This book is a tragic love story about a girl with brain cancer who falls for a boy with cystic fibrosis. Til Death Do Us Part
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April Lancaster and Kelli, her best friend, are talking in a patient recreation room in a New York hospital. Kelli tells April that there is a guy starting at her. This guy had been intently starring at April for some time. April obviously wants to ignore the guy and she tells Kelli so. Kelli tells her that meeting a guy in a hospital could be good but April shrugs it off . April is clearly annoyed. April did not want to entertain the idea of the boy because he is obviously sick.
The subject changed to a ski trip to Vermont that the girls had been planning. April says her parents likely will not let her go because of the headaches April had been having. One of the headaches caused her to lose consciousness in school which is why she is in the hospital. It is clear that April is hiding something when Kelli asks if the doctors know anything but Kelli does not notice. The girls talk for a while discussing an alternate trip to the beach and high school graduation. Just then Chris Albright, April's boyfriend, appears. April did not expect him but she was glad to see him. Kelli excuses herself whispering to April that three is a crowd. It is clear that the guy that was watching April is still watching her while the group is talking.
When Kelli leaves Chris asks April if there is somewhere more private the can talk and April takes him back to her room. In her room Chris expresses regret about having to leave April for a whole week but April encourages him to have fun. They talk for an hour. When Chris leaves there is a knock on April's door and she is faced with a tall, gaunt, dark haired boy. He is the same one from the rec room. The boy introduces himself as Mark Gianni. He tells April she is the most beautiful girl he had ever seen and tells her she is the person he intends the marry.
April reluctantly allows Mark in to talk. He has a coughing fit and asks to sit down. She lets him sit on her bed . April and Mark have dinner and learn a few interesting things about each other. Mark is the youngest of three siblings. His older siblings are both girls. His father is a cop. His mother is a homemaker. Mark rebuilds old cars and races them but he really wants to be a career race car driver. He has cystic fibrosis and the illness restricts him from having the career he wants and causes him to spend a lot of time in the hospital. Mark works in a print shop owned by his uncle. He goes to NYU at night and he owns his own apartment. Mark tries to get more information about April. She is hesitant but she obliges. April tells him she is dating Chris. April realizes Mark keeps her mind out of the gloomy places. However she is still resistant to him and in disbelief concerning his shocking declaration. She tells him her mother is part owner of an antique shop, her father is an investment counselor, and she is an only child. She is a senior in high school. April is 17 years old. Mark is three years older than her. She tells him she is at the hospital for tests. When Mark takes a cup full of pills before dinner she asks what they are for. He explains that CF causes inadequate digestion and hinders mucous break down. The pills help him with those two things. She decides to ask the nurse about CF after Mark is retrieved for his respiratory therapy session. When she asks the lingering nurse about cystic fibrosis the nurse tells her CF is fatal.
April is having a conversation with her mother while waiting for a CAT and MRI. April talks to her mother about Mark and his disease. Mrs. Lancaster is uninterested. April also tries to vent her fears but her mother doesn't want to hear them. April finds that thinking about Mark takes her mind off of her own issues. It is revealed that April's parents tried four times to conceive but April was the only successful pregnancy. It is suggested that that is why April and her mother are so close. April's doctor, fresh out of surgery, visits April while she waits. They talk about April's previous experience with brain cancer and about the hope that the headaches and blackouts are not connected to the previous diagnosis. Aprils father is waiting in the hospital room when she and her mother return from the tests. The family talks about possibly going to Spain but April wants to graduate first. She also wants to go to the beach with her friends before they all split up. It is revealed that Kelli is surprised that April isn't spoiled being the only child of two well off parents. This is revealed after April's father suggests an expensive Chinese restaurant. He has also arranged for the restaurant to deliver the food directly to April's room complete with candles, cloth napkins, table cloth, and two waitresses. They all have dinner by candle light. April finds herself thinking about Mark and what everyone else is thinking.
