If you were to close your eyes and not see Catherine McCall’s athletic haircut, or the tanned, toned arms of a competitive swimmer, you might think you were listening to a Southern belle. The author of Lifeguarding, an intimate memoir of growing up gay and Southern in an alcoholic family, still has the accent of someone who could “pass” for high society in Louisville, Ky. Although she drew the line at becoming an actual debutante, she fit into the world her financially strapped parents were always striving to hold their place in, a world of country clubs, sorority parties, waterskiing on the Ohio river, and gin and tonics by the pool.

Now a psychotherapist in Wilmington, McCall originally planned to write a guide to self-care based on her psychiatric practice. Her therapeutic manner comes through in the way she prefers dialogue with an audience to reading from a lectern, and she intends the book in much the same way. By revealing as much personal information as she did in Lifeguarding, McCall hopes her story may be the catalyst for readers to start their own conversations.

The book opens with McCall working as a lifeguard as she waits to get into medical school. She had not yet come out to herself or her family as a lesbian. As her father tries to soothe grief with alcohol, secrets threatened to drag down her whole family, in much the same way McCall herself used to let all the air out of her lungs at the deep end of the pool, rehearsing death by water.

Water has as many personalities in this book as the various bodies of water that map out McCall’s Louisville childhood, from the treacherous Ohio river that killed her uncle, to a sunken quarry where she witnessed a boy drown, to the smog-filled humidity of the very air itself in the Ohio Valley, which symbolizes the suffocating atmosphere of her home life. Yet water also represents emotional safety and the refuge of routine. McCall has spent all her life in or near the water, from the pools where she practiced daily and even stoked Olympic dreams, to her childhood love affair with the ocean, sparked by family vacations to Florida, which led McCall to the ocean-side city where she lives now.

Part 1 of the book accurately evokes a child’s sense of impending doom. She’s living in a house with “fun house floors,” where stability and reality are threatened. Swim practice, an everyday event for years for McCall and her two siblings, provides a sense of order, echoed in turn by the rhythm and repetition in the narrative. Epigraphs from the American Red Cross lifeguarding manual head each chapter, and litanies of phrases overheard from adults, captured and magnified in a child’s ear, cordon off her early interpretation of family interactions into narrow channels like swim lanes.

Part 2 is the touching coming out story of McCall’s high school, college and med school years. The scene of her first kiss, described with tenderness and humor, recreates the cloud of heart-pounding excitement that surrounds first romance. Only slowly does McCall come into possession of her own voice, and accepting her own sexuality is essential to the process.

To her great credit, McCall doesn’t sugarcoat the difficulties of coming out to her family, nor does she spare their flaws or soften the hard edges of prejudice and denial (her own included). Calm waters can suddenly turn deadly. One of the “secrets” Lifeguarding brings up from the sludgy bottom is how homophobia gets passed down even in unspoken ways, through things as subtle as tone of voice when pronouncing words like “weird” and “strange.”

McCall’s first full-length work is revelatory and beautifully written in the voice of an honest healer. Though she gave up lifeguarding long ago for medicine (and now plans on giving up her practice for a full-time writing career), her memoir teaches one of lifeguarding’s most fundamental rules: The first life you save has to be your own.

Catherine McCall will read from Lifeguarding on Thursday, Aug. 3 at 7 p.m. at Quail Ridge Books & Music, 3522 Wade Ave. in Raleigh. For more information, call 828-1588 or visit quailridgebooks.booksense.com.