The Fear of Missing out By: Kate McGovern

I give this book 4.5 stars (out of five).This book is very, very, very, very good but it’s also extremely sad. I’m not going to lie, I cried a lot while reading this and unless you’re one of those monsters who doesn’t cry at sad books then you probably will too. Although this book will definitely make you sad there’s also a chance it will make you mad. I won’t say why just quite yet, but I got both very sad and very mad while reading this. I have to warn you it’s a really emotional story, but the emotional journey is worth it to read Astrid’s story.

Astrid has an astrocytoma, a type of brain tumor. She’s already beat it once, she first developed it in ninth grade and her doctor was able to get rid of it. But now she’s sixteen and the cancer has come back, she doesn’t believe in god. Instead Astrid believes in science, when Astrid got sick she learned quite a lot about neurology. So much so in fact that the previous summer she had an internship and wanted to become a neurologist when she gets older.

Astrid has a boyfriend, Mohit and her best friend Chole to keep her grounded but when her cancer comes back, with her new knowledge of neuroscience Astrid knows it’s very bad. Looking at her scans and knowing the available treatments options more than anyone else can tell that she doesn’t have a lot of time left. Her mother remains optimistic and wants Astrid to sign up for a potential clinical trial of a new treatment, but she isn’t quite as excited. At home Astrid lives with her mom and her little brother Liam, her parents are divorced and her dad lives in a different state.

Anyways, Astrid has to decide what to do. She could be a part of the clinical trial but she’s really against the idea of spending her last months or year alive living at a hospital or undergoing painful experimental treatments. She’s already had chemo and she’s familiar with her illness, she understands the science behind it and even just looking at her scans and what she’s feeling she knows that she doesn’t have a very good chance at survival. She has honestly given up on the idea of getting better again way before anyone else, she wasn’t the one who wanted to be a part of the clinical trial her mom and Mohit did. They wanted her to take what could’ve been her last chance at beating the cancer but she knew it wouldn’t be worth it for her to die in an even worse condition because of her treatment. She doesn’t want to spend her last few months in hospitals, she wants to go and explore, to see the world while she still can. But reasonably not everyone around her agrees with that.

So at first Astrid tries not to let her returning cancer control her life, she still goes to school when she can and resting when she needs to. She still spends time with her friends and boyfriend and tries to keep doing things normally for a while.

Astrid has a few different arcs pulling her in different directions. For one, her mother is desperate. No parent wants their child to die, especially not before they even graduate high school. So of course Astrid’s mom is insistent on doing everything they can to ensure her best chance at recovery/survival. Astrid doesn’t want to disappoint her mom but she also wants those decisions to be hers, she wants to make her own medical care decisions even if they aren’t what’s best for her physical health (or what her mom would choose). Astrid is also dealing with her little brother and the thought of never seeing him grow up or being able to guide him through high school, or go to his wedding. But she also notices that after she recovered from her cancer before she stopped spending as much time with him and she sets out to restore their relationship. She doesn’t want to leave him behind but she also knows he’ll have to get through life without her.

Throughout this book many, many times Astrid describes what the symptoms of her astrocytoma are and how they are affecting her. Sometimes these descriptions of her pain and things she has to deal with are so vivid and realistic that it’s hard to imagine living with it like Astrid does. Her main symptoms are headaches, dizziness and being unsteady, problems with her vision (like spots clouding her vision and seeing in red) and also many other forms of pain. I think this is very important and relevant to the story even though this book mainly focuses on the emotional side of cancer, death and pain. The headaches also cause other pans in her back and legs and are overall very bad.

While at a medical conference Astrid stumbles upon a booth explaining and advertising cryopreservation, this is the science of preserving bodies after death with the hope that as technology and science progresses at some point in the future we could be able to wake people up from the dead. This process is normally done in controlled environments by freezing the patient’s body directly after death and then transporting them to a facility with larger machinery (that preserves the person’s body). After this encounter Astrid becomes hooked on the idea of cryopreservation, she does more research into it and starts seriously thinking about it. She thinks it could be what she wants, to still be a part of science even if she can’t be the one studying things. She knows it’s a last resort but she also really wants to have control over her life and death and she thinks if there’s any possibility she could wake up again and be able to see her friends and family later in life, then it could be worth the risk.

