Dr. L is currently a research fellow in oncology who completed medical residency at Harvard. Dr. L worked with many truly remarkable patients during her clinical training in adult and pediatric cancer care. Kristine was one of those patients; her name has been changed to protect her identity.

Kristine was a spitfire. She was 20 years old when she died and had never had an easy day in her life.

Kristine was diagnosed with cancer when she was 16. At that time, she was anorexic and hooked on prescription painkillers. Her relationship with her parents was more damaging than supportive and she moved out even at her young age.

But people were drawn to Kristine. There was an inexplicable spark about her that made you want to know her better. She often came to clinic with an entourage of "adopted" family—friends from narcotics anonymous who fiercely watched over her. While every one of us felt that need to protect her and help her, she was stronger than any of us.

She completed treatment for her cancer the first time and disappeared back into what was her "normal" teenage life. Then the cancer came back and so did she. The medical team fought the cancer with high dose chemotherapy and a bone marrow transplant. During this intense, inpatient treatment, she tried to kill herself. The team fought her depression as hard as they fought her cancer and she recovered. Again, she disappeared back into her real world.

I met Kristine when she relapsed the second time. She knew the ropes better than I did at that point and she knew it; she wasn't going to let any newbie doc futz around with her. But she also recognized a "second relapse" didn't bode well. She taught me—in a trial by fire sort of way—how to earn her trust and succeed in caring for her. Together we agreed we'd fight this cancer as hard as we could. She had turned her life around: she was no longer anorexic, not addicted to substances, working full time, surrounded by people who were positive influences. She was not going to let cancer take all that she had worked so hard for.

Kristine went through our most aggressive and toxic anti-cancer treatment, an allogeneic bone marrow transplant. She agreed to treatment knowing it would be harder than anything else she had ever gone through, but also knowing it was her only chance for the good long life she had been fighting for the past four years.

The side effects of transplant can be deadly, and Kristine developed a reaction to her transplant medicine couldn't control. While we treated the reaction with everything we had, it became apparent we weren't going to be able to control it. Kristine and I had daily conversations about what this meant; she understood she was going to die. She required a high level of care in order to keep her comfortable, and she decided to remain in the hospital for her last few weeks.

That's when the people began to come. The nurse's station became a guest screening desk, to make sure the 30 people a day who wanted to see her didn't interrupt her rest. Her biological family came to make amends. Her narcotics anonymous sponsor never left her bedside. Her guardian angel, a father-figure from narcotics anonymous, kept a respectful distance but was always there to help with tough decisions or give support in any way. Finally, there was the seemingly never-ending trail of Kristine admirers, who had been drawn to her spark over the years just as I was.

Kristine passed away too young, but she touched more lives than many who live decades longer.