Book Review: Salt in my Soul

I knew it wasn’t going to be easy to read Mallory’s Smith’s book, Salt in my Soul, for this month’s book review.

Going into it, I was aware that the only reason I could read the memoir meant that it was published posthumously. Mallory kept meticulous, over 2500 pages worth of journal entries surrounding her journey with Cystic Fibrosis(CF). Before her double-lung transplant in 2017, she entrusted her mother with these entries, with the desire that if anything should happen to her, that her mother compile them into a cohesive book meant to help those “struggling with cystic fibrosis, loss, chronic illness, body image issues, depression, anxiety, or transplant.”

I would be lying if I said I jumped in immediately to read Mallory’s memoir when I received the book. It’s one of those books you have to circle a few times before committing to reading it. It has nothing to do with the writing style, and everything to do with the content matter. You know you are about to take an emotional journey with Mallory through her ups and downs, her victories and losses, all to end at the same place: her passing away.

Spending 294 pages with Mallory’s voice, told through Diane Shader Smith’s deft editing, you can’t help but fall in love with her writing style and ache when she aches, either through the physical pain brought on by the disease, or the disappointment in missing out on a potentially life-saving lung transplant.

None of this should dissuade you from reading Salt in my Soul, instead I hope it motivates you to read it for the gift of wisdom she gained during her fight. So much insight in such a young life, so much we can appreciate as we journey with our own chronic illnesses.

I am grateful to have the opportunity to read Mallory’s book for MS Mommy Blog, and appreciated reading someone else who had a similar philosophical journey as my own.

Note: I was approached to review this book, though I received no compensation to do so. All links are unaffiliated and I receive no monetary benefit by providing them.

Book Information

Title: Salt in my Soul: An Unfinished Life
Author: Mallory Smith
Date Published: 2019
Publisher:  Spiegel & Grau
Pages: 320
Genre: Non-Fiction, Memoir

Goodreads Link
Amazon US Link
Official Book Website

Salt In My Soul from Salt In My Soul on Vimeo.


The memoir is broken up into six parts: Mallory’s life in high school (2008 – 2010); college (2010 – 2014); post-college and living in San Francisco (2014 – 2016); falling in love (2016); the decline in her health and transplant (2016 – 2017); and her final wishes (2017). All told, it spans eleven years of Mallory’s life, the most critical years in her short life.

Some of the first lines of the memoir are Mallory’s explanation for the memoir’s title: the importance of salt in the life of a person with CF. Salt is a significant component of the disease: the body loses salt due to the breakdown of proteins. Salt is necessary to replace via water and food, and she observes how healing swimming in the ocean was throughout her childhood.

Because of her disease, her relationship to salt comes at a deeper level.

From there, the style is in diary form, not unlike Anne Frank or other famous published diarists. Here, we get Mallory’s most intimate thoughts in a stream-of-consciousness manner. While Diane, Mallory’s mother, breaks in occasionally to clarify a short-hand term or something a person without CF would be familiar with, it is Mallory’s mature prose.

There are the occasional breaks in Mallory’s writing to include thoughts from her friends, coaches, boyfriend, and other significant people in her life.

We follow Mallory’s journey in high school and the usual pangs of deciding where to apply to college, but with the added pressure of choosing a location that will either be close to CF treatment or home. Mallory ends up at Stanford, partially for the independence gained by being slightly farther away from her family, but also because of their renown CF department in the hospital.

Mallory details each of her hospital stays, the impersonal nature of some healthcare scenarios; the pang of wanting to connect with other CF patients but not being able to due to infection risks; the desire to leave for fear of missing out on college; and the pressing reality of her health deterioration.

Between each hospital stay are periods of hope and relief: meeting her boyfriend, Jack, at a New Year’s Eve party; dreamy-sounding trips to Hawai’i for her health; fantastic freelance opportunities to write for Susan Gottlieb, and NPR; and the hope of transplant in Pittsburgh.

With each dark spot in Mallory’s health, it is punctuated with moments of uplift, even at the end when she is surrounded by all who loved her. Mallory’s resilience and optimism don’t fail her, even in the moments when she questions both.