This is what sparks the next main part of the story, after telling both Mohit and Chole about her interest in cryopreservation they both (somewhat reluctantly) decided to help her make it happen. Chole suggests making a vlog to explain Astrid’s situation and ask for donations to be able to make the trip to Arizona to visit the closest cryopreservation facility (Astrid emailed and talked with some people and she’d be able to take a tour). So eventually that’s what they do, Astrid is pretty awkward talking to the camera but they get a presentable vlog out there and some donations start coming in, mainly from people in their community but also some from total strangers would stumbled upon her story. Astrid’s mother is very mad when she finds out about the video, because Astrid said things publicly before consulting with her mother. However, Astrid did try to talk about it but her mom was busy getting back into work and Astrid didn’t want to have to discuss her own death just yet. (Her mother is already grieving her healthy daughter, now Astrid wanting to start talking about death means that she’d have to think about her life without Astrid and she’s just not ready to do that).

But eventually after they finally do talk it through and her mom agrees to a visit, only because she has to agree that Astrid deserves a say in her life and possible death. After working out all the details and health cautions Astrid, Chole and Mohit load into a trailer-van with lots of food and equipment. They’re traveling a long way and they have to be prepared for anything with Astrid. On the way there they make stops at landmarks in each state, seeing things from a book for most popular roadside attractions like Lucy the Elephant in New Jersey. Throughout their entire road trip they are also filming and posting more vlog style content to show people more of Astrid’s journey.

After they make it to Arizona Astrid makes a quick stop to meet up with her dad, her parents divorced years ago mainly because her dad is one of those people who believes in doing everything naturally like living remotely and not owning a car or using wifi. Her dad has a new wife now named Suzanne. Anyways, their visit doesn’t go too well for a few reasons, one of them being that her dad keeps blaming Astrid’s cancer of her conditions (living in a city, having a tv, etc) and suggests essential oils and natural alternatives as treatments. And also because Astrid finds out Suzanne is pregnant and they never told her, she’s a little hurt and angry. The baby will be born right around the time she’s certain she’ll probably die, so it’s sort of like evening it out. The last thing she says to him before leaving is, “ Bye, Dad. I’m sure Mom will call you to tell you when I’m dead.” (Which is an extremely powerful line by the way).

They eventually make it to the facility and get a tour of the building as well as an explanation of the process. As part of this tour the doctor running it also explains a new possibility they’re working on, although they have not tried it with humans yet. It’s a similar yet slightly different process in which freezing and preservation methods start before death instead of directly after. Using this new method scientists have been able to have successful results using rats and they explain this as a new possibility to Astrid and her friends.

They stop at one more place is Arizona mainly because Astrid insists not only on going to the park and hiking but hiking all the way up a hill and seeing a beautiful view while she still can. And it’s a challenge but Astrid pushes herself all the way up the top, and when she gets there she sees a very rewarding views with both her closest friends. Here she’s finally able to express what she really wants: to be able to make her own decisions and not need the council trial or the cryopreservation. But whatever she ends up doing, she wants to do it by choice. And that’s when she passes out.

[Spoiler warning: Skip the rest of summary to avoid them and be aware of minor spoilers throughout the rest of the review]

Astrid wakes up to her mom at her bedside in a hospital in Arizona, she had a seizure and has been there for a week. In this hospital bed is where Astrid makes her decision, she doesn’t want to be a part of the trail and she doesn’t want to be part of cryopreservation, she wants to live her life to the fullest while she can but not fight back when her cancer starts winning. When it gets to the end, she’ll stop drinking and eating so that she doesn’t have to prolong her suffering and she can die on her own terms. The money people donated to Astrid’s cryopreservation would instead go into researching new treatments for cancer so that other kids can have options that she doesn’t. And after she decides she posts an update vlog to explain it to the people following her story. Her decision blows up and lots of people (mainly the religious ones or parents) disagree with her and think she shouldn’t be able to do what she wants because apparently they know better then her and she can’t possibly make her own decisions because she clearly doesn’t understand what it’s like to have brain cancer and nearly die or anything. (basically lots of people on the internet were talking about her and giving her and her family hate).

