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Die Young with Me

A Memoir

About The Book

In the tradition of John Green’s The Fault in Our Stars and Me and Earl and the Dying Girl, this incredibly moving and harrowing true story of a teenager diagnosed with cancer is “a resounding affirmation of how music can lift one’s spirits beyond gray skies and bad news (Kirkus Reviews).”

Punk’s not dead in rural West Virginia. In fact, it blares constantly from the basement of Rob and Nat Rufus—identical twin brothers with spiked hair, black leather jackets, and the most kick-ass record collection in Appalachia. To them, school (and pretty much everything else) sucks. But what can you expect when you’re the only punks in town?

When the brothers start their own band, their lives begin to change: they meet friends, they attract girls, and they finally get invited to join a national tour and get out of their rat box little town.

But their plans are cut short when Rob is diagnosed with a rare form of cancer that has already progressed to Stage Four. Not only are his dreams of punk rock stardom completely shredded, there is a very real threat that this is one battle that can’t be won.

While Rob suffers through nightmarish treatments and debilitating surgery, Nat continues on their band’s road to success alone. But as Rob’s life diverges from his brother’s, he learns to find strength within himself and through his music. Die Young with Me is a “raw, honest picture of the weirdness of growing up” (Marky Ramone) and the story of a brave teen’s battle with cancer and the many ways music helped him cope through his recovery.

Reading Group Guide

This reading group guide for Die Young with Me includes an introduction, discussion questions, ideas for enhancing your book club, and a Q&A with author Rob Rufus. The suggested questions are intended to help your reading group find new and interesting angles and topics for your discussion. We hope these ideas will enrich your conversation and increase your enjoyment of the book.


Rob Rufus and his twin brother, Nat, have just started a band. Supportive parents help supply them with instruments and space in the basement to practice, the local West Virginia YMCA has provided them a venue to host their very first show, and girls Rob felt all but invisible to have started taking notice. But just as ambitions of punk-rock stardom seem within grasp for these two teenagers, Rob is diagnosed with a rare form of cancer. While his brother reluctantly leaves to represent their band, playing the eastern leg of the coveted Warped Tour, Rob endures intensive surgery and nauseating rounds of chemotherapy. His condition not only weakens him to the point of being unable to pick up a drumstick, it threatens his very life. Yet it is his unwavering passion for the musicianship now denied him, along with the heroic support of family and friends, that ultimately gives him the strength to persevere.

Topics and Questions for Discussion

1. Though Rufus admits that he and his brother Nat have “the exact same interests and opinions about literally everything” (p. 5), he later comes to find that the two are not “identical at all” and he is “beginning to get used to the idea” (p. 302). What besides Rufus’s illness comes to define each twin differently from the other? How do you interpret the fact that they communicate better through writing music than speaking (p. 378)?

2. At numerous points between rounds of chemotherapy, Rufus senses that Ali might be distancing herself from him. How do you compare their first Valentine’s Day together (p. 91) to their last (p. 363)? In what ways do the two become more mature over the course of their relationship, even if it means that they ultimately part?

3. Despite severe symptoms, Rufus initially procrastinates going to the doctor. Why do you think he does this? Has his approach to treatment changed by page 263, when he lies to his psychiatrist about feelings of depression and anger?

4. Beginning with Dr. Sherman’s insinuation that he abuses prescription drugs because he has spiky hair (p. 86), Rufus experiences many instances of bias against punk culture. Do you think that kind of prejudice increases after September 11, when Rufus states that “anything, or anyone, considered outside the norm was suspect” (p. 314)?

5. When Rufus first begins to be evaluated by doctors, seeing his parents react strongly is the first thing that really “shook [him] up” (p. 87). How do Rufus’s mother and father cope with his cancer in different ways emotionally? How do those coping mechanisms evolve over the course of the book?

6. Many of Rufus’s experiences with his doctors leave him feeling as if they are “just patronizing [him]” (p. 99). Which of his anecdotes cast the American medical system in a negative light? Which demonstrate the empathy and skill of specific professionals in the field?

7. On page 184, Rufus notes bitterly that one of his classmates who signed his get-well card does not recognize him at a party, and probably never even knew who he was. Where else do you see characters either struggling to identify with Rufus or refusing to sympathize altogether? What do you think causes this type of behavior?

8. Rufus describes the agony of oncology testing and chemotherapy in vivid detail, stating at one point that his “pain was all-consuming, even with the drugs. Now, it became more present every day. [He] was more present too” (p. 255). How do you think pain and illness can make a patient feel more present? Do life-threatening conditions necessarily make living feel all the more precious? Discuss with your book group.

9. When Ali brings Rufus a Catholic cross, he feels compelled to pray for the first time in his life, even though he is not religious (p. 166). Do you feel his relationship with religion changes over the course of the book? How would you explain his angry outburst toward his great-aunt when she calls him her church’s “miracle child,” not knowing that he has just learned of two cancerous recurrences in his body (p. 374)?

