Reading Group Guide

1)    What is the significance of the title? As Liz and Stephen move from city to city, the places they live—and the places they escape to—become important milestones in the book. Do you think the title she’s chosen, My Foreign Cities, has anything to do with this theme? If not, what do you think it represents? Why do you think Liz has chosen to describe these cities, whether literal or figurative, as “foreign?”


2)    Would you get married at such a young age to someone you knew might only have several years to live? Why or why not?


3)    Liz often expresses how she feels very old and very young at the same time. When her mother comes to visit, for instance, she says: “I was uncomfortably old but young with her now, experiencing something she hadn’t gone through yet, but also letting her be my mom like I hadn’t since I’d been little.” Does experiencing Stephen’s illness through the lens of Liz’s youth affect your impression of disease, disability, or sickness?


4)    In the beginning of the book, Liz describes skipping a class with Stephen in high school, seeking refuge at a nearby diner. For the fifty-five minutes they spend together, Liz remembers feeling as if they were “out of time… or that we’d slowed it down somehow.” She then realizes that “maybe this is what minutes felt like to [Stephen] all the time.” Time is a reoccurring theme throughout the book; at certain points it seems to speed up, catapult, spin out of control, while at others it seems to slow down just enough, dream-like, for them to sit within it and outsmart it. How is this sense of time affected by Stephen’s illness?


5)    As Liz, Stephen, and their friends learn to cope with the consequences of Stephen’s illness, Liz describes scenes that are almost childish—Thanksgiving becomes one large slumber party, Stephen jokes about sex to the nurses in his hospital gown, etc. This contributes to a sense that they are approaching illness in a slightly offbeat way, pushing against preconceived notions of “how to be” in a hospital or in a life-threatening situation. Name some instances in which Liz, Stephen, and their friends approach his illness unconventionally. How did this alter their experience of his illness?


6)    About halfway through the book, a friend tells Liz to try being honest with Stephen about how she feels about cystic fibrosis, to try treating the disease as if it was “a separate entity, a third party in the relationship.” How does the presence of cystic fibrosis become a character of its own in the book?


7)    After Stephen’s lung transplant, he feels different, as if a part of him is missing. How does their relationship, and Stephen’s personality, change after the lung transplant?


8)    The hospital almost becomes another home, or even another character, in Liz’s story. Sometimes the hospital is a cold, unwelcoming or irritating place, but most of the time it’s a source of comfort. Did Liz’s perception of the hospital change your impression of hospitals or healthcare? How so?


9)    Liz often relates her experience of an event to the weather or setting she finds herself in, frequently drawing comparisons between her state of mind and the natural world. She describes a night as “spread out like fields of snow,” and her experience of returning, ever so slowly, from grieving as “thawing out.” Later on, she imagines speaking to Stephen, telling him “the river, the glaciers, mirrored life right now, expansive and wild, endless in scope.” Why do you think she finds herself compelled to describe things this way?

10) Stephen’s illness unfolds as we read, and the end seems inevitable. At one point, Liz says that she “wants to give you a break, the break we got after this bleak month.” As readers, how do you think the pace of Liz’s writing, and the order in which she has chosen to record these events, affects our experience of her story?


11) Do you think grief can be properly expressed or shared with someone else? Does it seem like Liz is able to share her own grief over losing Stephen? What do you think she means when she says, “I remember thinking it took energy to grieve in some kind of original way?”


12) A friend tells Liz that, after a while, the person you grieve for will no longer be “reduced to your own missing,” but will come back to you, whole and real. Does this ring true to you?


13) In her acknowledgements, Liz describes My Foreign Cities as her attempt to write the book she and Stephen always meant to write. How do you think this story might have been different if Stephen had been able to write his own narrative?