When Astrid’s mom finds out about the video she was furious, in fact she said some outrageous things after finding out and I will be talking about this in detail after the summary because I have quite a lot to say about this and her character. Eventually Astrid gets better enough and they fly back home. They keep talking about the trial and different options, but the reality is that Astrid keeps getting worse and it isn’t likely to stop. Now she’s in a wheelchair and can’t do things entirely on her own anymore.

Chole and Astrid’s mom post an emotional update video on their vlog channel, Chole explains that she’s been Astrid’s best friend since forever and the one behind the camera. She reiterates that the people who know Astrid personally aren’t exactly thrilled with her decisions either but that doesn’t mean random people on the internet know better then those who actually know her. And Astrid’s mom talks about how she obviously doesn’t want her daughter to die, but she also can’t make those decisions for her or force her to pursue something she doesn’t want to.

Astrid lives long enough to see a few more things she really wanted to, a few more views, a few more memories made. Eventually the seizures came back, but they didn’t stop her from turning seventeen. The cancer keeps getting worse, first Astrid is bound to a wheelchair and then she stays in bed most of the time. When the time comes she stops drinking and eating, she knows her death will be peaceful and she can find solace in that.

The ending is beautiful. “My brain is broken. But my mind? My mind is still all mine. Strong enough still to make my own choices.” “My tumor made of stars. The view from here is beautiful.”

My Comments:

The ending is 100% genius but also impossibly emotional. Throughout the majority of this story you know that Astrid is going to die, there’s really no way for avoiding it, but you don’t know how. And the ending is sort of open, you don’t know for sure if Astrid dies she could have just fallen asleep but it is pretty likely that after the last conversation over the phone she had with Mohit she died in her sleep. But the real reason the ending is so amazing is because it ties into themes and ideas that were brought up ages ago even in the very beginning of the book and connect them into the ending. Specifically the book opens with talking about how an astrocytoma sounds like a type of star, something beautiful, bright and magical only to reveal it’s really a type of tumor. The ending ties back into the theme by saying “My tumor made of stars.” and talking about the stars and other bright shapes taking over her vision. But this isn’t the only meaningful reference, the very last line “The view from here is beautiful.” is also extremely important. Throughout the entire book Astrid is going to extreme lengths to see and experience things while she still can, this could also be a call out to the place Astrid and Mohit often go to (referred to as “their view”). It’s basically saying that the view she sees when she closes her eyes is nearly as beautiful as the things she could’ve seen if she’d lived longer and it’s a very thought provoking sentiment. Quickly before the ending (in the last full scene/conversation) Astrid reminds Mohit of their Venn diagram that they made the first time they went to their spot and talked about faith, science and religion. It was one of the memories that’s used to introduce the readers to Mohit and Astrid’s relationship. The Venn diagram has Mohit’s faith on one side, Astrid’s science on the other and architects in the middle (because making a building takes both science and faith). This is just connecting their entire story or at least what we’re told of their relationship, he’s the last person she talks to and their last conversation was about something from the very beginning of their relationship (when they were still learning new things about each other).

At some point Astrid started recording a video diary that was a list of ‘Things I’ll miss when I’m dead’, and then she continues recording them throughout the rest of the book. These lists are very personal and telling to what Astrid really feels. They include things like
Wondering what will happen next.
Chole bossing me around
People who know me as well as I know myself + Beautiful views
Possible graduations
Being loved.
These lists are important to show her character and what she’s thinking and feeling, but they’re also a good change of pace and an interesting break from the main story.

