Between Two Kingdoms: Key Insights & Takeaways

What happens after you survive? Suleika Jaouad was 22 when she was diagnosed with leukemia, and her memoir Between Two Kingdoms explores a question most survival narratives ignore: how do you learn to truly live when merely staying alive is no longer the goal? Through years of brutal treatment and a transformative 15,000-mile road trip across America, Jaouad discovers that the space between sickness and health contains its own profound wisdom.

This guide unpacks the essential insights from Jaouad's journey—the lessons about uncertainty, identity, relationships, and meaning that apply far beyond cancer wards. Whether you've faced your own health crisis, supported someone through illness, or simply want to understand what it means to live fully in the face of mortality, these ideas will reshape how you think about survival, healing, and what comes after.

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What is the "liminal space" between sickness and health?

The liminal space is the territory between being sick and being well—a state where you're neither fully ill nor fully healthy, existing in perpetual uncertainty. Jaouad reveals that this in-between state isn't a temporary waystation to pass through quickly; for many survivors, it becomes a permanent way of being that requires its own acceptance and navigation strategies.

This concept challenges the binary thinking most people bring to illness. Society expects you to be either sick (in treatment, fighting) or well (cured, back to normal). But Jaouad's experience shows that health exists on a spectrum where most people actually live. The wisdom of the liminal space is learning to function fully without requiring perfect conditions or guaranteed outcomes. You don't need to know if the cancer will return to make meaningful choices today.

Understanding this concept intellectually is one thing—but when you're actually facing uncertainty, can you recall this perspective? Loxie helps you internalize insights like these through spaced repetition, so they're available when you need them most, not just when you're reading about them.

Why is survival alone not enough after serious illness?

Survival without purpose is hollow because beating illness physically doesn't automatically restore meaning, identity, or the ability to engage with life beyond medical milestones. Jaouad discovers that after years focused entirely on staying alive, she has no idea how to actually live. The skills that helped her survive—compartmentalizing emotions, surrendering control to doctors, existing in suspended animation—become obstacles to thriving.

This insight reveals a gap in how we think about recovery. Medical success is measured in remission, blood counts, and survival rates. But the psychological and existential work of rebuilding a life receives far less attention. Jaouad finds herself facing an unexpected crisis: she won the battle everyone told her to fight, yet feels more lost than ever.

The transition from surviving to living requires conscious effort. It means rediscovering what brings joy, reconstructing relationships altered by illness, and finding purpose that extends beyond the next scan or appointment. For Jaouad, this meant embarking on a 15,000-mile road trip—not to escape her trauma, but to actively construct a new relationship with being alive.

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How does a life-threatening diagnosis permanently divide your life?

A serious diagnosis creates an immediate and irreversible divide in personal history, splitting existence into "before" when illness was abstract and "after" when mortality becomes immediate and tangible. This temporal rupture means you can never fully return to who you were—the experience fundamentally reshapes your identity, relationships, and understanding of what "normal" means.

Before diagnosis, the future seemed infinite. Plans were made with the assumption of continued health. After diagnosis, every moment carries the weight of potential loss. Jaouad describes this shift as becoming someone who has faced mortality in a way that permanently changes how you see yourself and how others see you.

The impossibility of "going back to normal"

Society's expectation that survivors should "bounce back" ignores the profound transformation they've undergone. Friends and family often want the old person back—but that person no longer exists. The pressure to pretend nothing has changed when everything has creates isolation and frustration. Returning to your previous life after serious illness reveals not just that you've changed, but that the old frameworks for living no longer fit.

This doesn't mean life after illness is worse—it's simply different. Many survivors find unexpected gifts in this transformation: clearer priorities, deeper relationships, heightened appreciation for ordinary moments. But these gifts only emerge when we stop trying to restore what was and start building something new.

How do you live with the permanent possibility of relapse?

Living with potential relapse means accepting that uncertainty becomes a constant companion, requiring daily choices to engage with life despite never knowing if the disease will return. Jaouad confronts this reality directly: the cancer could come back tomorrow, next year, or never. There's no final "all clear."

