“Alone in my bed, after everyone had gone, I sensed a feasting taking place under my skin, something wending its way through my arteries gnawing at my sanity. As my energy evaporated and the itch intensified, I told myself it was because the parasite’s appetite was growing. But deep down, I doubted there ever was a parasite. I began to wonder if the real problem was me.”

Before her diagnosis, Suleika attributes her itchiness and exhaustion to her poor choices. Self-blame, self-doubt, and guilt characterize the pre-diagnosis character. Even in Chapter 1, the illness takes on a life of its own, consuming her body and her sanity, whether she acknowledges it or not, a foreshadowing of the ravaging effects it will have on her body, relationships, and plans.

“I began taking uppers the way some people add an extra shot of espresso to their coffee—a means to an end, a way to stave off my deepening exhaustion. In my journal, I wrote: Stay afloat.”

Due to her self-blame, Suleika chooses to ignore her symptoms, and, instead, she self-medicates with cocaine and other uppers. Her self-admonition in the journal signals that she is a woman on the edge, wanting to persevere through a difficult last year of college and doing everything she can to survive in-tact. The severe measures that she takes emphasize the depth of her exhaustion, the impetuosity of youth, and the gravity of the illness she and everyone else refuse to take seriously.

“[M]y fever crept up and up until my body felt like it might combust. I started shivering. Rivulets of sweat pooled in the hollows of my collarbones, and I remember feeling fragile for the first time in my life. ‘It’s like I’m made of eggshells,’ I told him again and again. […] Will grew concerned and suggested we go to the emergency room. ‘Let me take care of you,’ he said.”

During their trip to Amsterdam, Will and Suleika take mushrooms. Suleika’s body reacts to the drug-induced trip, and Will’s willingness to take care of her foreshadows their future relationship: Will’s too-willing devotion and Suleika’s denial of his needs. The references to fire echo the ways chemotherapy will burn through her body, and her