I really liked that the characters had lots of varying views of religion, Astrid and her family were atheists who quite blatantly don’t believe in god, while other characters are Christian or Hindu. I really like to see that diversity but also how those differences affect the way the characters think and act, it’s pretty realistic and interesting.

Everything in this book focuses on the emotional side of death rather than the physical pain and release. Besides the descriptions of Astrid’s pain and knowing how it’s affecting her, her pain is hardly ever mentioned in fact it is ignored multiple times. Astrid is such a strong person that she hides and minimizes her pain, this causes other characters to assume she isn’t in pain or that it isn’t too bad. I was honestly very surprised by this aspect of this book, because Astrid is literally dying and other characters are too busy focusing on the emotional loss of her dying then her. If my best friend was dying I wouldn’t be focusing on how much it will hurt me when they die, I’d be focusing on how they feel and how to make them as comfortable and happy as possible. It’s very interesting but also insane to me that some of these characters (main Mohit and her Mom) were able to focus so much on the loss and not pay attention to the pain she’s in. They almost looked at her choosing not to do the clinical trial as her giving up and hurting them, which is absurd to me.

I think that this focusing on the emotional side of death is the reason that it’s able to project such a strong commentary on morality. It’s mainly from Astrid’s perspective since she’s the one dying but again when she thinks of death she does question, will there be pain or relief? But most of the time she thinks of the things she’ll miss and the people she’ll leave behind. She knows that life is important and meaningful but since she can’t control her cancer she takes control of what she can. I think this commentary and story are what make this book truly worth reading, these are the things that are the backbone of the plot and they make all the individual details fit together so much better.

Now I want to explain why I got mad at a few characters drawing from some specific instances but also more generally. I’m going to start with Astrid’s Dad, the reason I dislike him is that multiple times he implies that Astrid’s cancer could’ve been avoidable or treatable if she lived differently (more like him). You can clearly see how this affects Astrid and I think it’s very unfair for him to put his frustrations with the illness on to her when she’s already dealing with literally being sick. Okay, that was simple enough but these next two characters, Astrid’s Mom and Mohit will be a lot longer and more emotionally fueled (just for a warning).

Both Astrid’s Mom and Mohit often minimize Astrid’s pain/cancer, they act like whenever she’s not in the hospital she’s not in pain/struggling and (in my opinion) don’t think about her enough. Like when they think she’s going to die every time they talk about it they only mention how hard it will be to cope with losing her, but they don’t consider the fact that Astrid is literally going to die. From my perspective it’s pretty selfish to be so focused on losing someone that you can’t acknowledge they’re in pain. This is very frustrating, especially since we’re reading from Astrid’s perspective, on top of everything else (including, you know, brain cancer!) Astrid now has to balance and deal with everyone else’s feelings which just adds to her stress. In my opinion both these characters were too focused on themselves to the point where they actually made things worse for Astrid. I understand that they’d be under lots of stress and similar things too (they are losing someone very close to them) but that’s no excuse to yell at her while she’s in a hospital bed or make assumptions about how she feels.

Now here are some specific examples of this;

Firstly, one day just after Astrid’s cancer has made a comeback Mohit takes her out to the fair for a day. But after a while it gets to be too much for her and she has to first take a rest and then she has to ask to leave. Astrid describes how she feels in this moment, she has bad pain in both her arms and her head and her vision looks like she’s seeing through a filter, which is why I find the argument that starts between Astrid and Mohit in the car so confusing and frustrating, actually infuriating. Either Mohit is dumber than a third grader or he’s an asshole, you can decide which. But he decides that since she was okay throughout the rest of the day that she was being melodramatic, almost as if she asked to leave so that they couldn’t have fun and not because she felt terrible. He even had the audacity to say that she “played the cancer card,” so now you might understand why I have strong feelings about this. But let me explain this in case anyone is confused, you can’t blame the person with a terminal illness for not having the energy to finish the day after going on roller coasters. Honestly, if I was Astrid I would’ve told him to stop associating with me right then and there, I don’t know what could redeem someone from putting the blame on someone with cancer just for ruining the day they had planned.