10. One consequence of Rufus’s chemotherapy is tinnitus, which he distracts himself from by playing “music in [his] head constantly. It was usually just a verse, or a single riff dubbed over the hum and set on repeat. [He] sectioned [his] consciousness into two parts—one of them inward and constant, the other struggling to keep a grasp on the world around [him]” (p. 179). Do you see this as the first step in his eventual physical recovery? Or is the tonic of inward music necessarily distinct from his physical conditioning to play drums again?

11. Tattoos take on great meaning for the twins, and the matching ink on their arms bonds them together. Yet Rufus notes that “although it wasn’t a conscious decision, each new tattoo was nothing but a remnant of that horrible year [. . .] [a]ll of those experiences, relived in thick bright lines up and down my arms—as colorful as fantasies, but as permanent as a scar” (p. 345–346). Do you feel that his tattoos celebrate his triumph over cancer, or serve more as an enduring reminder of pain?

12. Consider the last line of the text on page 376. How does Rufus’s Mustang serve as both a positive and misleading metaphor? Why do you think he returns to the idea of his janitor returning to Hamburg here?

Enhance Your Book Club

1. Make a list of all the specific albums mentioned in the book. Then choose one or two that you are unfamiliar with and listen to them before reporting back to your book club. What were your impressions? Does the album remind you of a different one you really enjoy, or could it be an influence on another recording you have heard?

2. Rufus holds as significant the last picture taken of him and Ali before his diagnosis. Do you have a photograph that records a moment of significant change for you? If you have a copy of one, share it and your memory with your book group.

3. Check out some of the media on the website for the Rufus brothers’ band, Blacklist Royals, ( and discuss it with your book club. How does material from the album Die Young with Me compare to that of the memoir?

A Conversation with Rob Rufus

Many readers must identify with the way you describe growing up in a stifling community. What advice would you give young musicians trying to break out of suburban existence?

Small towns have a way of viewing life as utilitarian, an outlook that I think breaks the creative soul. For a rural garage band, “the road” has the same allure that the Old West had to prospectors—freedom, opportunity, and, most important, escape. So, if you’re one of those brave, reckless rock ’n’ roll souls, then my advice is simply to GO! Go on tour! Go to the big city! Quit your shitty day job! Try to make it!

Sure, you might not end up a rock star. But your scope of existence will be enriched beyond your wildest dreams, and you might just find a place out there where you belong.

Several years have passed since the point at which you leave off at the end of this memoir. Can you share one or two moments from your cancer battle of which you are really proud?

That’s a hard question to answer—mainly because I was just trying to survive the best I could. I think that’s human nature. But I can say that I didn’t let the cancer break me. I didn’t let it break my dreams, and I didn’t let it break me. I didn’t, my brother didn’t, and my family didn’t. We didn’t let it define our lives. So, out of anything, I’m really proud of that.

Describe your process for writing a memoir and an album about your autobiographical experience with cancer. Did one come before the other? Did the writing emerge alongside the music?

I actually wrote the majority of this memoir before our album ever came to fruition. I’d been banging my head against a wall for about four years, struggling to write my book and yet convinced I would never finish it. Even if I did finish, I figured no one would give a shit. But I still had the title, Die Young with Me, floating around in my head.

After one especially brutal tour, I was going through some further health problems, and I wrote the song Die Young with Me in a pretty depressive state. When I played it for Nat, we realized that our collective songwriting was all pointing back to my battle with cancer. So we decided to run with it. Since I was afraid my memoir would never see the light of day, I included aspects, phrases, and titles from the book into those songs.

Making that album was a whole other battle. No one in our camp was interested in doing a depressing cancer album. We lost record labels, a booking agent, four band members, and two managers during the struggle to make Die Young with Me. It was just my brother and me on that album, like it was in the very beginning. But I think the final product and our relationship are better for it.

I finished my memoir in between tours. It’s interesting to me now, because the album serves as a soundtrack of sorts.

You describe your first YMCA show as “one of the best nights of [your] life” (p. 35). What do you think it is about early moments in a musician’s career that make them so memorable?

The early moments of a musician’s career are magical. I think that’s because they’re so full of possibilities. It’s the hard-won transition from fandom to legitimacy, you know? Finally, you’re on the level. You feel like you’re a contender, and that’s an amazing fucking feeling.

You aren’t jaded, you aren’t frustrated or exhausted, and you aren’t full of demands—you’re at the starting line of your very own adventure, and you’re just happy to be there, man.

Journalists often address your struggle with cancer in reviews and interviews with Blacklist Royals. Do you feel like a role model for cancer survivors in the music industry? If so, what kind of responsibility do you think musicians who overcame or are living with illness have to spread awareness about these conditions?

