This story is told in first-person present-tense entirely from the POV of Madeline, who is turning eighteen in the first chapter. Maddy has lived her entire life isolated in the protective confines of her home, thanks to a condition that’s left her without a functional immune system. She has a strong relationship with her doctor mother, and her full-time nurse, Carla, and is resigned to live more vicariously than actually. Until she meets the boy next door…
Simple, serviceable prose with restrained vocabulary. I sometimes forgot this wasn’t aimed at a Middle Grade audience. As some reviewers have noted, this feels like a deliberate diverging away from John Green’s famed work involving a dangerously ill teen—The Fault In Our Stars. It’s almost as though this is meant to be alternative reading for those who didn’t care for hyper-mature teenagers spouting existential literary quotes, (or for Nicholas Sparks-style sobfests, for that matter.)
I personally enjoyed the well-threaded references to Antoine de Saint-Exupery’s The Little Prince. The parallels drawn were gut-wrenching and skillfully utilized, regardless of how one might feel about the suicide-related aspects.
And here’s where my medical background swoops in like Nurse Ratchet and mercilessly underscores aspects I might have otherwise been able to ignore...
-Why are surgical filtration masks never mentioned?
No masks of any kind, in fact, for the purpose of at least reducing risk. No one from the outside ever wears one when they go through the decontamination process to enter Maddy’s house. And when Maddy contemplates taking the chance of leaving the purported safe-haven of her home, absolutely zero risk-diminishing measure cross her mind. Hazmat suit? No. Super-soaker full of Purell? Nay. Gloves? Nope. Dollar Tree flu masks? Not even. It’s as though no one has the slightest idea how to manage the practicalities of someone who is immuno-suppressed. I could understand Maddy’s eventual willingness to take risks to live more normally, but why not do so more safely?
-On a related note, it’s pretty unclear why anyone thinks Maddy needs a full-time nurse—who constitutes an additional and consistent exposure risk (i.e. by going out into the world and home to her family ever night.) Maddy isn’t consistently ill and presents as fully independent, albeit within her controlled “bubble” home environment. The house is high-tech and she could easily be monitored while her mother is away at work. As much as she SHOULD know about her own care by age 18, she could be taking and keeping track of her own vital signs. I have a lot of trouble fathoming how a full-time nurse is logical or cost-effective.
-I'm deeply disappointed no efforts were made at using the story to better inform readers about either SCID or Munchausen's by Proxy. Aside from a brief first-page explanation of Severe Combined Immunodeficiency, additional information isn’t offered along the way—not even when the obvious educating opportunity of the potential boyfriend presents. All focus was instead placed on the romance. But as far as we know, Olly doesn’t ask many questions or otherwise research his beloved’s condition… (That I find most difficult to believe. The fault of too much personal experience, perhaps.)
Issues with medical suspension of disbelief aside, I also had some trouble buying the romance.
It starts out beautifully with Olly going to theatric extremes in trying to win and maintain Maddy’s close-distance attention. The bunt cake montage is certainly chuckle-worthy, and sets up readers to anticipate getting to know a young man with a great sense of humor. But alas, that is also the last point where I have recollection of feeling humored. There’s no resurfacing of this goofball-ish determination we at first found endearing. I suspect most of the appeal in their relationship is to those who are more enthralled with Maddy’s first-time-sensations—as those are somewhat amplified due to her lifetime of isolation and longing.
It is implied that a good deal of their romance blossomed gradually via online interactions—which unfortunately, left most of the emotional intimacy to telling rather than showing. We aren’t privileged to know much of what they talked about online. By the end of the book, I felt like I still didn't know either of them particularly well.
Content Note: The book contains a sex scene that, while not graphic, isn’t what I’d call fade-to-black either. Condom use is at least mentioned.
Issues of mental illness are sidestepped, and the handling of the feature illness may strike immuno-suppressed readers (and their family and/or caregivers) as trivialized. There’s also a persistent message that could easily lead some readers to the depressingly insidious conclusion of: “If you are living with limitations, you’re not living at all!”
And therein lies my biggest qualm with this book—a seriously problematic disability portrayal. I could fumble through expanding on this and all the spoilers that would entail, but I’d prefer to point to a far better qualified source--Jennifer J. Johnson’s review from Disability In Kidlit: