The ridiculously successful The Fault In Our Stars unlocked a lot of doors in what I guess we're gonna need to start calling Sick Kid Fiction instead of Cancer Kid Fiction, and this is one I've been particularly eager to see opened, especially after Five Feet Apart (and to a lesser extent Midnight Sun and even The Space Between Us) gave us a cancer kid story where they didn't actually have cancer, and where both the protagonist and the love interest survive to the end, although the norms of the genre and the nature of their illness still necessitated a death. But finally, finally Hannah Moscowitz has opened that door with Sick Kids in Love, and I am almost indescribably excited.
The Premise
Isabel Garfinkel has Rheumatoid Arthritis. Sasha Sverdlov-Deckler has Gaucher disease. They meet cute in the drip room of Linefield and West Memorial Hospital when their infusion schedules (hers every month, his every 10 days) happen to overlap. After some initial hesitation and awkwardness (Ibby inital caps Doesn't Date), they transition from hanging out constantly to actually getting together. There's not a lot of overarching plot aside from their relationship. They go on a few dates, meet each other's families, and spend a lot of time just chilling together and watching TV. Sasha understand Ibby in the ways her healthy friends and father don't (even though her father's a doctor). He's also more comfortable with her illness than she is, and encourages her to actually handle herself like a sick person rather than trying to pretend she's just like everyone else. When Sasha's impulsive and sometimes irresponsible temperament leads to a fight, they handle it, but eventually Ibby's insecurity and indecisiveness, which has more to do with her parents' recent divorce than her RA, leads to a short breakup, which Ibby resolves when she realizes that making maybe-necessary changes to herself that her boyfriend happens to be asking for isn't necessarily "changing for a boy" in the bad way. This bit of the story also involves Ibby finally starting to lose patience with her friends' ableism, which they react to with...varying degrees of understanding. This spills over into the opening of the final episode of this very episodic book, when Sasha's spleen ruptures, necessitating an emergency splenectomy. Cuteness, recommitment, frustration with doctors, and hospital bed snuggles ensure.
The Feels
Sick Kids in Love called me out about once every three pages. Like, I came out here to have a good time, but I honestly feel so attacked. I often relate to the kids in actual cancer kid fiction, and Stella from Five Feet Apart is pretty much my role model (which is super weird, I do realize), but they're all, as Ibby would say, part of the Shiny Dying People Club, not the Long Slog Club. It's different.
Isabel Garfinkel has Rheumatoid Arthritis. Sasha Sverdlov-Deckler has Gaucher disease. They meet cute in the drip room of Linefield and West Memorial Hospital when their infusion schedules (hers every month, his every 10 days) happen to overlap. After some initial hesitation and awkwardness (Ibby inital caps Doesn't Date), they transition from hanging out constantly to actually getting together. There's not a lot of overarching plot aside from their relationship. They go on a few dates, meet each other's families, and spend a lot of time just chilling together and watching TV. Sasha understand Ibby in the ways her healthy friends and father don't (even though her father's a doctor). He's also more comfortable with her illness than she is, and encourages her to actually handle herself like a sick person rather than trying to pretend she's just like everyone else. When Sasha's impulsive and sometimes irresponsible temperament leads to a fight, they handle it, but eventually Ibby's insecurity and indecisiveness, which has more to do with her parents' recent divorce than her RA, leads to a short breakup, which Ibby resolves when she realizes that making maybe-necessary changes to herself that her boyfriend happens to be asking for isn't necessarily "changing for a boy" in the bad way. This bit of the story also involves Ibby finally starting to lose patience with her friends' ableism, which they react to with...varying degrees of understanding. This spills over into the opening of the final episode of this very episodic book, when Sasha's spleen ruptures, necessitating an emergency splenectomy. Cuteness, recommitment, frustration with doctors, and hospital bed snuggles ensure.
The Feels
Sick Kids in Love called me out about once every three pages. Like, I came out here to have a good time, but I honestly feel so attacked. I often relate to the kids in actual cancer kid fiction, and Stella from Five Feet Apart is pretty much my role model (which is super weird, I do realize), but they're all, as Ibby would say, part of the Shiny Dying People Club, not the Long Slog Club. It's different.
Mostly from Sasha it's little offhand things, because he says stuff as he's thinking it and has apparently mostly gotten over any hangups he might have had about being sick, while Ibby's painfully relateable remarks are longer form, more thought out, and laden with anger she doesn't want to acknowledge. The effect is this kind of back and forth like,
"Healthy friends. Sounds exhausting."