April and Mark are talking about how soon both of them are getting out of the hospital. Everything is looking promising for both patients. Mark asks if April will keep in touch. She is flattered but she says no. She reminds him that she has a boyfriend. Unable to hold her fears inside anymore she tells Mark her story and he listens intently. He tells her he could not imagine anything bad happening to her and hopes her tests come back negative. Later, April and her parents are talking to her doctor. Doctor Sorenson tells them April is having a relapse of astrocytoma. Her parents are upset and April is feeling detached as the diagnosis is discussed. April has to have radiation treatments because nothing else will work on this particular cancer. The pills, the radiation, and then a gamma knife operation should get rid of the tumor according to the doctor. When April is packing to leave Mark comes to visit her. He reveals he is leaving soon too. Mark gives April a present, a red balloon with a yellow string that he blew up himself. The balloon has a scrap of paper in it. He says that he used to blow up balloons when he was a child to prove he was well after a bout with CF. Touched, April takes the gift. Mark reveals that the paper has his number on it. April reminds him again that she has a boyfriend. Mark says she should keep it just in case anything happens or she wants to talk.
April and Kelli are talking in April's bedroom. It becomes evident that telling people about her diagnosis at school would cause people to treat her differently. Knowing this April asks Kelli to keep the cancer diagnosis to herself. April asks this of Kelli after the two girls had talked about Mark's illness. Kelli said the CF was a turn off. The girls mostly talk about April but they also talk about the ski trip. They also talk about how Chris will react to her diagnosis. Later, Chris picks April up for their dinner date at the Long Island County Club. April would rather be at a more lively place opposed to the country club. April tells Chris she is having a recurrence of astrocytoma. Chris seems angry with her. He tells her she should have told him sooner. She tells him she did not think it would be an issue and that she was told it was gone for good. She starts to cry and he comforts her but it is evident that things have already changed between them. Chris takes her home without eating dinner and they have a conversation on the stoop. Chris asks if she will come cheer for him at his soccer game. April tells him she has treatments five days a week. This upsets Chris more. Chris leaves April at her house feeling cold and empty.
Dr. Sorenson arranged for April to have her treatments at a hospital closer to her home. April and her mother go to see the facility and the equipment the day before April's treatments start. The oncologist shows April around evoking old memories of when April was battling cancer at five. The oncologist explained to April the procedures and what will have to be done. April and her mother leave. April spends the night scared and lonely. She hoped her boyfriend would call but he does not. In school the next day April runs into Chris and asks him why he did not call. His answer is vague. When April goes in for her treatment she is frightened. However, the treatment only takes a few minutes. On the way out of the facility April runs into Mark. April hesitantly agrees to go with Mark to catch up and get a soda. They end up at a coffee shop. April asks Mark how he knew she was having her treatments but he does not tell her. They talk about April's fears and how Chris reacted. She asks Mark how he deals with being ill in a well world. He tells her he gets the most out of life despite being sick sometimes. While talking April feels guilty about throwing away his number. He tells her he wants to take her out for one date so she can get to know him. She hesitantly agrees for one date.
Kelli is surprised April decided to go out with Mark. Kelli asks about Chris. April says Chris doesn't seem to like her anymore. He has not called since she told him she was sick. April says Mark accepts her and understand her plight. Kelli points out that there is a difference between Mark and April. He is sick and will never get well but April may get well. On Saturday Mark picks April up and shows her his world. They go to his shop where he is working on a couple of old cars. After that they go to an expensive restaurant at Trump Plaza. This shows the contrast between their two worlds. Late in the afternoon they take a cab to Mark's parents house. There his mother, two sister, and father are all waiting. Everyone is delighted to meet April. Over dinner some tension arises over Mark's racing. His mother(Rosa)is concerned that the fumes may cause an attack of CF. Though she is asked to stop Rosa continues to try and convince Mark not to race that weekend. This causes Mark to get up and leave. April hastily follows. Out on the street, April tells Mark that his mother is right. Angry Mark says that it is his life not the and he does not want the disease to control it. April understand the way he feels. He hugs and kisses her before asking for another chance.
Mark takes April to a cafe where they sit starring out the window wordlessly for a time. Mark eventually starts talking about how his disease has affected his life. He was teased in school. He wanted to date and have girlfriends but was restricted by his illness. His illness made him an outcast. At 21 years old he still had not had a girlfriend. April apologized for ever mean word ever said to him. April realizes she had treated Mark similarly and feels guilty. He does not want her to feel sorry for him. He just wants her to know that he is happy for all the time they had spent together so far. He knew it was a long shot asking her out. He asks her to give him a chance to prove himself again. April talks about how she is also different now. She has been afraid of what her friends will say when they find out. April reveals that her boyfriend has been distant which makes her feel worse. Mark says it is Chris's loss. April is afraid to take a chance on Mark because of his health. On Monday, April resumed radiation treatments. At school that day she found that she was glad for a friend like Kelli. It was likely Kelli that kept people at bay. April knows people know about her but no one is making her feel sick April eventually runs into Chris. He had his arm around another girl. April politely makes a point of telling him that she will be fine with the help of her true friends. She tells him to have a good life and leaves in her car. She realizes she is happy that things turned out the way they did. Mark is better for her and she feels nothing over her recent break up. Meanwhile Mark had been calling her nightly. The pair talks for hours every time they are on the phone. Mark invites April to watch him race. She agrees knowing it will change the relationship.
