beth.

Although it is a memoir rather than a treatise on the care of the mentally handicapped,
the book touches on many issues: institutionalization vs. living in the community, sterilization vs. childbearing, and self-determination vs. forcing the mentally handicapped to eat what they should or to wear clothing appropriate for the weather. The one issue that was brought up repeatedly by other passengers of the buses Beth rode was their indignation at having to support Beth, through SSI payments, when she did not have a job and refused to get one. Some of the bus drivers and some of the other passengers supported her right to live as she chose.

By the year's end, Beth is unchanged -- colorful, extremely talkative, frequently stubborn and inflexible, limited in her ability to see another person's point of view but possessed of a strong sense of right vs. wrong, and unwilling to get a job, dress appropriately for the weather or to eat vegetables -- but Rachel has begun to make significant changes in her life. The book inspired me to work on my own family relationships.

The book club discussion was attended by more than half the members. We had a spirited discussion. Members rated Riding the Bus with My Sister 4 stars.