The diaries of a remarkable young woman who was determined to live a meaningful and happy life despite her struggle with cystic fibrosis and a rare superbug—from age fifteen to her death at the age of twenty-five

“Captures the heartbreaking beauty of being alive.”—Beck Dorey-Stein, New York Times bestselling author of From the Corner of the Oval

Diagnosed with cystic fibrosis at the age of three, Mallory Smith grew up to be a determined, talented young woman who inspired others even as she privately raged against her illness. Despite the daily challenges of endless medical treatments and a deep understanding that she’d never lead a normal life, Mallory was determined to “Live Happy,” a mantra she followed until her death. Mallory worked hard to make the most out of the limited time she had, graduating Phi Beta Kappa from Stanford University, becoming a cystic fibrosis advocate well known in the CF community, and embarking on a career as a professional writer. Along the way, she cultivated countless intimate friendships and ultimately found love.

For more than ten years, Mallory recorded her thoughts and observations about struggles and feelings too personal to share during her life, leaving instructions for her mother to publish her work posthumously. She hoped that her writing would offer insight to those living with, or loving someone with, chronic illness.

What emerges is a powerful and inspiring portrait of a brave young woman and blossoming writer who did not allow herself to be defined by disease. Her words offer comfort and hope to readers, even as she herself was facing death. Salt in My Soul is a beautifully crafted, intimate, and poignant tribute to a short life well lived—and a call for all of us to embrace our own lives as fully as possible.

Praise from Students, Educators & Medical Professionals for Salt in My Soul:

“This raw personal account of living with an often-invisible chronic illness provides meaningful insight into the patient experience and provides an important reminder of and inspiration for humanism in medicine.”—Amy Blasini, MD, University of Michigan Medical School
 
“Some themes that recur throughout [Mallory's] memoir are body image, access to healthcare, depression and anxiety, and pain medication management. What is perhaps most impactful about Mallory’s story, however, is that she never let her illness define her, despite knowing that it would lead to an early death. Her writing is eloquent and captivating, making her book personal and powerful to readers.”—Lishan C., Class of 2021, Castilleja School, Palo Alto, CA
 
“Every medical student, physician, and allied health care worker should read this book.”—Dr. John D’Cunha, Chairman and Professor, Department of Cardiothoracic Surgery, Mayo Clinic
 
“I read Salt in My Soul last month and it taught me more about the patient experience than I learned in med school, residency, and so far in fellowship.”—Dr. Alexandra Kass, Boston Children's Hospital
 
“Mallory’s powerfully moving personal account of her brave battle with chronic illness and disability provides raw insight for the next generation of physicians, the future of medicine.”—Dr. Louisa Lu, Yale School of Medicine, Fulbright Scholar, Doris Duke International Clinical Fellow, UCSF Visiting Scholar
 
“Living through a pandemic and striving for a sense of normalcy and progression in such an uncertain time and social climate has made my students more empathetic and able to relate to Mallory’s struggles even while not all coping with chronic illness conditions. They understood her stress and her heartbreak, her grief and her hope, her determination and her sense of meaninglessness in it at times.”—Lynne Reeder, Teacher, West Perry High School
 
“[Smith] was a gifted writer and her words tell an informative and poignant story of what it is like to endure a chronic illness with such a poor prognosis. I believe all who read her book will have a moving experience, but I particularly recommend it to health care professionals and students and literature majors, as well as to youth with chronic illnesses and their parents.”—Richard I. Shader, MD, Clinical Therapeutics
 
Salt in My Soul should be required reading for every nursing student since it perfectly captures the patient experience and provides insight into the importance of humanism in daily care.”—Michelle Wolff, Johns Hopkins University School of Nursing
I could title my memoir Ode to Salt since salt is part and parcel of the cystic fibrosis experience. Broken proteins lead to an imbalance of salt inside and out of the cells. If you kiss or lick the skin of a CF-er, you’ll get a firsthand taste, literally, of how fundamental salt is to the disease. CF patients lose so much salt in our sweat that we can get water intoxication from drinking normal water unless we add salt to our water and our food. And salty water helps counteract some of the worst symptoms of the disease. I’ve noticed the healing effects of salt water since I was a little girl, swimming in the ocean in Southern California and on the many, many family trips we took to Hawaii for my health. I feel as if there’s salt in my soul. —Mallory Smith

I have big dreams and big goals. But also big limitations, which means I’ll never reach the big goals unless I have the wisdom to recognize the chains that bind me. Only then will I be able to figure out a way to work within them instead of ignoring them or naively wishing they’ll cease to exist. I’m on a perennial quest to find balance. Writing helps me do that.
 