At the race track Mark asks April for a token of luck. She gives him an expensive scarf which he ties around his arm. He kisses her and leaves her with his father. Rosa, Mark's mother, did not come to the track because she is fearful and disapproving of Mark racing. Mr. Gianni tells April that Mrs. Gianni eventually gets out her disapproval and comes out to support Mark mid-season. Mark's father explains to April how races are structured. It is revealed that Mark loves to race because it helps him feel in control even though his life revolves around CF. When the race is going on April finds herself cheering enthusiastically for Mark. At the end of the race Mark gives April his trophy saying she is the reason why he won.
April finds herself drifting away from her old friends as graduation gets closer and closer. April also realizes that she loves Mark. Though her parents are still concerned about her relationship with Mark they do not bother her about it because Mark makes April happy. April makes plans to go with Kelli to the beach and her other friends after graduation. It is evident Mark is becoming a fixture in her life.
April graduates from high school. As a gift her parents offer her a trip to any place in the world. Instead of expanding her horizons and going on the trip she decides to stay close by for Mark. She wanted to be there for Mark if he had another bout with CF. One day Mark takes April's to his apartment. He shows her his pills, his breath apparatus, and introduces her to his roommate who is also his respiratory therapist. He makes it clear that his disease isn't going away. He will have cystic fibrosis forever. In this chapter Mark admits he loves April and when he asks her if she loves him she does not answer immediately.
April examines her feelings before going up to the roof where Mark has set a table with candles and balloons. Mark gives her a golden heart on a chain that is split in halves. He takes half and she takes half. She realizes that he is the person that makes her feel special. She tells him she loves him too. He tells her knowing that she loves him is its own reward. After saying this he releases her from any obligations which upsets her. April reassures him that her love doesn't work that way and they hug.
April shows Kelli the gift from Mark. Kelli is impressed. Both girls are realizing that life after high school will be very different. Kelli is going to Oregon for college and April is still dealing with her illness. On a brighter note April received acceptance letters from colleges in different part of the country. Later, April has to go see doctor Sorenson for out-patient testing and this makes it difficult for April and Kelli to hang out before they part for school. April will also be unable to go to the beach with her friends.
April goes for tests but wont have results for a while. She has her mother drop her off at Mark's apartment. Mrs. Lancaster visibly disapproves of the way he lives. When Mrs. Lancaster leaves April asks Mark to help her learn how to do his treatments but he refuses. This drive a wedge between the couple. When April receives the results of her tests she is shocked. Her tumor did not shrink but it seems to be dormant. This throws a wrench in her plans. April feels distant, disconnected, and angry.
When April hears the news that her tumor did not shrink she runs out of the doctors office, she hails a cab,and goes to Marks apartment. Immediately, she pours out her fears and frustrations to Mark. Mark listens to her intently. He tells her how he blows off steam when he is upset. Mark takes April out to an abandoned air strip and convinces her that speeding his car around the strip will make her feel better. As April navigates the track she feels her negative emotions melting away. April realizes Mark eases her fears. Afterward, April goes home to highly concerned parents and it is back to reality. Mr. and Mrs. Lancaster thought that April may have run off and committed suicide. They are angry but relieved to see her. After a fight April goes to her room. Her mother follows her and April admits to her mother that she loves Mark.