The next moment is a conversation between Astrid and her mother, when she first brings up the idea of cryopreservation. And here is when the Mom sort of introduced the idea that because she’s her mother she can’t let Astrid give up, she can’t just accept the end of Astrid’s life and she won’t. But underneath it all Astrid is thinking but it’s still me, it’s my life and I think in this scene I just really wanted the Mom to understand that she’s not just talking about her daughter, she’s talking about Astrid-who has to face death without much of choice anyways.

Another for Mohit, Astrid and him get into a small fight in which he’s basically saying he doesn’t want her to give up on her life for cryopreservation and she’s saying that no matter what happens to her needs to be her choice. After he storms off and Astrid has to follow him and apologize he explains that everyone who loves her doesn’t want to lose her before they have to and it’s unfair to ask them to. But I just don’t quite understand his logic, I don’t understand how people’s emotional pain of losing Astrid sooner rather than later could outweigh Astrid’s pain (the physical pain she feels that makes her even want to consider cryopreservation).

Now onto the part that makes me what to physically murder someone, when Astrid’s Mom sees the video she posted about eventually wanting palliative care. First of all, I can’t respect her for yelling at her daughter while she’s in a hospital bed with a terminal illness, I just can’t. If you know she’s sick then you should know extra stress is most likely going to make her worse. During this ‘conversation’ she says that since Astrid is okay right now that she shouldn’t give up on her life yet. I think she’s genuinely hurt that her daughter considered doing that, in the end she says that Astrid is her daughter and there’s no way she can/will do that. She also specifically says, “You’re not in pain.” to her daughter who was currently lying in a hospital bed. Astrid clarifies (although not out loud) that she is in pain and lots of it and it’s 110% unfair for her mother to assume that since she isn’t dying right that second she isn’t in pain.

Even after that fight her Mom stayed mad for a very long time and was (in my opinion)immature about it, I mean who doesn’t visit their daughter while they’re in the hospital? I know this is slightly less out of the ordinary for them but still, Astrid has to go to her in a wheelchair to be able to talk with her own mother.

Again when they get home again Astrid and her mother have the following exchange (this was part of a larger conversation I just used a snippet of dialogue I wanted to talk about specifically).
“Don’t be angry at me, my girl. You think I don’t know that? But you’re asking me to let you leave it. You can’t know just how impossible that is.”
“Exactly, Mom. I’m never going to have a child. I’m never going to know what that feels like. Just like I’m never going to see the Pacific Ocean, or ride in a self-driving car, or go to college, or watch Liam grow up. I’m not going to be able to hold your hand while you’re dying.”
“I don’t care about that.”
“I do, though. I’ll miss everything, Mom. I just want control over this one thing.”

See how quickly her Mom dismisses the things Astrid is worried she’ll miss? It just goes to show what she’s focusing on but at least in the end she came around and let Astrid make her own final decisions (even if it meant losing her sooner).

There’s only one more specific moment I want to talk about and it’s actually about Chole, throughout most of the book she’s pretty chill. She keeps her emotions and fears of losing her best friend private/quiet and always tries to help Astrid however she can (like with the vlogs and road trip). But there’s only one moment when she gets frustrated and says something very mean to Astrid which was, “I have a life, Astrid. I’m sorry you don’t, but I do.”

I hope looking at the actions and words of some of these characters you can understand why I was upset at them. I think it does really stem from how much of an impact having a dying best friend, girlfriend or daughter would have, but also I think it’s a little bit of selfishness. I can’t imagine saying something like that or leaving someone who is in the process of dying just because losing them affects you too much. I can understand why the characters would be mad and upset about the cancer/death but don’t take it out on the victim and above all don’t leave them alone during their last moments (days, weeks or months).

I just wanted to mention this one nurse background character named Celia, just because she’s honestly one of the kindest characters in the entire book. She’s compassionate with Astrid even though she’s religious and when Astrid gets transformed home she even gives her the crucifix necklace she always wears. Even though Astrid is not religious she knows this isn’t Celia trying to force religion on to her, more like offering her faith and a piece of herself. It really is a gift. I just wanted to highlight this moment of kindness because in my opinion there were way too many selfish actions in this book.

