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Tessa's list contains many of the things teens are curious about, especially those that exact a heavy price. Knowing she will soon die means that Tessa can experiment with sex, drugs and criminal behavior without having to endure their consequences. With the help of her best friend Zoey, Tessa rushes headlong into the experiences she believes to be emblematic of being alive.

What she discovers is that life and death are more luminous and complex than she ever could have realized. I am particularly grateful to author Jenny Downham for not beginning the book with a list typed out in the first chapter. We only discover what's on Tessa's list as she experiences them and it changes as Tessa becomes sicker. Her initial desires for wild teen transgressions are replaced by simpler longings, whether it's as profound as the company of the people who love her or as a prosaic as another cup of tea.

The author uses a few tricks to get the full emotional range out of Tessa's experiences. One of the characters becomes pregnant, which highlights the life cycle.

Tessa contemplates fetal development at the same time she monitors her own body's decline. She also manages to fall in love between starting her list and taking her final breath. Instead of feeling manipulated by these developments, I found myself both elated and heartbroken. Downham's description of the disease is unflinching.

“Before I Die” wall at artsPlace creativity festival | Bow Valley Crag & Canyon

Even though Tessa is refusing chemo, the doctors still monitor the progression of her disease. The author does not rely upon popular ideas of the afterlife, and the characters in this book do not spend a lot of time reflecting on them. Instead, Tessa is comforted by the idea of the larger life cycle. She thinks of herself as star dust: " I want to be buried right here under this tree. Its roots will reach into the soft mess of my body and suck me dry. I'll be reformed as apple blossom.

I'll drift down in the spring like confetti and cling to my family's shoes In the summer they'll eat me. Not a subscriber? Subscribe today! Letter from Oregon — From the January issue.

By Brooke Jarvis. P eter Rasmussen was always able to identify with his patients, particularly in their final moments. But he saw himself especially in a small, businesslike woman with leukemia who came to him in the spring of , not long before he retired.

Alice was in her late fifties and lived in a sparsely furnished farmhouse outside Salem, Oregon, where Rasmussen practiced medical oncology. Like him, she was stubborn and practical and independent. She was not the sort of patient who denied what was happening to her or who scrambled after any possibility of a cure, no matter what the cost.

100 Things to Do Before You Die

From the start, Alice refused chemotherapy, a treatment that would have meant several long hospitalizations with certain suffering, a good chance of death, and a small likelihood of truly helping. As the illness progressed, she also refused hospice care, though she did accept palliative blood transfusions. She wanted to live until January 1, for tax purposes.

A global movement

Then she wanted to die at home. Alice sent Rasmussen a card with a watercolor of flowers on the cover. It was one of the personal rules he imposed on the process to help himself feel less terrified.

But Alice was sure. Rasmussen was impressed.

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The strongest was that patients should have the right to make their own decisions about how to face it. By the time he retired, Rasmussen had helped dozens of his patients end their lives. But he kept thinking about her. How could you be sure what you would do before the decisions were real?