Pack Up the Moon (2021) is a novel by best-selling author Kristan Higgins, renowned for her exploration of the human heart. The novel follows Lauren and Joshua, a couple who face an unimaginable challenge: a terminal diagnosis. The work falls within the contemporary romance genre but pushes its boundaries as Higgins delves into the themes of Grief as a Path to Personal Growth, the Immortality of Love, and The Healing Power of Interpersonal Connections.

This guide uses the 2021 print edition of Pack Up the Moon published by Berkley, an imprint of Penguin Random House LLC, New York. 

Content Warning: The source material focuses on death and the grieving process. It also contains a brief scene with suicidal ideation and outdated autism references, which characters discuss in conversation. 

Plot Summary

The novel uses dual timelines and the alternating perspectives of Lauren and Josh with frequent transitions into memory and imagined events. The first chapter introduces Lauren, who has a terminal diagnosis of idiopathic pulmonary fibrosis (IPF), or lung disease. Despite her impending death, Lauren remains rooted in joy and gratitude on her anniversary—February 14. She writes a heartfelt letter to her father, who died during college, expressing her love for her husband, Joshua. The story then shifts to Josh, who shares a beautiful moment with Lauren on their anniversary in Chapter 2. Then, Chapter 3 shows Josh’s grief at Lauren’s funeral. The perspective switches to Lauren in Chapter 4, and the narrative runs through Josh and Lauren’s relationship in reverse chronological order. Lauren details her worsening condition in a letter to her father (a letter to her father opens all of Lauren’s chapters) and recalls relaxing memories on Cape Cod with Josh over the summer. In Josh’s forward-moving timeline, he fails to take care of himself in the weeks following Lauren’s death. Sarah, Lauren’s best friend, delivers a letter from Lauren—the first of many that allow Lauren to guide Josh through his first year without her while she watches from the Great Beyond.

Lauren opens Chapter 9 with a letter to her father detailing her recent hospital stay due to pneumonia, which she catches when she has 11 months left to live. The chapter then shifts to a trip to Turks and Caicos, where Lauren and Josh grapple with the impact of her illness on their travels. By Chapter 10, Josh questions his decision to rely solely on their doctor, Dr. Bennett, for Lauren’s treatment, pondering their missed opportunities for clinical trials. He interacts with an AppleCare technician, Rory, while reminiscing about his and Lauren’s dreams of visiting Hawaii and Yellowstone. Josh grapples with grief and anger more in Chapter 11, having to deal with the absence of messages from well-wishers after Lauren’s passing. He experiences flashbacks to his childhood, highlighting how he has learned to manage emotional outbursts caused by autism. Josh releases anger in a gym session, but his emotional turmoil continues, resulting in sleepless nights and painful visions of Lauren.

Lauren’s month-three letter opens Chapter 12, directing Josh to buy new clothes. He meets Radley, a compassionate retail employee, and the shopping experience marks an emotional turning point for Josh. A subsequent incident in a restaurant leads to Josh defending a waitress and punching a customer who uses an anti-gay slur.

In Chapter 13’s letter to her father, Lauren embraces acceptance of her IPF diagnosis, describing her life as “normal.” Lauren and Josh discuss their future and their relationship with Sarah, who has become closer with Lauren since her diagnosis. Sarah’s friendship helps Josh fulfill Lauren’s suggestion in Chapter 14’s letter: Thanks to Sarah, Josh embraces karate as a new hobby.

On what would have been Lauren’s 29th birthday in Chapter 15, Josh grapples with his grief, wishing for a place to leave flowers. As Josh’s grief intensifies, Lauren’s acceptance continues in another letter to her father, which shares moments of happiness and her gliding adventure on the couple’s trip to California. Chapter 16, however, reveals the couple’s emotional struggles, including thoughts of divorce.

By month five, Josh returns to work, still struggling with grief and frustration. He finds solace in Radley and Pebbles, his and Lauren’s dog. A business opportunity from Chiron Medical Enterprises triggers a flashback to Lauren’s curiosity about his work.

