Slipping Off the Edge of the Earth: Zac and Mia by A. J. Betts

At this point, the standard sequence is as follows: The new patient's "significant other" comments on the view, the bed, and the size of the bathroom. The patient agrees. Often, there's nervous laughter at the gray stack of disposable urinals and bedpans, prompted by the belief that the patient will never be weak enough or desperate enough to use them.

Then there's a stretch of silence that follows their gaze from one white wall--with its plugs and label-makered labels and holes for things they can't even imagine yet, They track the walls, north to south, east to west, before they sag with the knowledge that that this has become real, the treatment will start tomorrow, and this bed will become home.

Zac knows the drill. He heard it in person, still in his school uniform on the first day, and through the thin walls of his room, over and over as new patients arrive in the adult oncology unit, where he's waiting out the isolation period after a bone marrow transplant.

But soon a full blast of pop music from next door lets him know that the new patient is a teenager like himself.

Then it hits me.  The newbie's gone Gaga. The girl's got cancer and bad taste.

But as days go by, loneliness pushes Zac to respond to Mia's tap on the wall and soon they swap taps for Facebook messages and a sort of black-humored conversation in which Zac reports that Mia's odds, with a small cancer in her ankle, Google out far better than his leukemia, which has already failed to be cured after chemotherapy. At first, Mia moans about missing her friends and the prom, but as her tumor fails to respond and she faces surgery, her mood darkens, while Zac goes into remission and heads for home on an olive farm near Perth.

But Mia's surgery turns into an amputation when the cancer is too large to remove. She feels trapped between her boyfriend's and BFFs' awkward turning away and her angry relationship with her mother. She finally takes flight, crutches and all, on a bus, not knowing where she'll stop.

I've learned a lesson today--no more unplanned detours. Life doesn't favor the curious. No more hopping on or off. No more trying my luck with bus drivers or girlfriends or ex-boyfriends or mothers or doctors or random strangers who once stayed in adjoining hospital rooms and fed me bullshit lies.

Everyone lies. So just take your backpack and go, Mia. Go....

But on the run Mia's leg becomes infected. Sick and weak, she turns to Zac and his family, and their care and Zac's good sense begins the healing process for Mia. But then Zac's leukemia returns, and he goes back to the same hospital room for yet another transplant. Mia realizes that he needs her. She follows and makes some peace with herself and her mother to be near him. But this time Zac's beloved Google doesn't offer much in the way of odds.

I know I feel too much. But I want. I want Zac to live. To want to live. I don't want to be in the world without him.

"We're all going to die sooner or later," Zac says.

"Then later, choose later!"

A. J. Betts' forthcoming American edition of Zac and Mia (Houghton Mifflin Harcourt, 2014) is a hopeful, funny, sad, and unresolved love story of two young people caught between love of life and the fight for life. Author Betts uses the alternating voices of Zac and Mia to chronicle the path of their illness and their increasing feeling for each other, with no descent into smarmy "sick lit" cliches. Like John Green's best-selling The Fault in Our Stars, this novel takes an unsentimental look at love and at death in the midst of life and life in the midst of death.