Each year when I see my doctor for my routine appointment, it comes up. Usually with a nurse, someone who is kind but impersonal, working their way through the checkboxes marking my family medical history, glossing over my paternal grandmother’s stroke and my mom’s diabetes, smoothly scrolling down until they pause on my siblings.

“And you have a sister who is deceased?” she asks me today, like I knew she would. On her screen I can see the mouse hovering over the electronic record. In a small box, the brief details: Breast cancer diagnosed at age 23, died at 28.

“Oh,” she says, dismay and pity implicit in her tone. And I look away, trying to hold on to my composure, fumbling in my purse for a Kleenex as it deserts me.

She notices, and as I try to wave away her concern, she grabs me and pulls me in for a tight hug.

“I’m so sorry,” she says. “I lost a sister too – not from breast cancer, but – you know, you never really do get over it.”

Why does this get me every time? I wonder. Almost nine years later, and it still singes my heart.

It’s the best and worst time of the year. The lingering warmth of summer, leading to the crispness of fall, is my favorite time of the year — yet it’s also the most bittersweet.

A couple of weeks ago, I was at Madeline Island. As my mom and I sat by the beach, toes in the sand, we talked about all of the good memories we’ve compiled from more than twenty years of visiting each summer, pausing to talk about the hard times too. Woven in our good memories of campfire s’mores and ice cream cones from Grampa Tony’s are painful memories of days where Katrina was too sick to get out of bed, her misery a palpable presence even the sunny days couldn’t diminish. That final year, we left the island earlier than we’d intended. And as the summer waned into the fall, her hospital stays got longer, her good days shorter.

This fall, the hard memories have risen to the top a bit more than usual. We got the chance to spend time with an uncle I’ve only gotten the chance to know in the past couple of years, whose failing health and recent passing can also be blamed on cancer, just like Kate’s. And I once again felt torn. The part of me that wants to cherish every moment battled with the part of me that can’t help but remember all of the pain of the past, buried and now revived. The old cancer battle merges with the new until the indignities of illness simply seem unbearable.

And yet — for all the pain of those final months with my sister, I cherish those days as some of the sweetest, too. Because when it comes right down to it — when everything is stripped away, and the veil between this life and the next seems thin — all that’s left is what really matters.

And I was reminded of that a couple of weeks ago at my cousin’s wedding as I spoke quietly to my uncle, wrapping up the evening and saying what became our final goodbye.

“You know I love you, right?” my uncle said gruffly, gravely. And I smiled and told him that I love him, too. The sweetness of that — of knowing that beyond any pain, any circumstance, love remains — makes the unbearable bearable, the bitterness sweet.

“Trust steadily in God, hope unswervingly, love extravagantly. And the best of the three is love.” 1 Corinthians 13:13b