"Healthy friends. Sounds exhausting."
"There's only so much you can carry quietly by yourself, so you turn an illness into a list of rules instead of a list of symptoms, and you take pills that don't help and you think instead of feeling. You think."
Those quotes aren't actually right next to each other in the text; it's an exchange that goes on throughout the whole novel, and every time we hit one I had to stop and take a breath. Most of it doesn't extract as well as the bits above, so if you really wanna know what I mean, you're gonna have to go read it yourself. (There's an audiobook). But this book made me feel seen in a way that I don't think can ever be entirely comfortable, even when it's exactly what you needed.
Those quotes aren't actually right next to each other in the text; it's an exchange that goes on throughout the whole novel, and every time we hit one I had to stop and take a breath. Most of it doesn't extract as well as the bits above, so if you really wanna know what I mean, you're gonna have to go read it yourself. (There's an audiobook). But this book made me feel seen in a way that I don't think can ever be entirely comfortable, even when it's exactly what you needed.
And this is maybe the other place where it really differs from cancer kid fiction. Sick Kids in Love isn't for healthy people. I don't know what a healthy reader would get out of it because, like Sasha, I don't really hang out with anyone who's not sick or disabled, but they'd best be prepared to adapt quickly and not take things too personal, because it's amazingly not here for their ignorance, their pity, or how hard they're trying. When Ibby told Sasha her labs were normal and Sasha said "Wow, that's really frustrating," I almost cried. When Ibby calls out Ashley for pity-flirting with Sasha, I cheered. If you're not already here for that, the novel isn't super interested in helping you get there. It treats as normal things that a lot of healthy people maybe wouldn't want normalized, like right at the beginning when Ibby says she has to go back and get something from the bubble tea place, so she doesn't have to keep pace with her friends. Or, although she doesn't say so on the page, ask them to slow down and have it become a Thing. Sasha, when they're together, does half the work of keeping track of how Ibby's doing, and has zero weirdness about the other half. She does the same thing for him. It works. The text continually emphasizes that being sick isn't a problem. Symptoms are only as much of a problem as they are. What gets to you, what makes the overall experience of chronic illness just suck, is elevators at the subway station being reserved for wheelchair users, and friends who one way or another don't believe that you know your own limitations, and parents who think negative test results are a good thing, and doctors who tell you to try losing some weight. The pressure not to just - exist in the world as a sick person, and the silent, lethal assumption that the two halves of that idea are somehow mutually exclusive. (To be clear, the text does not directly discuss the relationship between chronic illness and suicide. If that's something you need to be careful about, you should be okay here).
Oh, also it's Jewish, in that casual, comprehensive way that a lot of YA romances set in New York City are Jewish. It does a better job, or at least has more fun with it, than a lot of the others, and I'd probably be writing a lot more about that if the core subject matter were like, almost literally anything else.
Form and Function
I mentioned earlier that Sick Kids in Love is really episodic, but it bears repeating. Once we've got everyone established, weeks or months sometimes pass between chapters, many of which center around holidays or other major events in the characters' lives - the winter dance, the first decent warm day in spring. I felt like I was reading a 13 episode Netflix series, in all the best possible ways, and honestly, this thing is practically begging for single season TV adaptation. For a realist YA novel, there's very little formal wonkiness, and the fact that texting hurts Ibby's hands means that we get a lot of old school phone conversations. When text messages do appear, they're in a simple, sans serif bold font.
The book's only serious formal conceit is the advice columns. Ibby writes a column for her school newspaper where she asks a bunch of people a question (from things like "What's your best tip for time management?" to "What's your favorite subway line?" to "What secrets are you keeping?") and curates the answers she gets to make something fun and coherent. Often, these questions reflect the themes or content of the preceding or following chapter. Once Sasha is introduced, we always get answers from him, and almost always from Ibby's father. And from Claire, but Claire is...beyond the scope of this book review. The answers give us a different angle on the major characters. Sasha's responses are often rambling, snarky, and barely on-topic. Her friends talk about their lives and their feelings, helping us get backstory and keep current on school drama even thought most of the story doesn't happen there. The other random people in the columns add depth, flavor, and humor, and help solidify the feeling that this is a New York Novel. I suppose this part might be a little tricky of a screen adaptation, but there are ways.
