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Discussion Module

Side Effects
by
Amy Goldman Koss

Publishing Information: Roaring Books Press: New Milford, Conn., 2006
ISBN: 01596431679 / 1596432942
Pages
: 144 p.
Ages: 12 & Up

Summary:
When Izzy goes to the doctor to check her swollen glands, she thinks he'll give her some medicine but it's not that simple ... Izzy has cancer.

Book Talk:
Have you even been thrown a life changing event and never thought you would make it through? That is exactly what happens to Izzy when she awakes one morning to find out that she has lymphoma. Not only is eighth grade difficult enough, but Izzy has to deal with having cancer, too.  

"Mom!" I yelled.   "What's lymphoma?"

"He said they have much better luck with it now," she answered, if you can call that an answer. Then she auto-dialed my aunt Lucy, and I heard her say, "Lou? They think Isabelle has cancer. Meet us at Children's Hospital. We're going now," and she hung up.

They thought I had what? Then I was on floor too, as if all my bones had either melted or been suddenly removed. (pages 17, 18)
Subject Headings & Major Themes:

Cancer
Chemotherapy
Family Problems
Friendship
Hodgkin's Disease
Lymphoma
Resilience

Awards & Reviews:
YALSA Best Books for Young Adults, 2007

Fourteen-year-old Isabella is a typical teenager. She is concerned with friends, school, and gaining weight until the fateful morning that she discovers the enlarged glands in her neck. With the subsequent diagnosis of stage-four Hodgkin's lymphoma, she enters the netherworld of cancer: IVs, PICC lines (which she refuses), chemotherapy, hair loss, nausea and more nausea, and even medical marijuana. It's a harsh, realistic story of teen cancer, one that author Koss describes in her introduction as Issys descent into hell, with a safe return. Chronicling the appearance, disappearance, and rearrangement of friends, which will remind readers of Cynthia Voigt's Izzy Willy-Nilly (1986), as well as the overwhelming side effects as the chemo takes its toll, Koss refuses to glamorize Issy's illness or treatment. Instead, she settles for an honesty and frankness that will both challenge and enlighten readers. -- Frances Bradburn
Booklist, September 15, 2006, p5

Kirkus Reviews, September 1, 2006 (Starred Review)

At once acerbic and warm-hearted, Koss's (The Girls) novel offers a first-person account of a 14-year-old's grueling ordeal after she is diagnosed with stage IV Hodgkin's lymphoma. In an introductory note, the author remarks that many "kids get all kinds of cancers, go through unspeakable torture and painful treatments, but walk away fine in the end." Though Koss lets readers know in advance that Izzy will pull through, the teen's candid, often comical narrative will involve them deeply in her adjustment to the drastic changes that come with her illness and treatment. Often sarcastic and glib, Izzy, diagnosed in the first chapter, delves into the details of her chemotherapy and its devastating side effects, including hair loss, mouth sores, rashes and shooting arm pain. ("Was it necessary that I have every possible side effect from chemotherapy? Couldn't I just skip a few?" she wonders.) When Izzy returns to school, she uses humor to cope with her peers' awkward, over-friendly attitude toward her, commenting that there was "something spooky and science-fictiony" about "all this smiling and nodding and helloing." Koss interjects many poignant moments, including Izzy's dread of continuing her "chemo nightmare." The teen's thoroughly likable and uplifting best friend plays an enormous role in helping Izzy to remain positive and avoid self-pity. This tale will certainly open readers' eyes to the tribulations of young cancer patients and how to offer support. Ages 11-up
Publishers Weekly , December 11, 2006, p71

Gr 6-10 - A problem novel that's nicely paced and easy to read. Ultra-normal teenager Izzy learns that she has stage IV Hodgkin's lymphoma. She undergoes standard treatments, withstands her newfound pity-popularity at school, leans on her best friend, and grows in her understanding of her mother. She narrates with a relatively light, joke-cracking tone as her ballpoint pen doodles cartoon jibes at the things making her uncomfortable. Throughout, readers see how the teen's condition affects her loving family and supportive best friend. Reassured by the preface, they will have no fear of Izzy's recovery. Rather, the story focuses in great detail on her treatments and how she gets through them, holding out for a future in which she will have long, braided hair and a boyfriend who can deal with serious stuff like cancer. Readers witness every hospital visit, every injection, everything that goes in, and the color of what comes out (with some spectacular pukes). The book has realistically typical teenage characters and apparently solid research into various Children's Hospital patients and their treatments, but it's not too heavy, complex, or long.   Rhona Campbell, Chevy Chase Neighborhood Library, Washington, DC
School Library Journal , September 2006, p209

