Elizabeth Scarboro’s memoir, My Foreign Cities, opens with a great leap. It is summer and the author has scrambled up the rocks of Boulder Canyon with her boyfriend, Stephen, who quickly takes the plunge into the swimming hole below. Scarboro is more cautious. If she turns back, she will have to navigate the slippery rocks she has just scaled.  She inches toward the ledge. She pauses, and then she jumps.

It’s an evocative introduction to Scarboro, a young woman who always wanted a life of adventure—ideally, as she writes in high school, “as an international journalist, moving from country to country and boyfriend to boyfriend.” But adventure comes in unexpected places.  Scarboro’s begins at age 17 when she falls in love with Stephen—a handsome, impetuous classmate who has cystic fibrosis (CF). With a life expectancy of just 30 years, Stephen knows his days are numbered, but he and Scarboro plunge into a relationship just the same.    

My Foreign Cities is a tender story of young love much like any other—there are Ferris wheel rides in small-town Colorado, romantic hikes in Northern California, funny college roommates in Berkley, a proposal, a wedding, a new house and even two new dogs. Yet Scarboro’s life with Stephen is splintered with suffering normally reserved for the very old—enduring the pain of illness, the isolation of hospitals, the powerlessness of watching a spouse die and the magical thinking that comes with grief.

“Stephen and I had planned to write a book together about living with cystic fibrosis, with alternating chapters from our points of view,” says Scarboro, who took up the project 10 years ago in the wake of Stephen’s death.  

“Honestly I was trying to write fiction,” says Scarboro, “but I kept coming back to writing about the hospital, and I realized I needed to do this first before I could write any fiction. I was getting further away from the reality that I used to live with, and I wanted to write about it before I got completely removed from it. I could feel myself heading into a more normal place and I thought, ‘This is the time.’”

Scarboro hopes her book is a source of comfort and companionship. “I think the hardest part of the whole thing is the isolation. I remember looking for books about couples in a similar situation and I couldn’t find any,” she says. “I was really moved by Mark Doty’s book Heaven’s Coast, about Doty’s relationship with his partner who died of AIDS. I thought, ‘I’d like there to be something out there for people dealing with CF to turn to—more than a medical book—something emotional that they could read, so they don’t feel crazy or that there’s something wrong with them while they’re going through all of this.’”

Scarboro admits that neither she nor Stephen really grasped the magnitude of CF until they moved to Berkley for college, mainly because Stephen was so healthy as a boy. “It’s so strange to say it, but when you’re 17 years old, 30 seems like forever away.  The reality of it for us was very abstract”.

As the disease progressed, however, they became all too familiar with its particular brand of cruelty. In the book, Scarboro recounts a nurse who says, “If you want to know what it’s like to have CF, coat your mouth with peanut butter, plug your nose and breathe through a straw.”

“I could tell she wanted family members to actually try this,” writes Scarboro, “but I never did. I’d imagined it, though, and it felt frantic.”

In Scarboro’s clear-eyed, plain-spoken prose, readers will feel her sense of panic and share in her bewilderment as she paces hospital waiting rooms, doles out pills from a locked tackle box and makes end-of-life decisions before Stephen’s lung transplant. 

Yet for all its raw immediacy, this memoir is also tempered with the hard-won perspective that comes with time. In a passage both poignant and profound, Scarboro writes, “Youth helped us with illness in some ways—we had the energy for it, the spirit to tackle it…and most of all, friends who were willing and able to do it with us. But youth worked against us too—we could have used the sturdiness that comes later on, the knowledge that what we had together wouldn’t fall apart if we weren’t always happy in it.”

My Foreign Cities is not a self-help book in the classic sense but it will help you in the way that any good book does—by seizing your imagination, searing its story in your memory and laying bare a journey of inspiration, quiet heroism and heart.

Kirk Reed Forrester is a freelance writer based in Houston whose work has appeared in The Texas Observer, flower and Virtuoso Life.