This ongoing uncertainty demands a fundamental shift in how you relate to the future. Rather than waiting for guarantees that will never come, you learn to make peace with questions that have no answers. The exhausting pursuit of certainty and control gives way to something unexpected: freedom. When you stop waiting for the future to be secured, you're released into the present.

Jaouad's insight here extends beyond cancer survivors. All of us live with uncertainty—we just don't usually acknowledge it. Illness simply makes visible what's always been true: life offers no guarantees. Learning to live fully within that reality, rather than fighting it, becomes a path to genuine peace.

Wisdom fades without practice
These insights about uncertainty and presence are powerful when you read them—but can you access them during an anxious moment? Loxie uses spaced repetition to help you internalize these concepts so they become available when life actually tests you.

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How does illness reshape identity?

Serious illness permanently alters identity by creating a before and after that cannot be bridged—you become someone who has faced mortality, and this changes both how you see yourself and how others perceive you. Jaouad grapples with no longer being the ambitious young woman starting her career, but not quite being a "cancer patient" either. She exists in an identity limbo that mirrors her physical liminal state.

Physical transformations from treatment—hair loss, weight changes, scars—force patients to grieve their former selves while learning to inhabit bodies that feel foreign and unreliable. But the deeper identity shift happens internally. Your values change. Your tolerance for superficial concerns evaporates. Relationships that once seemed essential may no longer fit who you've become.

Integrating rather than erasing the experience

Healing doesn't mean forgetting what happened or returning to who you were. It means integrating the illness experience into a new identity that encompasses both who you were before and who you've become. Physical scars from medical trauma become evidence of endurance rather than damage when we view them as part of our survival story rather than marks to hide.

This integration work takes time and intentionality. Jaouad finds that new rituals help bridge the gap between her old and new selves—structured ways to honor both who she was and who she's become. The goal isn't to "move on" from illness but to move forward with it as part of your story.

What does grief teach us about mortality?

Experiencing profound loss and grief fundamentally reshapes understanding of mortality by making death's reality immediate and personal. Before illness, death is abstract—something that happens to other people, someday far away. After watching fellow patients die, after your own close calls, mortality becomes visceral and present. This forces survivors to reconstruct meaning from the recognition that life is finite and fragile.

Jaouad confronts survivor's guilt directly: the burden of questioning why you lived when others didn't, and the responsibility to make your survival meaningful. This guilt can paralyze or motivate. Channeled properly, it becomes fuel for living fully—not out of obligation to the dead, but out of recognition that life is a gift that others didn't receive.

The grief doesn't disappear. But it transforms. It becomes integrated into daily life, showing up unexpectedly in moments of joy as well as sorrow. Learning to carry grief while still engaging fully with life is one of the essential skills of the liminal space.

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How do transformative journeys reshape our relationship with ordinary moments?

Transformative experiences fundamentally reshape how we perceive everyday life by creating a heightened awareness of mortality that makes us more present, grateful for small pleasures, and willing to release what no longer serves us. Jaouad's 15,000-mile road trip wasn't about escaping her past—it was about actively rebuilding her capacity for presence and engagement.

The journey created physical distance from medical trauma while providing new experiences to overlay painful memories. Constant movement across changing landscapes gave her mind space to process deep trauma—something that couldn't happen while remaining in the environment associated with illness. Open roads and solitude forced confrontation with inner fears because there's nowhere to hide from yourself when external noise and social buffers are removed.

Physical adventure as recovery

Physical activities became crucial for reclaiming bodily autonomy after medical treatment. For Jaouad, this included learning to salsa dance—transforming her body from a site of illness into one of joy and movement. The body that had been poked, prodded, and poisoned by treatment could also experience pleasure, rhythm, and connection.

This principle extends beyond grand adventures. Any physical engagement that reconnects you with your body as something other than a medical problem contributes to healing. The key is creating new associations and experiences that aren't defined by illness.

How does life-threatening illness test relationships?

Serious illness tests relationships by forcing both partners to confront mortality, dependency, and the question of whether love can survive radical change. Jaouad's relationship with her partner, Will, is transformed by her illness. He becomes caregiver, witness to her suffering, and fellow traveler through uncertainty—roles that fundamentally alter the dynamic between equals.