To quote Neruda: Tengo que acordarme de todos, recoger las briznas, los hilos del acontecer harapiento (I have to remember everything, collect the wisps, the threads of untidy happenings). That line is ME. But my memory is slipping and that’s one of the scariest aspects about all this. How can I tell my story, how can I create a narrative around my life, if I can’t even remember the details?
 
But I do want to tell my story, and so I write.
 
I write because I want my parents to understand me. I write to leave something behind for them, for my brother Micah, for my boyfriend Jack, and for my extended family and friends, so I won’t just end up as ashes scattered in the ocean and nothing else. 
 
Curiously, the things I write in my journal are almost all bad: the letdowns, the uncertainties, the anxieties, the loneliness. The good stuff I keep in my head and heart, but that proves an unreliable way of holding on because time eventually steals all memories—and if it doesn’t completely steal them, it distorts them, sometimes beyond recognition, or the emotional quality accompanying the moment just dissipates.
 
Many of the feelings I write about are too difficult to share while I’m alive, so I am keeping everything in my journal password-protected until the end. When I die I want my mom to edit these pages to ensure they are acceptable for publication— culling through years of writing, pulling together what will resonate, cutting references that might be hurtful. My hope is that my writing will offer insight for people living with, or loving someone with, chronic illness. 
 
Cystic fibrosis is a chronic genetic illness that affects many parts of the body. It operates like this: A defective protein caused by the cystic fibrosis mutation interrupts the flow of salt in and out of cells, causing the mucus that’s naturally present in healthy people to become dehydrated, thick, and viscous. This sticky mucus builds up in the lungs, pancreas, and other organs, causing problems with the respiratory, digestive, reproductive, endocrine, and other systems. In the lungs, the mucus creates a warm and welcoming environment for deadly bacteria like Pseudomonas aeruginosa and Burkholderia cepacia. The vicious cycle of infection, inflammation, and scarring that comes from the combination of viscous mucus and ineradicable bacteria leads to respiratory failure, the most common cause of death in cystic fibrosis patients.
 
It’s progressive, with no cure, which means it gets worse over time. The rate of progression varies from patient to patient, and is often out of our control
 
••• 
 
Cystic fibrosis is a disease that does a lot of taking—of dreams, of time, of travel, of friendships, of freedom, of potential, of plans, of lives.
 
Sitting in a hospital bed, I’m tempted to think about all the things that have been taken from me. More than that, it’s easy to think about all the things I want for my future that might no longer be possible, the will-be-takens.
 
I was diagnosed at the age of three. As a kid, I made plans; I loved getting in bed at night because I had the opportunity to fantasize uninterrupted about whatever I was excited about. Some of what I thought about had to do with the future: where I would choose to live later in life, places I wanted to travel to, what I might be like as a teenager and then as an adult. Mostly, I envisioned other parts of the world—back then, anywhere was better than Los Angeles. The foreign always transcended the familiar. The unknown was brimming with possibility, while the known was full in a less satisfying way; like a big glass of a clumpy protein shake, you know it’s good for you but it doesn’t rock your world: daily routines, school days spent reading textbooks, long medical treatments I didn’t want to do. As Dr. Seuss says, “You’re off to great places! Today is your day! Your mountain is waiting, so . . . get on your way!” I believed wholeheartedly in those great places to come.
Mallory Smith was a freelance writer and editor specializing in environmental, social justice, and healthcare-related communications. She graduated Phi Beta Kappa from Stanford University and worked as a senior producer at Green Grid Radio, an environmental storytelling radio show and podcast. Her radio work has been featured on KCRW, National Radio Project, and State of the Human. She died at the age of twenty-five on November 15, 2017, two months after receiving a double lung transplant. View titles by Mallory Smith

Educator Guide for Salt in My Soul

Classroom-based guides appropriate for schools and colleges provide pre-reading and classroom activities, discussion questions connected to the curriculum, further reading, and resources.

(Please note: the guide displayed here is the most recently uploaded version; while unlikely, any page citation discrepancies between the guide and book is likely due to pagination differences between a book’s different formats.)

First-Year Reading (FYR) Guide for Salt in My Soul

Designed specifically to be used by faculty or program facilitators for college First-Year Common Reading programs.

(Please note: the guide displayed here is the most recently uploaded version; while unlikely, any page citation discrepancies between the guide and book is likely due to pagination differences between a book’s different formats.)