With 21 months left to live, Lauren writes a letter to her father, expressing doubt about her diagnosis. The narrative shifts to a painful memory where Lauren’s life appears ordinary until her first collapse due to IPF, leading to a hospital stay.

Moving forward into month six, Josh seeks solace in helping others by volunteering at the Hope Center’s community garden. He reflects on his recent outburst with Sarah and begins to reconnect with her and other family members, finding healing in familial bonds. In month seven, Josh dreams of a fleeting moment with Lauren by the ocean. He reflects on his shifting beliefs in God and prayer throughout his grief journey. A dinner with Sarah helps them mend their strained relationship. Time slows for Joshua, who is still in month seven in Chapter 21. Lauren’s brief letter encourages Josh to see a medium. He does so with Ben, leading to a profound experience in which the medium, Gertie, delivers messages from Lauren that bring comfort, healing, and hope for future love.

In Chapter 22, Lauren has 25 months left to live when she expresses her need for hope, clinging to the possibility that her diagnosis might be incorrect. A vivid flashback recalls her initial diagnosis and her refusal to accept the grim reality. Meanwhile in Chapter 23, Josh moves forward into month eight, and Lauren’s letter encourages Josh to take action professionally and confront one of his fears. Josh grapples with his disappointment in the task, but his trip to San Francisco presents a new job opportunity and the opportunity to face his acrophobia.

In month nine, Lauren tasks Josh with kissing another woman in her letter. He contemplates this request and ends up meeting Cameron (Cammie), a consensual sex worker. Following the kiss, Chapter 25 shifts the narrative to Lauren’s perspective as she writes to her father, reflecting on her wedding day and the early days of her marriage to Josh. She reminisces about their honeymoon in Hawaii, where she collapsed on a hike and experienced the first warning sign of her illness.

In month 10, Josh embarks on a journey to meet his biological father, Christopher, at Lauren’s request. He confronts Christopher about abandoning him and his mother and seeks answers about the past. Through their emotional encounter, Josh learns more about his father’s history and family. Josh reunites with his own extended family, and Lauren’s sister, Jen, shares the news of her pregnancy before the holidays. Josh then celebrates Christmas with a group of friends and family in Chapter 28. His emotions fluctuate as he grapples with Lauren’s absence during the festive season. Ultimately, he finds reasons to cherish life and those around him, preventing him from succumbing to despair.

In Chapter 29, Lauren expresses her deep love for Josh and reflects on the happiness she has found in their marriage—51 months away from her death. The chapter provides insight into the early days of their relationship and Lauren’s growing admiration for Josh, despite their differences.

Lauren’s letter to Josh in Chapter 30 encourages him to buy a house where he can create a life beyond her passing. By Chapter 31, Josh closes on a house and, with the help of Radley and Sarah, moves some of his belongings there. He struggles with his first anniversary without Lauren and commemorates her by holding a Korean jesa ceremony. By the next month, Josh does not read Lauren’s final letter and instead accepts a new job. Moving further back in time, Lauren reflects on her journey from the Rhode Island School of Design to designing the Hope Center with 57 months left to live. She sets goals for herself and writes a letter to her father, detailing her aspirations and dreams, which include finding her future husband, ultimately foreshadowing her marriage to Josh.

Back in the present, month 14 arrives, and Josh still has not moved into his new house. Josh realizes the importance of not living in solitude and engages in various activities, fostering his relationships. Josh reads Lauren’s final letter, but Josh can’t let himself find love again before reliving her last day. 

Lauren’s backward-moving timeline breaks in Chapter 35, which recounts the final moments of her life with her family and Josh by her side. Josh also reflects on his life since Lauren’s passing. After the flashback, he takes Sarah out on a date, but he doesn’t feel a spark with her. Later, he encounters a waitress, Rose Connelly, who seems to align with his psychic’s prediction and Lauren’s hopes. Rose is present in the Epilogue when Josh plants Lauren’s tree at the Hope Center. He feels a sense of closure and Lauren’s enduring love as he moves forward in life.