Partners struggle to navigate the shift from caregiver-patient dynamics back to equals after treatment ends, often finding that old relationship patterns no longer fit who they've become. The intimacy of medical crisis creates bonds, but also strains. Resentments can build on both sides: the patient may feel guilty for being a burden, while the caregiver may feel exhausted and unacknowledged.

The challenge of returning to "normal" together

Recovery doesn't restore the relationship that existed before illness—it requires building something new. Both people have been changed by the experience. The patient has faced mortality; the caregiver has witnessed suffering they couldn't prevent. Coming back together requires acknowledging that neither person is who they were, and the relationship must evolve accordingly.

Some relationships don't survive this test. Others emerge stronger, deepened by shared crisis. The outcome often depends on both partners' willingness to do the difficult work of rebuilding connection rather than expecting automatic return to normal.

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How do you create meaning from suffering?

Creating meaning from suffering transforms past experiences by converting raw pain into wisdom, art, or service that benefits both ourselves and others. Jaouad's writing—including her New York Times column "Life, Interrupted"—became a way to make sense of her experience while connecting with others facing similar struggles.

Writing about illness serves multiple functions: it creates meaning from pain, asserts agency when medical outcomes remain uncertain, and breaks the isolation that both patients and families experience by creating community through vulnerability. Sharing personal stories of struggle establishes trust and connection before any in-person meeting occurs.

Connection through shared vulnerability

Meeting readers who followed Jaouad's journey created profound human connection because shared vulnerability through writing establishes understanding that transcends normal social barriers. On her road trip, she visited many people she'd connected with through her column—fellow patients, caregivers, readers who saw their own stories in hers.

This principle applies beyond writing. Any authentic sharing of struggle—whether through art, conversation, or simply being present with someone in pain—creates meaningful human connection. The isolation of suffering breaks when we recognize that others have walked similar paths.

How does accepting uncertainty lead to peace?

Peace emerges from embracing life's fundamental uncertainty because accepting impermanence frees us from the exhausting pursuit of guarantees and control. Jaouad discovers that waiting for certainty—waiting to be "fully well" before living—means never living at all. The only way forward is to engage fully with life while holding uncertainty alongside hope.

This acceptance isn't resignation or passivity. It's an active choice to live within questions rather than demanding answers. When you stop fighting uncertainty, energy previously spent on anxious control-seeking becomes available for actual living. Paradoxically, accepting that you cannot secure the future allows you to be more present in the current moment.

Confronting mortality clarifies what matters. Survivors often shift focus toward purposeful living—pursuing delayed dreams, repairing relationships, seeking experiences over accumulation. The awareness that time is finite transforms how you choose to spend it.

The real challenge with Between Two Kingdoms

Reading Jaouad's memoir can feel transformative. Her insights about uncertainty, presence, and meaning resonate deeply—especially if you've faced illness yourself or supported someone who has. But here's the uncomfortable truth: most readers will forget the majority of these insights within weeks.

Research on the "forgetting curve" shows we lose up to 70% of new information within 24 hours if we don't actively work to retain it. That powerful realization about living in the liminal space? The perspective shift on uncertainty you felt while reading? Without reinforcement, they fade back into vague impressions.

This matters because Jaouad's wisdom is meant to be applied, not just understood. When you're actually facing uncertainty—waiting for test results, supporting a sick loved one, confronting your own mortality—can you access these insights? Or have they slipped away, leaving you to rediscover them the hard way?

How Loxie helps you actually remember what you learn

Loxie uses spaced repetition and active recall to help you retain the key concepts from books like Between Two Kingdoms. Instead of reading once and watching insights fade, you practice for just 2 minutes a day with questions that resurface ideas right before you'd naturally forget them.

The science is robust: active recall—being asked to retrieve information rather than passively reviewing it—strengthens memory far more than rereading. Spaced repetition optimizes the timing of that recall, ensuring you practice at the exact intervals that maximize retention.

The result? Jaouad's insights about living in uncertainty, finding meaning in suffering, and embracing the liminal space become genuinely available when life tests you. They move from "things you read once" to "wisdom you can access."

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