I’ll never forget learning the word “bildungsroman” in my high school English class while reading Twain’s Huckleberry Finn. A bildungsroman refers to a coming-of-age-story in which a young person sets out on a literal journey and in doing so experiences a psychological, spiritual and/or developmental journey. I have loved that word ever since. It captures so much about how our physical odysseys impact us on multiple internal levels. As oncology social workers, we see this connection frequently, how moving through the physical aspects of cancer treatment can awaken insights and intentions about what is most important in and to one’s life.

Kate McGovern’s Fear of Missing Out is a bildungsroman, boldly updated for our current times. McGovern introduces us to Astrid, an independent 17-year-old girl with an astrocytoma (“Yes, my tumor matches my name,” the main character quips in the first few pages of the book.) who takes a road trip with best friend Chloe and boyfriend Mohit to a cryonics facility to determine if cryopreservation would offer her hope for a cure in an unknown future. It is on this voyage to seek answers to her anxieties about facing a terminal illness and “missing out” on all the things most adolescents have little doubt are ahead of them that Astrid finds clarity about what it is she needs in the time she has living with an incurable cancer.

In addition to incorporating the controversial field of cryonics, the author also attempts to tackle issues such as voluntarily stopping eating and drinking (VSED) and the impact and response of social media and crowdfunding in the context of serious illness. While the imagined cryopreservation lab and information about VSED seemed clunky at best, this latter focus on the role of technology and its immediacy in responding to Astrid’s process of grief is done quite effectively. For instance, Astrid’s public video blogs about her illness and her intention to visit a cryopreservation facility gets far reaching responses, both positive and negative. The author shows how this not only affects Astrid but also her family members and friends. This is effective in highlighting the challenge so commonly faced by families coping with cancer and anticipatory grief in how to support one another while facing their own personal losses.

The different ways in which Astrid and her family and friends all manage their grief seemed authentic and was where this novel was at its best. In addition, a most touching and effective theme throughout McGovern’s novel is Astrid’s ongoing video recorded list of “Things I’ll miss when I’m dead…” Items on this list range from people important to Astrid, to small pleasures such as scrambled eggs and Netflix to future aspirations. In this way we are reminded that in all our lives, what is important is varied and personal, from our big hopes and dreams to our daily delights.

Through Astrid we see the complex nature of grappling with an end-of-life illness. She longs for privacy, control and choice while simultaneously wanting connection with others, spontaneity and for others to care for her in the way she needs. This piece of Astrid’s character development seemed the most genuine feature of this novel. I could conceive using some of the passages in this book as teaching points for patients, families, social work students or health care professionals as illustrative of the complex inner conflicts that patients with cancer face, regardless of age.

Where this novel missed an opportunity was in adequately capturing the medical system’s role and options for Astrid. To be fair, this is a young adult novel, not intended for the critical eye of a social worker in the field of oncology. The scenes in which Astrid’s oncologist are present do capture some of the social and emotional difficulties that clinicians, patients and families confront in determining what their choices are with regard to treatment. The more technical and educational aspects of palliative care and/or hospice, however, are mentioned in a somewhat haphazard way in which it does not seem there is a clear understanding of how these services are interwoven or what they look like in reality.

McGovern’s book is a quick read, often enjoyable and clearly intended for the young adult audience. The majority of character development is focused on Astrid and her friends. Aside from Astrid’s mother, other adults in the story seem more one dimensional, even at times functioning as stereotypes. As an oncology social worker, it was difficult not to overthink this book and long for the opportunity to insert some great scenes with Astrid meeting with her oncology social worker. That said, McGovern creates a compelling storyline that illustrates some of the challenges of facing a cancer diagnosis, particularly at a young age, while stumbling in other areas. While the oncology social worker in me found this to be an interesting read, though with some faults that were difficult to overlook, I would guess that my high school self, that girl who delighted in learning words such as “bildungsroman,” would have absolutely loved it.