For someone who couldn’t travel for nearly most of life Astrid had an extremely interesting obsession with books about traveling to new and different places. It started when she first got sick and was waiting in the chemo center, she started reading a book about all the different things to see on a trip to Japan. And after that she became fascinated with these types of books and accumulated them for many different places, it’s interesting to me that as she became more and more aware that she might not be able to visit any of these places that she got even more interested in reading and learning about them. To me it seems kind of ironic but I can also understand how it could be comforting to think about everything she could see and experience.

I loved Astrid’s character, because she’s so strong and brave. Think about it, she has brain cancer and she’s in a lot of pain from that. She also has the emotional burdens of knowing she’s going to die and miss out on the rest of everything and leave everyone behind. This is amplified by everyone trying to control her decisions surrounding the rest of her life. But despite all of that everything that she goes through she is still strong enough to hold her ground and fight for control, she makes sure she gets to die the way she wants and I admire her for that.

I really appreciate that this book had non-heterosexual couples and relationships and even called out things for being heteronormative. This is something we see more and more nowadays in any form of media but I really liked it here, especially because it shows that all types of couples can also have problems and get divorscies.

In one specific scene Astrid reminisces on Liam’s birth (her little brother), and thinks “ He’s eight now, the age I was then. I wonder if he’ll remember my death as clearly as I remember his birth.” I think this line is very good and significant because you can see that at this point Astrid is not worrying about the effect of her death on herself but only of the people around her. There’s a clear parallel between life and death, she doesn’t want to leave her brother behind but she doesn’t have much of a choice.

I also just realized something important, the dots that appear on the cover art and on the pages that start new chapters are meant to show the dots that Astrid sees, the things that cloud into her vision from her cancer. We read about her experiencing this a lot throughout the book and maybe I’m a bit slow but I didn’t realize at first that we were also being shown it visually. I think this is a really great detail and it’s very emotional too, being able to picture more clearly what Astrid’s vision might’ve been like during events of the book. It makes it even sadder.

One of the many things that is absolutely perfect about this book is the title, it says it all; “The Fear of Missing Out.” Could that technically be interchangeable with the fear of dying? Because when we are dead we will be missing out on everything, and that’s kind of what Astrid is struggling with. The title is so genius because it’s what motivates Astrid throughout the entire story, she knows she going to die but she’s so scared of missing the very, very important things in life that she’s still willing to put herself out there on the internet and physically to explore the possibility of cryopreservation. She’s doing this because she doesn’t want to miss things like her little brother growing up, graduating high school and seeing everyone around her grow up as well. It’s not so much about herself but it’s more about everyone else, which I found to be interesting. Astrid doesn’t think about dying as being so bad but she does think of all the things she will miss and everyone she will leave behind. Overall I just want to say that I really like the title and I think it is a great sort of summarizing phrase for the story.

I think there was a really nice detail in here as well amongst everything else, Astrid sees a free climber (someone who climbs mountains without any restraints or safety measures) on tv at one point early on in the book and then towards the end she finds out he died. And he died right around the same place where Astrid had her first seizure. I think it’s a great parallel between the two characters, they both fought for the freedom to make their own decisions and died on their own terms. The climber wasn’t expecting to die, he didn’t have to make that decision but he died doing what he loved and lived for doing. When Astrid finds out she thinks about this, “at least he died doing what he loved.” And when Astrid died later on she also died on her own terms, which is why I thought this was a very interesting detail to include.

This book is very, very emotional but besides that aspect it’s a great read. It’s very thought provoking and will definitely make you ask yourself a few interesting questions. I really enjoyed reading this book, despite all the times it made me cry or want to punch somebody. I really, really like the story and I think it would be a meaningful experience for mainly teen readers. I hope you have found my review to be compelling enough to find and read this amazing book.