It took three weeks for April to decide she wasn't going out of town to for college. She is going to an in-state school. April's parents still do not support her relationship with Mark but they avoid talking about it. Before Kelli leaves for college April visits with her. The girls talk about Mark, the future, and Kelli's troubled parents. Kelli's parents have been having a lot of issues for a long time. Kelli thinks her parents may end up getting a divorce. April listens to Kelli until it is time for Kelli to go. As Kelli rides away April realizes how massively her life has changed. She recounts her troubles. After April's college orientation Mark takes April out on a date. Mark again attempts to release April from any obligation to him. This causes her to snap. She asks Mark what kind of person he thinks she is. She explains to Mark that saying things like that is stupid. Mark promises not to question April's love again. Mark also admits he fell in love with her at first sight. April tells him he is her one and only true love. For Mark's birthday April buys him an expensive fire retardant racing suit. This upsets Mark's mother because she does not approve of him racing at all. She is concerned that the fumes are bad for him. Mark received a lot of gifts and his birthday celebration was huge. It is revealed that his birthdays are that way because of his terminal illness. He was not expected to live as long as he did. April realizes she had only thought of what Mark wanted instead of how his mother would feel when she chose his gift. As the party dies down, April and Rosa talk about Mark's love of racing, his permanent illness, and the dangers Mark faces. April understands Rosa's concerns but says that the suit can only protect him. Rosa expresses some feelings that April and Mark should not be together and April wonders why Rosa is suddenly resistant to their relationship.
When Mark finds April they discuss what she and Rosa were talking about. He is not surprised that his mother had encouraged April to pressure him into quitting racing. In his apartment after his birthday celebration, Mark gives April a gift. She is taken aback because it is his birthday and she feels she should not be the one getting gifts. Mark give April a ring and proposes to her. April says yes. April feels a wide range of emotions from fear to joy. She realizes her parents will not be happy and she also realizes that they are both still ill. When she goes home April and her parents have another fight. They tell her she is too young to marry. She tells her parents she will marry Mark with or without their blessing. They tell her that she still needs their permission because she is underage. She tells them she will figure out a way to marry Mark. April ends the arguments by going to her room. Her mother follows her and reminds April of the adversity her and Mark will face beyond the normal challenges of marriage. April is still optimistic but knows her mother is right. Mrs. Lancaster tells April that she spoke to Rosa. This explains why Rosa had changed her mood from grateful to reluctant. April is incredibly hurt and taken aback. Know this has only deepened April's resolve and April promises she will marry Mark.
After her mother leaves April calls Kelli. She asks Kelli to be her maid of honor and Kelli agrees happily. During their conversation April feels a longing for the life that she would have had if she had been able to go to college and be cancer free. April tells Kelli about the fight she had with her parents. Kelli tells April that Mr. and Mrs. Lancaster would do anything for her. Kelli encourages April to wait her parents out.
April and Mark begin planning their wedding. Mark's family is more enthusiastic than April's parents. April pushes Mark to allow her to learn his therapy requirements. He is resistant but he tells her his mother will teach her. April is frightened by the idea but she is determined to learn. Mark is afraid April will be grossed out by all the mucous but he knows she has to learn to do the therapy.
After a dinner, Rosa explains how to do the thumps that will loosen up the mucous in Mark's lungs. April has to hit Mark on the back and chest with the palm of her hands repeatedly. April is afraid that the thumps will hurt Mark yet he asks her to thump his back harder. After a while April is tired and sweaty but she is determined to get the hang of it.
After the therapy is over Mark leaves the room. While he is gone Rosa and April talk. Rosa tells April what she said to Mrs. Lancaster. When April's mother showed concern about the relationship Rosa told Mrs. Lancaster that she felt that April and Mark could handle the challenges of marriage and that April could handle whatever Mark's illness brings. Rosa also tells April about how she prayed that Mark would find a girl like her. Rosa also chronicles the difficulties Mark faced since he was diagnosed at two. April tells Rosa that she loves Mark and thinks that they will be okay.
April realizes she had not thought about her own illness since she fled Dr. Sorenson's office. April and Rosa continue to talk about the future and April lets slip that she may want children. Rosa is visibly upset and April is not sure what is wrong. Just then Mark comes back into the room. Rosa advises Mark to speak with April about the issue of having children. When they are alone Mark reveals that he cannot give her children ever.
Mark reveals that men with CF are sterile. April is upset because Mark waited so long to tell her. She is also upset because he did not trust her enough to tell her about his sterility. He chose not to tell because he thought it would run her away. Though she is upset she still loves Mark and the pair make up. Mark tells April that she will likely outlive him. She does not want to hear it but he makes her listen. He tells her he wasn't afraid of death before he met her. Now that he has her there is a lot of living he wants to do. They tell each other that they love each other. The next day April realizes that planning a wedding is more than she can handle. She resolves to get her mothers help. She goes down to her mother's antique shop to Mrs. Lancaster out. She meets with her mother's business partner, Caroline. Caroline is happy for April. April is surprised Caroline would know about her wedding because of how her mother felt about her relationship. After an awkward conversation with her mother, April asks for her mother's help picking out a wedding dress. Her mother admits that she does not want to miss out on any part of April's wedding including the preparations. April is relieved that her mother is helping out and it is later revealed that her father has come around too.