The only place where the book's structure really fails it is in the transition from the end of the acknowledgements to the beginning of the "book group guide", a set of discussion questions intended to help book clubs and classrooms talk about what they just read. The last paragraph of the acknowledgements is a shout out to Moscowitz's fellow chronically ill people, ending on the line "We are here, we are here, we are here." The first discussion questions asks "The author wants us to understand how people live with invisible illnesses...Do you know anyone with a chronic illness? If so, how do they handle their issues?" Do you know anyone with a chronic illness? Honestly, it felt like a slap in the face. Now, Moscowitz didn't write these questions - they were written by a media specialist named Nancy Cantor. I don't know whether Moscowitz even got to look at the questions before the book went to print. I kind of hope she didn't. That first question is... violently othering, following a book that does evening in its considerable power to refuse exactly this narrative. The rest of the questions are a combination of pointless and destructive, but none of them are quite so insulting.
Conclusion
This is exactly what I wanted in a chronic illness novel. When I was jumping around at the Barnes and Nobel brandishing it at my roommates, this is exactly what I was hoping it would be. I hope it opens the door still further, because there are a lot of common chronic illness experiences that this one story didn't have the time or space to cover. I want undiagnosed and misdiagnosed kids, kids who use mobility devices, kids with multiple conditions, kids who didn't get sick until they were teenagers. This book gives me hope that we might eventually get them.
Oh, also, Sasha's bi and two of Ibby's friends are lesbians, so if you've been reading this review like "Ew, het", don't worry, the straightness is largely incidental except for creating the opportunity to compare gendered experiences with chronic illness and medical care.
If you're chronically ill, you will almost definitely like this book. If you're not, but you're up for an insider perspective, no bullshit, no handholding look at what it's like, I highly recommend it. In either case, I can't promise it will be an entirely comfortable experience, but it will be fun, and you'll almost certainly learn something.
Another good way to have fun and learn something is to be gay, do crimes, and read All The Things.
(Note: The Nancy Cantor who developed the discussion questions is a retired elementary school teacher and is NOT the same Nancy Cantor associated with Rutgers and Syracuse University. If you want to google her, I suggest including "Entangled" or "Nova Southwestern University" in the search terms).
The only place where the book's structure really fails it is in the transition from the end of the acknowledgements to the beginning of the "book group guide", a set of discussion questions intended to help book clubs and classrooms talk about what they just read. The last paragraph of the acknowledgements is a shout out to Moscowitz's fellow chronically ill people, ending on the line "We are here, we are here, we are here." The first discussion questions asks "The author wants us to understand how people live with invisible illnesses...Do you know anyone with a chronic illness? If so, how do they handle their issues?" Do you know anyone with a chronic illness? Honestly, it felt like a slap in the face. Now, Moscowitz didn't write these questions - they were written by a media specialist named Nancy Cantor. I don't know whether Moscowitz even got to look at the questions before the book went to print. I kind of hope she didn't. That first question is... violently othering, following a book that does evening in its considerable power to refuse exactly this narrative. The rest of the questions are a combination of pointless and destructive, but none of them are quite so insulting.
Conclusion
This is exactly what I wanted in a chronic illness novel. When I was jumping around at the Barnes and Nobel brandishing it at my roommates, this is exactly what I was hoping it would be. I hope it opens the door still further, because there are a lot of common chronic illness experiences that this one story didn't have the time or space to cover. I want undiagnosed and misdiagnosed kids, kids who use mobility devices, kids with multiple conditions, kids who didn't get sick until they were teenagers. This book gives me hope that we might eventually get them.
Oh, also, Sasha's bi and two of Ibby's friends are lesbians, so if you've been reading this review like "Ew, het", don't worry, the straightness is largely incidental except for creating the opportunity to compare gendered experiences with chronic illness and medical care.
If you're chronically ill, you will almost definitely like this book. If you're not, but you're up for an insider perspective, no bullshit, no handholding look at what it's like, I highly recommend it. In either case, I can't promise it will be an entirely comfortable experience, but it will be fun, and you'll almost certainly learn something.
Another good way to have fun and learn something is to be gay, do crimes, and read All The Things.
(Note: The Nancy Cantor who developed the discussion questions is a retired elementary school teacher and is NOT the same Nancy Cantor associated with Rutgers and Syracuse University. If you want to google her, I suggest including "Entangled" or "Nova Southwestern University" in the search terms).
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