How 'Sick Lit' & Books About Teens With Cancer Shaped My Childhood

I was 10 the first time my school called my parents. I hadn't done anything wrong per se; I wasn't a problem kid, just a — well, a troubling one, perhaps. My teacher was apparently concerned about my reading habits: Namely, that they were kind of fucked up.

This was that special stage in elementary school life before classmates split off into designated cliques and instead are defined by what they read. Popular factions in my school included the Baby-Sitters Club girls, the kids who stuck to R.L. Stine, and the precocious Tolkien readers who rolled their eyes at Narnia fans. And then there were the other kids: those gloomy pre-adolescent types who sit on the grass at recess, nose deep in a book about the Holocaust or bulimia or teenagers dying — slowly — of cancer. You know, the "sick lit" fans, like yours truly.

In recent years, sick lit has gone mainstream. Thanks to John Green’s blockbuster book The Fault in Our Stars (and the blockbuster movie that followed) the genre has even become a little prestigious. We now have serious conversations about the importance of responsible narratives around teen mortality, grief, mental illness, etc. We debate the merits of 13 Reasons Why with its harrowing depiction of suicide, and its questionable romanticisation of the aftermath. We scrutinise stories of terminal teenage love, like the one at the centre of Five Feet Apart. Are these narratives helpful? Damaging? Exploitative? All great questions worth thoughtful answers. But back in the '90s, no one was asking them. That wasn’t what sick lit was about. Back then, it was straight-up tragedy porn. And the genre was ruled by the greatest tragedy porn star of all time: Lurlene McDaniel.

McDaniel was the Jacqueline Wilson of sick lit. She was prolific, releasing 75 YA novels in her 35-year career, starting with 1982’s Will I Ever Dance Again? and followed by a litany of others with equally on-the-nose titles: Too Young To Die, A Time To Die, Please Don’t Die, Sixteen And Dying, She Died Too Young. You get the idea. McDaniel didn’t invent the tragic-teen narrative (I see you, Beth March!) but she is typically credited with turning it into a genre — and a highly profitable one at that. McDaniel’s books sold millions of copies and most are still in print today, their dreamy pastel covers given a fresh, modern facelift. Each book had minor variations, but they followed a fairly standard formula: A beautiful teenage girl with her whole life ahead of her is derailed by a devastating illness — either her own or that of someone close to her. If the protagonist herself was sick, then she would survive to the end of the novel, having learned some valuable lesson (and fallen in love with a super hot and compassionate guy — another McDaniel trope). If it was her friend, sibling or boyfriend battling the disease, then that character would probably bite the dust and our heroine would learn her life lesson through their death. Oh, and find love too, obvs.

Most of McDaniel’s medical tragedies centred on kids suffering from cancer. Often it was a brain tumour or leukaemia — a cancer that often affects young people and was far less treatable in the 1990s than it is today. (Thus, in pop culture, leukaemia had become the tuberculosis of its time: "the romantic disease" that stole innocent lives and offered "almost symptomless, unfrightened, beatific deaths," as Susan Sontag wrote.) Leukaemia was McDaniel’s bread and butter, but she did branch out occasionally. Some of her characters needed organ transplants or suffered from cystic fibrosis. Others struggled to manage their diabetes. But most readers (myself included) preferred her hopeless cases. They — okay, we — wanted to feel the exquisite agony of a life snuffed out by a mysterious plague, not grim realities of managing a chronic disease you might actually survive. As my fellow sick-lit fan Margaret Lyons reflected in 2014: "The books about diabetics were, at best, a last resort."

Occasionally, McDaniel dabbled in HIV/AIDS narratives, which now come off as preeeeeetty uncomfortable. See, for example, Baby Alicia Is Dying, which follows a wealthy young white girl whose heart is opened when she takes care of an abandoned black baby, born with HIV. The jacket copy reads: "Desi thinks it's totally unfair that innocent baby Alicia was born HIV positive. [She] can relate to feeling unloved. Her parents give her all the material things she needs, but there seems to be a wall between her mother and herself." From baby Alicia, Desi finally feels the love she’s been missing from her rich, generous but emotionally distant mum — yet Alicia is not her child, and she must let her go. "Can Desi cope with the harsh realities and still believe in love?" Spoiler: Yes! She can! Baby Alicia’s horrific death eventually brings Desi closer to her mother (and her super hot and compassionate science lab partner, Brian).

This is just one of many things we’d now identify as problematic or just plain weird about McDaniel’s books — and, really, any sick-lit stories. It’s a messed-up genre that romanticises and trivialises some of life’s most gruesome realities, exploiting our deepest traumas and fears. On the other hand, we love that shit. Not just macabre little tweens, but all of us. Melodramatic "crying and dying" tales have been one of the most enduring genres of popular entertainment since ancient Greece.

This is, of course, the central question that sick lit begs: What is it that all of us, children and adults, get out of these harrowing tales? Are we using them to grapple with our own mortality? Is it a form of healthy catharsis? Or are we all just a bunch of sickos getting our kicks? Personally, I think it's mostly the latter, and no one wants to admit it. As journalist Michelle Slatalla wrote of sick lit in 2009, "...today’s tear-jerkers are a new example of an age-old fascination with other people’s problems, the modern equivalent of going to the opera to see a tortured Tosca leap to her death from the Castel Sant’ Angelo." Sick lit pushes the most painful emotional buttons in our brains without actually forcing us to experience the much, much greater pain of living the reality. Horror movies and haunted houses do the same thing, letting us have a tiny taste of sheer terror though we know the whole time that we're safe. Pain, like pleasure, provides an endorphin rush, and humans have been using entertainment to chase that high for thousands of years. In the fifth century, we wept at Greek tragedies. Today, we've got Netflix and Grey's Anatomy.

In the 1950s, there was Death Be Not Proud. In the '60s, there was A Separate Peace. The '70s gave us Love Story — the wildly popular book, movie and song. These books (all written by men, by the by) are considered far more literary and important than McDaniel’s — and while the former point is absolutely true, I don’t think it’s fair to brush aside her work as totally meaningless fluff. Glaring flaws and all, these stories touched a generation of kids who found some kind of unnamable satisfaction in her tragic medical dramas. Those same kids then grew up to read Jodi Picoult and Jacquelyn Mitchard — and, of course, John Green.

Without McDaniel, none of these books would have a place on the bookshelf. It was she who proved there was a market for fiction like this. Decades before 13 Reasons Why, McDaniel was writing about the ripple effect of suicide in When Happily Ever After Ends. In Time To Let Go, she wrote about adolescent PTSD, and in A Time To Die she explored the painful isolation of teenage love and CF. We don’t like to think about children having dark, complex emotions or thinking about these things — but of course they do. For every adult who likes a rom-com there’s someone who prefers to weep through Beaches and Steel Magnolias, and the same is true for kids. McDaniel spoke to those kids directly, and in language they could understand. Was it good writing? No! Not at all! But as McDaniel herself said last year, when she announced her retirement from YA, "I am not a great writer. I just know how to write a story that will touch the heart."

That’s really what sick lit is all about. That’s why we roll our eyes at it in public, then go home and jump into bed with the latest cancer weeper. That’s why we devoured it as kids but never waxed nostalgic about it as adults — not the way we do with The Baby-Sitters Club or R.L. Stine. Sick lit exists simply to stimulate and poke at our deepest, ickiest emotions. It doesn’t have to be literary or cool. It’s feelings porn, and porn is embarrassing — but everybody’s seen it.