About

The diaries of a remarkable young woman who was determined to live a meaningful and happy life despite her struggle with cystic fibrosis and a rare superbug—from age fifteen to her death at the age of twenty-five

“Captures the heartbreaking beauty of being alive.”—Beck Dorey-Stein, New York Times bestselling author of From the Corner of the Oval

Diagnosed with cystic fibrosis at the age of three, Mallory Smith grew up to be a determined, talented young woman who inspired others even as she privately raged against her illness. Despite the daily challenges of endless medical treatments and a deep understanding that she’d never lead a normal life, Mallory was determined to “Live Happy,” a mantra she followed until her death. Mallory worked hard to make the most out of the limited time she had, graduating Phi Beta Kappa from Stanford University, becoming a cystic fibrosis advocate well known in the CF community, and embarking on a career as a professional writer. Along the way, she cultivated countless intimate friendships and ultimately found love.

For more than ten years, Mallory recorded her thoughts and observations about struggles and feelings too personal to share during her life, leaving instructions for her mother to publish her work posthumously. She hoped that her writing would offer insight to those living with, or loving someone with, chronic illness.

What emerges is a powerful and inspiring portrait of a brave young woman and blossoming writer who did not allow herself to be defined by disease. Her words offer comfort and hope to readers, even as she herself was facing death. Salt in My Soul is a beautifully crafted, intimate, and poignant tribute to a short life well lived—and a call for all of us to embrace our own lives as fully as possible.

Praise from Students, Educators & Medical Professionals for Salt in My Soul:

“This raw personal account of living with an often-invisible chronic illness provides meaningful insight into the patient experience and provides an important reminder of and inspiration for humanism in medicine.”—Amy Blasini, MD, University of Michigan Medical School
 
“Some themes that recur throughout [Mallory's] memoir are body image, access to healthcare, depression and anxiety, and pain medication management. What is perhaps most impactful about Mallory’s story, however, is that she never let her illness define her, despite knowing that it would lead to an early death. Her writing is eloquent and captivating, making her book personal and powerful to readers.”—Lishan C., Class of 2021, Castilleja School, Palo Alto, CA
 
“Every medical student, physician, and allied health care worker should read this book.”—Dr. John D’Cunha, Chairman and Professor, Department of Cardiothoracic Surgery, Mayo Clinic
 
“I read Salt in My Soul last month and it taught me more about the patient experience than I learned in med school, residency, and so far in fellowship.”—Dr. Alexandra Kass, Boston Children's Hospital
 
“Mallory’s powerfully moving personal account of her brave battle with chronic illness and disability provides raw insight for the next generation of physicians, the future of medicine.”—Dr. Louisa Lu, Yale School of Medicine, Fulbright Scholar, Doris Duke International Clinical Fellow, UCSF Visiting Scholar
 
“Living through a pandemic and striving for a sense of normalcy and progression in such an uncertain time and social climate has made my students more empathetic and able to relate to Mallory’s struggles even while not all coping with chronic illness conditions. They understood her stress and her heartbreak, her grief and her hope, her determination and her sense of meaninglessness in it at times.”—Lynne Reeder, Teacher, West Perry High School
 
“[Smith] was a gifted writer and her words tell an informative and poignant story of what it is like to endure a chronic illness with such a poor prognosis. I believe all who read her book will have a moving experience, but I particularly recommend it to health care professionals and students and literature majors, as well as to youth with chronic illnesses and their parents.”—Richard I. Shader, MD, Clinical Therapeutics
 
Salt in My Soul should be required reading for every nursing student since it perfectly captures the patient experience and provides insight into the importance of humanism in daily care.”—Michelle Wolff, Johns Hopkins University School of Nursing

Excerpt

I could title my memoir Ode to Salt since salt is part and parcel of the cystic fibrosis experience. Broken proteins lead to an imbalance of salt inside and out of the cells. If you kiss or lick the skin of a CF-er, you’ll get a firsthand taste, literally, of how fundamental salt is to the disease. CF patients lose so much salt in our sweat that we can get water intoxication from drinking normal water unless we add salt to our water and our food. And salty water helps counteract some of the worst symptoms of the disease. I’ve noticed the healing effects of salt water since I was a little girl, swimming in the ocean in Southern California and on the many, many family trips we took to Hawaii for my health. I feel as if there’s salt in my soul. —Mallory Smith

I have big dreams and big goals. But also big limitations, which means I’ll never reach the big goals unless I have the wisdom to recognize the chains that bind me. Only then will I be able to figure out a way to work within them instead of ignoring them or naively wishing they’ll cease to exist. I’m on a perennial quest to find balance. Writing helps me do that.
 
To quote Neruda: Tengo que acordarme de todos, recoger las briznas, los hilos del acontecer harapiento (I have to remember everything, collect the wisps, the threads of untidy happenings). That line is ME. But my memory is slipping and that’s one of the scariest aspects about all this. How can I tell my story, how can I create a narrative around my life, if I can’t even remember the details?
 