When I’m out with the band, it’s weird getting asked about being a cancer survivor, because the questions are usually superficial. (Did it, like, suck having cancer?) That being said, I personally think anyone with a public voice has a responsibility to use it. I don’t think I’m a role model, but I don’t really think it’s about that. I think I’m lucky enough to try to tell it like it is, in my music and words, and that hopefully it will make listeners empathetic, angry, or passionate enough to spur some sort of change, either internally or externally.

Maybe that’s just the old punk rocker in me—I’m pissed off, you’re pissed off, screw this shit, let’s do something about it!

You look back fondly in the book on your relationship with Ali but also come to acknowledge that she has become linked to a painful past for you. Do you think a girlfriend could have been a central part of your support structure after your illness as well as during it, like your family has proven to be?

I think the variable here is context—the relationship with my family started the day I was born, seventeen years before I got sick. But with Ali, I was sick the majority of the time we were together. Cancer was the overwhelming theme of our relationship, and it’s hard for anyone to build a healthy romantic relationship rooted in tragedy, especially at such a young age. Shit, we were just kids.

But I don’t think any girlfriend could have been there for me the way Ali was. She still swears she’s my “number-one fan.” Meeting a girl as an adult who’d offer me the kind of support Ali and my family did back then would be nice, sure . . . but I’m not holding my breath.

You have toured across the world, experiences that unfortunately fall out of the frame of this book. For curious readers, what is one of the most unlikely or strange things to happen to you on tour?

God, that’s another book entirely! Everything on the road is strange. It’s another dimension with its own norms, standards, and practices. But the things that stick out to me are sweet things—like the first time I met someone with my brother’s lyrics tattooed on their skin, or being in Germany and having someone show me an old Defiance of Authority CD they bought on eBay.

When things like that happen, it grounds me completely. It reminds me where I’m from, and where I’ve been since. The road has been the adventure that I always dreamed it would be, and I’m glad I haven’t reached the end of it yet.

Has the process of writing about your past made you wish you had done anything differently? With the benefit of hindsight, how would you deal with your peers who were insensitive to your condition?

The amazing thing about art is its ability to retroactively give meaning to the past—things I once regretted I can now, through the process of writing, accept as part of a bigger picture. So I don’t think I would treat my insensitive peers differently. Besides, getting to write about those assholes is vindication enough, and will hopefully encourage others to be a little more empathetic.

From the moment your cousin first exposes you to hardcore records in his basement to the moment you are singing onstage with Pennywise, you eloquently describe the attitude central to punk music. Is the punk-rock philosophy just as central to who you are today as a musician? What music do you listen to today that you could have never imagined at age eighteen?

The punk-rock attitude is still with me today. It always will be. It’s a philosophy that’s defined the trajectory of my life, for better or for worse. That skeptical view of society’s limitations that hooked me in as a kid, it never goes away. I hope it doesn’t, anyway.

These days, I listen to all types of music. As an adult, I can hear the loneliness and anger of punk in other music genres, only expressed in different ways. Paul Simon was just as sick of society as Joe Strummer was, he just had a different way of saying it.

That being said, I was listening to Don Henley all morning. I doubt teenage Rob would be too stoked on that.

Did you refer to any other rock biography or memoir while preparing your own story? What other books or media inspire you creatively?

I like rock biographies, but I didn’t refer to any while working on Die Young with Me, mainly because I’d never read a rock bio about an unsuccessful musician. The book that inspired me above all others had nothing to do with music at all, actually—it was Born on the Fourth of July, by Ron Kovic.

God, I remember reading that book like it was yesterday. I’ve always been interested in Vietnam-era culture, mainly because my dad never talks about his time overseas. I’ve read all the books, seen all the movies, heard all the CCR albums . . . but I’ve never read anything as powerful as Born on the Fourth of July—the way Ron Kovic described the war, the disability, the isolation, the hospital stays . . . it totally rocked me. The romance of Vietnam was stripped away, and all that was left was the raw, brutal truth. Man, it moved me like no autobiography ever had.

I remember thinking to myself that I’d love to write a book like that. I wanted to trash this romantic obsession our culture has with dying young. I wanted to make teenage cancer seem as real, and vicious, as it truly is. I didn’t want to pull punches. Life is too short for bullshit like that.

About The Author

Emily Beaver

Rob Rufus is a musician and writer living in Nashville. His band, Blacklist Royals, has released two full-length albums and played in sixteen countries over the past five years. His new project, The Bad Signs, released their first single in 2015. He is the author of Die Young with Me.

Product Details

  • Publisher: Atria Books (April 4, 2017)
  • Length: 400 pages
  • ISBN13: 9781501142628

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Awards and Honors

  • ALA Alex Award

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