The Lancaster's and the Gianni's come together to coordinate for the wedding. After discussing the wedding over a meal everyone, including Mark's mother, goes to the track to watch Mark race. It is the last race of the season. Mark is dressed in his new racing suit. After talking to April he takes her scarf as a token of good luck before going to his car. As the race heats up he crashes his car.
Mark is extracted from his flaming car and flown to the same hospital as which he and April met. In the waiting room the tension is building. Everyone is concerned about Mark's condition. Rosa's fears have been realized and she cannot be consoled. Eventually Mark's sisters show up and they cry with their mother. Though April's father encourages her to get some rest, April refuses to leave. When a doctor comes into the waiting room he speaks to Mr. Gianni and April. It is revealed that Mark has a few burns, cracked ribs, and a broken foot. However, Mark is alive and, all things considered, he is doing well. Though he is doing well, Mark is not out of the woods yet. When Mark and April are alone they kiss. April is being forced to go to a hotel but she will be back in the morning. Aprils tells Mark she loves him before leaving the room. The next day Mark looks better. It is evident that Rosa stayed by his side all night. When Mark and April talk he reveals that he plans to race again once he is well. April doesn't want him to race again but she does not fight with him at that time. Instead or fighting, the subject is changed to their wedding. Mark promises not to do anything reckless until after their wedding which is months away. April gives Mark a break and goes to get something to eat. She meets the doctor that is taking care of Mark in the hallway. The suit saved his life but he still inhaled a lot of smoke. The cracked ribs will make it difficult to thump his back and chest to clear the mucous. The doctor suggests a drainage tube that will be surgically inserted into Mark's lungs to clear the mucous. This will also help avoid pneumonia. It is suggested that Mark's decongestants and medications be upped to help clear his mucous as well. The operation is successful. During Mark's recovery April spends as much time as she can with her fiancee. To occupy her daughter Mrs. Lancaster continues with the wedding plans. April finds herself caught between reality and a fantasy. Mark tries to stay hopeful but as time goes on his hope begins to dwindle and soon his hope crumbles. One day he tells April that this hospital stay feels different than the others. He fears he may never leave the hospital. April tries to cheer him up but she realizes there is a real possibility that her fiancee will catch pneumonia.
Mark is on a strong antibiotic for pneumonia. April wants to believe he will get better but the news about Mark is grim. Since his lungs are scared from years of cystic fibrosis there is a real chance he may not make it this time. April calls Kelli and tells her what is happening. Kelli is sympathetic. During the conversation April realizes that her life has revolved around Mark for the past few months. The conversation also makes April realize that nothing can be done except to wait. After four days it has become clear that Mark is only getting worse and he is suffering more and more daily. Mark apologizes to April and tells her he wishes he could have seen her in her wedding dress. April knows that Mark's time is drawing to a close. With a heavy heart she asks her father to get her wedding dress even though it is still unfinished. Her mother helps her into the dress and makes April a makeshift bouquet and a wreath for her hair. Meanwhile Mark's mother has called a priest to give Mark last rites. Just before Mark passes away he gets to see April in her dress. April drifts through the next few days and through Mark's funeral like a ghost. She feels distant and far away the whole time. Mark is buried in his racing suit, with a rosary, and the two pieces of the heart he bought. After the funeral April calls Kelli and tells her the news. The pair cry together. Mark had become everything to April. Now April feels alone. April understandably falls into a depression and the New York cold does not help. Everything around her reminds her of her lost love. She asks her father if she could take him up on the offer to go anywhere in the world. He says yes. April doesn't care where she goes as long as it is warm there.
In the warmth of tropical St. Croix April feels the depression lifting. April spends six months on the island before she ventures out on a hike. She climbs a mountain and blows up a balloon. She sends the balloon heavenward and wonders if Mark can see it.
Best part of story, including ending:
I really like that this story deals with the challenges that people with serious illness face when they find each other and fall in love.
Best scene in story:
My favorite scene happens at April's high school. She runs into her current boyfriend. He has his arm around another girl until April addresses him. She breaks up with him freeing herself from his inconsiderate selfishness.
Opinion about the main character:
I dislike the way April treated Mark when they first met in the hospital. She didn't want to consider him because he was sick and she treated him poorly because he happened to be a patient at the hospital. It isn't his fault he is sick.