"Of course the story of my life is how I left my mother," Tom Spanbauer says. He's sitting in the dining room of his comfortable 1907 Sears and Roebuck kit house in Portland, Ore. It's a Monday afternoon in April; a pot of peppermint tea steeps on the table and the sun, visible for the first time in months, lights the steam's pale spirals. At 60, Spanbauer is handsome and a bit weathered, wearing a yellow shirt and faded red suspenders. "As a child," he says, "I was so bonded to her. I was kind of her boyfriend.... I guess I've always been investigating my personal history somehow, and fictionalizing it."

The story of Spanbauer's life does indeed bear some resemblance to that of his most recent creation, Rigby John Klusener, a gay 17-year-old farm kid from Idaho and the narrator of Spanbauer's fourth novel, Now Is the Hour, published this month by Houghton Mifflin. Spanbauer's exuberant, irresistible bildungsroman opens with Rigby John on the side of the road, trying to hitchhike to California. It is 1967, and he has left behind a cold and racist father, a lonely, hyper-religious mother, a pregnant girlfriend, a dead high school bully and a world in which he does not fit; in looping, brilliantly colloquial fashion, he tells how he wound up in the desert on his way to San Francisco.

Like Rigby John, the author was raised in a Pocatello, Idaho, farm family on the border of an Indian reservation; he had a brother who died very young, and a bully who tormented him. Like Rigby John, he grew up at the mercy of his parents' "medieval Catholicism," in which anything interesting was venial sin and anything enjoyable was probably a mortal one. And like Rigby John, he often resented it. "I had to take that anger and channel it, because you know if I'm just angry—mother was a bitch and father was an asshole—then that would be it," Spanbauer says. "Going back as a writer, not as a son but as a writer, going back and looking at that woman and that man and that situation—it's a wonderful way of healing things."

It isn't the first time Spanbauer has mined his own life for his fiction. His 1988 debut, Faraway Places (Putnam), written after he studied with famed editor Gordon Lish, combined autobiographical elements and Lishian minimalism; his bigger, bawdier 2001 novel, In the City of Shy Hunters (Grove), was a response to his experiences living in New York during the darkest days of the AIDS epidemic. But of course these books don't begin and end with personal history: they are richly imagined stories narrated by characters whose singular voices take on an incantatory power.

The sweep of his stories and the diversity of his characters (he's been called a "poetic fabulist") are testament to a life full of twists and turns and the resulting improvisations of survival. Spanbauer has been many things at many times: an altar boy and a pill-popping Studio 54 habitué, a Peace Corps volunteer and a hay baler, a waiter and a teacher. He was also a closeted husband for seven years, until he came out in 1978 and made his way to New York. "That's when I was going to all those incredible discos," he says. "Those were wonderful times! But there went the brain matter. There went the immune system."

Spanbauer wrote his most famous novel, The Man Who Fell in Love with the Moon, while working as a building superintendent in the East Village, having graduated from Columbia University in 1986 with an MFA in writing and $25,000 worth of school debt. The story of a young half-Indian boy who grows up turning tricks in the turn-of-the-20th-century Wild West and who falls in love with the cowboy he believes is his father became a cult hit. Of those years he was writing it, Spanbauer says, "it seems like I'm romanticizing them, because I knew I was HIV positive and everybody around me was dying. But I decided, well, I'm going to write this really crazy thing about these cowboys out in the middle of nowhere. I had nothing to lose."

In 1990, right before the book's publication, when he couldn't "pick up dogshit anymore, couldn't sweep another hallway, couldn't mop another stairwell," Spanbauer followed a lover to Portland, Ore., another hairpin turn in his bio. A year later, he founded Dangerous Writing, a private workshop that urged students to find "the sore place" in themselves and use it for their fiction. In his first session there were two students, one of whom Spanbauer had to pay to come. But attendance picked up, and the workshop quickly became legendary among aspiring Pacific Northwest writers; members have included Chuck Palahniuk, Joanna Rose and Ken Foster, who has said, "Everything I know about writing I learned from Dangerous Writers." Spanbauer tells his students to pay attention to their linguistic tics, to ground things in physical detail, and to write like they're on their second margarita and talking to a best friend they haven't seen in weeks.

But now it's time for another change in Spanbauer's path. The novelist, who was diagnosed with AIDS in 1996, suffered a stroke last September; for 12 hours he couldn't move his left arm. He recovered, but "I don't have the energy I used to have, and if I'm going to have energy I want to write with it rather than teach with it." He's working on an opera and a screenplay for The Man Who Fell in Love with the Moon, and he's considering a book about the craft of writing, as well as a book about his time in Kenya in the Peace Corps. A memoir? "No, I lie too much," Spanbauer says, smiling. "Plus fiction is the lie that tells the truth truer, so why stick to fact?"

At a reading a week later, courtly and dapper in a dark suit and an open-collared white shirt, Spanbauer tells the audience a story at the heart of his inspiration for Now Is the Hour—his sore place. He had gone to Idaho to visit his family, and when it came time for him to go back to New York, his mother called him aside. She pulled him away from his father and brothers, took him into the bathroom and locked the door behind them. " 'You have to take me with you,' " she told him. " 'These men that I live with don't look at me, and they don't talk to me, and they never thank me. You've got to take me out of here." It was 1988 and he was a grown man; he had to say no.

"So much of the story of my life is how I loved my mother," Spanbauer tells the audience. She died in 2003, when he was writing Now Is the Hour. The book is dedicated to her.