The novel’s portrayal of the Alpers and Ibsens illustrates some of the possible impacts that a life-threatening illness can have on family dynamics. Where Drums, Girls, and Dangerous Pie centered on Jeff’s diagnosis and treatment, After Ever After reflects on the way cancer has shaped Jeff’s identity, as well as his relationship with his parents and brother. The experiences of Jeff’s best friend, Tad, complement and contrast with those of the Alpers, rounding out the portrayal of families in crisis.

The first relationship to indirectly suffer from the impact of Jeff’s illness is the Alper siblings’ dynamic. As the older brother, Steven tried to protect Jeff by minimizing or repressing his own struggles. However, the pressure to perform the role of perfect son and brother eventually led Steven to break free from his family’s expectations in order to “find himself,” thus prioritizing his own well-being for the first time. This puts a strain on Steven and Jeff’s relationship because the younger boy feels abandoned by his older brother: “Basically, my hero woke up one day and quit the world” (37). However, as Jeff copes with his best friend’s relapse, he comes to empathize with Steven and realizes that his brother did not abandon him.