149 Ways to Wipe Your Ass is a saucy, quirky, humorous and introspective look at a multitude of subjects. Wolfe juxtaposes eccentric, off-center, and reflective stories of death and dying, exhaustion, suicidal thoughts, and touching moments with patients. He is reverential and appreciative of those things he likes and bold, satirical, discriminating, and uncurbed in those he doesn't. There is slapstick humor about penises, unconventional descriptions of painful scrotal surgeries, roguish reading lists, brassy analysis of the pharmaceutical industry, and blow-by-blow accounts of dripping and spurting blood. There are no-nonsense descriptions of people in his life with great character, cerebral analysis of his medical school experiences, and ruminative scrutiny of his internship. The sharing of these stories is genuine, meditative, and poignant.