But I do want to tell my story, and so I write.
 
I write because I want my parents to understand me. I write to leave something behind for them, for my brother Micah, for my boyfriend Jack, and for my extended family and friends, so I won’t just end up as ashes scattered in the ocean and nothing else. 
 
Curiously, the things I write in my journal are almost all bad: the letdowns, the uncertainties, the anxieties, the loneliness. The good stuff I keep in my head and heart, but that proves an unreliable way of holding on because time eventually steals all memories—and if it doesn’t completely steal them, it distorts them, sometimes beyond recognition, or the emotional quality accompanying the moment just dissipates.
 
Many of the feelings I write about are too difficult to share while I’m alive, so I am keeping everything in my journal password-protected until the end. When I die I want my mom to edit these pages to ensure they are acceptable for publication— culling through years of writing, pulling together what will resonate, cutting references that might be hurtful. My hope is that my writing will offer insight for people living with, or loving someone with, chronic illness. 
 
Cystic fibrosis is a chronic genetic illness that affects many parts of the body. It operates like this: A defective protein caused by the cystic fibrosis mutation interrupts the flow of salt in and out of cells, causing the mucus that’s naturally present in healthy people to become dehydrated, thick, and viscous. This sticky mucus builds up in the lungs, pancreas, and other organs, causing problems with the respiratory, digestive, reproductive, endocrine, and other systems. In the lungs, the mucus creates a warm and welcoming environment for deadly bacteria like Pseudomonas aeruginosa and Burkholderia cepacia. The vicious cycle of infection, inflammation, and scarring that comes from the combination of viscous mucus and ineradicable bacteria leads to respiratory failure, the most common cause of death in cystic fibrosis patients.
 
It’s progressive, with no cure, which means it gets worse over time. The rate of progression varies from patient to patient, and is often out of our control
 
••• 
 
Cystic fibrosis is a disease that does a lot of taking—of dreams, of time, of travel, of friendships, of freedom, of potential, of plans, of lives.
 
Sitting in a hospital bed, I’m tempted to think about all the things that have been taken from me. More than that, it’s easy to think about all the things I want for my future that might no longer be possible, the will-be-takens.
 
I was diagnosed at the age of three. As a kid, I made plans; I loved getting in bed at night because I had the opportunity to fantasize uninterrupted about whatever I was excited about. Some of what I thought about had to do with the future: where I would choose to live later in life, places I wanted to travel to, what I might be like as a teenager and then as an adult. Mostly, I envisioned other parts of the world—back then, anywhere was better than Los Angeles. The foreign always transcended the familiar. The unknown was brimming with possibility, while the known was full in a less satisfying way; like a big glass of a clumpy protein shake, you know it’s good for you but it doesn’t rock your world: daily routines, school days spent reading textbooks, long medical treatments I didn’t want to do. As Dr. Seuss says, “You’re off to great places! Today is your day! Your mountain is waiting, so . . . get on your way!” I believed wholeheartedly in those great places to come.

Author

Mallory Smith was a freelance writer and editor specializing in environmental, social justice, and healthcare-related communications. She graduated Phi Beta Kappa from Stanford University and worked as a senior producer at Green Grid Radio, an environmental storytelling radio show and podcast. Her radio work has been featured on KCRW, National Radio Project, and State of the Human. She died at the age of twenty-five on November 15, 2017, two months after receiving a double lung transplant. View titles by Mallory Smith

Guides

Educator Guide for Salt in My Soul

Classroom-based guides appropriate for schools and colleges provide pre-reading and classroom activities, discussion questions connected to the curriculum, further reading, and resources.

(Please note: the guide displayed here is the most recently uploaded version; while unlikely, any page citation discrepancies between the guide and book is likely due to pagination differences between a book’s different formats.)

First-Year Reading (FYR) Guide for Salt in My Soul

Designed specifically to be used by faculty or program facilitators for college First-Year Common Reading programs.

(Please note: the guide displayed here is the most recently uploaded version; while unlikely, any page citation discrepancies between the guide and book is likely due to pagination differences between a book’s different formats.)

Memoir as Medicine: Mallory Smith’s Salt in My Soul

Contributed by Diane Shader Smith, mother of Mallory Smith, author of Salt in My Soul: An Unfinished Life Literature and medicine have long been intertwined. In the early 2000s, Dr. Rita Charon helped formalize this intersection as a discipline through her work at Columbia University and her book, Narrative Medicine: Honoring the Stories of Illness

Read more