The memoir ends with transcripts given by Diane, Mark (Mallory’s father), Jack, and Meryl Shader (Mallory’s aunt) as her body dies from pneumonia after her double-lung transplant. Not a rejection of her donor’s lungs, but a carryover infection from her original lungs, the superbug B. cepacia that afflicts CF patients. Unfortunately, Mallory is given an experimental phage therapy to help fight the infection too late in her treatment. Had it come sooner, or before her transplant, she might have survived.

The hope for other CF patients comes at the very end of the book with a post-script from Steffanie Strathdee, the woman that helped Mark Smith get his daughter the experimental phage therapy. Steffanie, working with two researchers, created a “phage directory” which helps connect lifesaving phage therapy with patients that have superbug infections. Already, there have been several successes in the CF community with phage treatment, helping get patients healthy enough for successful lung transplants.

All because of Mallory’s own treatment and biopsy post-mortem.

Thoughts and Recommendation

Diary-style memoirs are one of my favorite style of writing. I’ve loved reading diaries since I was a little girl, even if they were fictionalized. I enjoy the intimate nature of these books, getting a first-person account of another person’s thoughts, feelings, and reactions to their daily lives. When I first received the book to review and flipped through it, I was excited to see it in one of my favorite formats.

Mallory’s writing style is so easy to work through, a technique that only comes from years of writing and reading (a byproduct of so many hospital stays). I found myself appreciating how clearly she wrote, even in such an informal format. Because it is a diary, it is easy to pick up and put down, though it’s hard to put down when you want to know how she’s going to handle this new infection, or how her date with Jack goes.

The writing was her way of working through the trauma of her disease, and it was essential to be able to express her thoughts and experiences on her life with CF. Mallory shares some of her deeper desires for keeping the entries: she wants to provide hope to others who suffer from a chronic illness.

Nothing is condescending about it.

Mallory recognized from a very early age the fragility of life, the importance of compassion (something she brings up multiple times over the eleven years of writing), and appreciating each opportunity she’s given. She was a huge proponent of self-care, where she risked her life by opting out of specific therapies to just enjoy life for her mental health.

For me, it was a validating read: I think if we had the opportunity to chat we’d have a lot in common with our philosophical approach to our respective diseases. She understood that being angry and grieving had its place in her emotional health, but spending too much time on it stole precious quality moments away from living her life. MS and CF are diseases that do not provide a timeline to our health: we may wake up one day worse off than the day before, and that may be our new “normal.”

Mallory fought to have a healthy life, as much as CF would allow.

The book is a loving memorial to Mallory from her mother and those who knew her best. I appreciate the evident care to balance the negative of her CF with the positive of how she chose to live her life. Mallory’s memory and desires to reach people suffering from CF or other chronic illness is intact, the drive to show that while a disease may ultimately take us, we don’t have to go down without a fight.

While it may be for privacy or desire not to take away from the book’s message, the only thing I wished to see were some pictures of Mallory’s life during this period. There is a lot of discussion surrounding her time on the swim team, surfing, or out and about; it would be nice to see glimpses into her active, healthy life. I am sure if I was motivated, I could find these pictures on her site or public social media pages, but it’s something I always enjoyed in a diary memoir.

If you are struggling with a chronic illness and looking for a high-quality memoir of a person in similar circumstances, I recommend checking out Mallory’s book. While all of our diseases take us on different physical journeys, many of us reach the same points: how do I manage my illness from a philosophical perspective? Do I allow the disease to take over entirely and wait for death, or do I choose to alter my path and find ways around the roadblocks?

Ill or not, everyone’s life outcome is the same: we are going to die. What we do with the time before then is all that matters. Mallory shows that while her life was cut short, she did not let the CF beat her spirit.

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One thought on “Book Review: Salt in my Soul

  1. I’ve come across this but haven’t read it myself. It really does sound like an eye-opening, evocative read, and the bit at the end about the phage treatment is almost like a tribute to her. I really would like to give this one a read myself. You’ve reviewed it brilliantly! xx

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