Discussion Questions and Ideas:

  1. What would you do if you woke up one morning to find that something with your body had drastically changed? Would you react like Izzy, or how would your reaction be different?
  2. What are your feelings or opinions about going to the doctor's office? Are you excited because you may miss a day of school, or are you frightened? Why do you feel this way? What happened in your life that may have influenced your feelings about going to the doctor's office?
  3. When Izzy learns that she has cancer, she falls to the ground, "as if all my bones had either melted or been suddenly removed." (p. 18) If you received news like Izzy's, how do you think you would react?
  4. Izzy hates the Children's Hospital because they treat her like she is eight years old. Even though the hospitals are called Children's Hospitals, they serve people up to the age of eighteen. What could these hospitals do to be more teen friendly?
  5. Izzy uses drawing as a way to deal with problems. How does drawing help Izzy to deal with the fact that she has cancer? Do you have a hobby that you do to help yourself through a problem? How does it help you?
  6. Izzy's mom has a more difficult time dealing with the fact that Izzy has cancer than Izzy does. How do you think your parents would react if they received scary medical news about you? How would you want them to react?
  7. Students in Izzy's school want to help cheer her up so they write her letters. She doesn't like them. As a student in her school, what else could you do to cheer her up?
  8. Throughout Izzy's entire time with cancer, her best friend Kay is always right there for her as a support or to brighten her day. Do you have a best friend like Kay? What does your best friend do to be a support for you during tough times?

Related Websites:
American Cancer Society - www.cancer.org

Teens Living with Cancer - www.teenslivingwithcancer.org

Teen Info on Cancer - www.click4tic.org.uk/home

Read-a-Likes:
Both Sides Now by Ruth Pennebaker, 2000
Defiance by Valerie Hobbs, 2005
Dream Journal by Karen Halvorsen Schreck, 2006
Going for the Record by Julie A. Swanson, 2004
Hard Hit by Ann Turner, 2006
Holding at Third by Linda Zinnen, 2004
Hope Was Here by Joan Bauer, 2000 (A 2005 RITBA Nominee)
Izzy Willy-Nilly by Cynthia Voigt, 1986
Less Than Perfect by Louise Albert, 2003
Loose Threads by Lorie Ann Grover, 2002 (A 2005 RITBA Nominee)
Red Velvet by Sandra Byrd, 2005
Rubber Houses by Ellen Yeomans, 2007
Running for Dave by Lori Jamison, 2005
Staring Down the Dragon by Dorothea N. Buckingham, 2003
Thicker than Water by Carla Jablonski, 2006
A Time for Dancing by Davida Hurwin, 1995
Toning the Sweep Angela Johnson, 1993
Under the Wolf, Under the Dog by Adam Rapp, 2004
Until Angels Close My Eyes by Lurlene McDaniel, 1998

Other Books by the Author:
What Luck! A Duck, 1987
Citty Crittes Around the World, 1991
The Baby, 1995
How I Saved Hanukkah, 1998
The Trouble with Zinny Weston, 1998
The Ashwater Experiment, 2000
The Girls, 2000
Smoke Screen, 2000
Stolen Words, 2001
Stranger in Dadland, 2001
Strike Two, 2001
Wher Fish Go in Winter and Other Geat Mysteries, 2002
The Cheat, 2003
Gossip Times Three, 2003
Kailey, 2003
Poision Ivy, 2006

About the Author:
Amy Goldman Koss was born in 1954 in Detroit, Michigan. At an early age, she began to love writing and drawing. Koss went college at Wayne State University. She married a news producer in 1982. Now, she lives in Glendale, California with her family.

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