1. Keith describes Elena as his hero. What specific qualities make Elena a hero? How would you define heroism? Do we have to suffer great trials to become heroes? Who are the heroes in your life?

2. Elena’s illness teaches the Desserichs to savor every minute with their loved ones, and to live in the present. Do we need to experience a crisis to learn to appreciate what we have, or is it possible to live this way all the time? What gets in the way of living like this? How can you bring the Desserichs’ lessons into your life?

3. “You don’t give up hope,” Keith says. “You just lie.” Throughout the days of Elena’s illness, the Desserichs strive to remain hopeful in the face of extraordinary fear and pain. Is it better to be hopeful or realistic? Is it possible to be both at once? At what point (if any) does hope become futile? Do you think you would manage to stay hopeful in the Desserichs’ situation?

4. Although this book is about Elena, it was written for Gracie. How does Gracie cope with her sister’s illness and death? What can we learn from Gracie about caring for loved ones? How do you think Gracie will feel years from now when she reads this book?

5. From time to time, the Desserichs wonder whether they have done something to deserve the suffering they are experiencing. Can we explain why bad things happen to good people? Do you believe that everything happens for a reason?

6. If you were told you had 135 days to live, how would you spend your remaining time? Elena creates a wish list. What would be on your wish list?

7. Elena leaves behind notes of love for her family. Are there any items or objects that others have left behind for you or that remind you of your connection to them? What do you hope to leave behind for those you love?

8. Keith explains how medicine only goes so far to help Elena. What other remedies does she receive? How do these offer her relief? During a stressful or challenging time, what untraditional methods do you turn to?

9. A portion of the proceeds of this book will go to The Cure Starts Now, a foundation started in Elena’s memory to help other children battling cancer. Elena’s story has inspired so many to become a part of this movement. How can you help to be a part of the cure? Brainstorm ideas.

10. Keith takes the reader into his private family moments –-- bedtime stories, tickle time, and words of love whispered every evening to his girls. What family rituals do you practice? How do these rituals enhance the family bond?