(Note: This review contains major spoilers.)

As “The Memory Book” opens, our narrator, Samantha “Sammie” McCoy, has recently been named valedictorian of her high school class and been accepted to her dream college, New York University. She’s also just been diagnosed with a terminal illness.

Lara Avery’s new YA novel is the story of Sammie’s desperate fight for her dreams in the face of this shattering news. Her disease, Niemann-Pick Type 3, is a particularly cruel one — as Sammie knows too well, having lost a great-aunt to it. As it runs its relentless course, it causes severe physical and mental deterioration, including memory loss. But Sammie can’t face this knowledge. She’s worked too long and hard to get out of her small rural community and make something of herself, and she can’t bear the thought of anything — even a deadly disease — getting in her way.

Sammie’s one concession to the inevitable is her “memory book,” a sort of journal that she keeps on her laptop to describe her life to her future self — just in case that future self really has lost all her memories. Through the pages of that memory book, we see her fierce determination to go on with life as usual — debate competition, graduation parties, college preparation — begin to clash with her rapidly advancing illness. When she finds herself stranded on the side of the road because she can’t remember how to get where she’s going, even with directions in front of her, Sammie finally has to grapple with the fact that she’s losing control.

“The Memory Book,” as you might expect, is a book that’s deeply sobering and often hard to read, but also, strangely, full of hope. It’s horrible to think of a young girl like Sammie having to lose her intelligence, her health, and ultimately her life. And it’s very hard to watch a bright mind going downhill as her narration becomes less coherent. (If you’ve ever read “Flowers for Algernon,” you’ll have a general idea of how it goes.)

Yet as Sammie goes through these crushing losses, she gains something as well: a deeper appreciation of her family, her home, and the life she has right now. She comes to understand that her hyperfocus on the future, while not always a bad thing in itself, made her take for granted the things and people around her in the present. It is through renewed and deeper connections with them that she finally reaches acceptance and peace before dying.

Unfortunately, the book has some content issues that parents will need to be aware of, including frequent profanity and some sexual content. Sammie has a sexual encounter with her old friend Coop towards the end, after realizing that she feels more than friendship for him, and then has to deal with the fact that her actions hurt another boy whom she had been dating. Sammie’s friend Maddie is in an on-again, off-again relationship with another girl (and is also head of the Queer Union at school). There’s a passing reference to Sammie’s parents cohabiting before marriage. There’s also some teenage drinking and pot smoking. At one point, Sammie cheats on a test because she’s afraid she’ll have a memory-loss episode that will keep her from passing it.

There’s occasional mention of Sammie’s left-wing politics (she opposes capitalism and counts Sen. Elizabeth Warren among her heroes). As for religion, Sammie’s family is Catholic, but Sammie sometimes doubts and even disparages her faith. At her brother’s confirmation, she finds herself thinking that it makes no sense for a 13 year old to “[declare] himself a soldier of Christ for the rest of his life.” But she also sometimes prays for help and, towards the end of her life, starts going back to church with her family.

“The Memory Book” is a powerful and poignant story that had me wiping away tears as I reached the end. Because of the content issues, parents will need to make a careful and informed decision about the book. But it does offer some redeeming factors among the negative ones — primarily, the truth that life can still be rich and meaningful even in the midst of great suffering, and the reminder to be thankful for the life and the loved ones we have.

Image copyright Poppy. Review copy obtained from the reviewer’s local library.

Gina Dalfonzo is editor of BreakPoint.org and Dickensblog, and the author of “One by One: Welcoming the Singles in Your Church” (Baker, June 2017).