Every Last Word, by Tamara Ireland Stone, is a young-adult novel published in 2015. Samantha McAllister, the book’s protagonist, is a junior in high school who suffers from Obsessive Compulsive Disorder (OCD). While Samantha appears like any average teenage girl, underneath the surface she is different from the majority of her peers: dark thoughts, incessant worries, and an obsession with the number three plagues nearly all of her waking moments. Through Samantha’s struggle to navigate the challenges of high school, Every Last Word intimately explores the effect of severe mental illness in the life of a teenage girl.

The novel opens with a brief vignette, set six months before the bulk of the narrative. The scene shows the extent of Samantha’s mental illness, and how profoundly it affects her life. It's Valentine’s Day and Samantha’s group of friends are on a school spirit committee responsible for preparing roses that will be distributed at their high school. The Crazy Eights, the nickname for Samantha’s friend group, are the popular girls at school—they are admired, hated, and feared by the general student body. While Samantha is cutting roses, a dark thought begins to consume her. She obsesses over the idea that she will take the scissors and cut Olivia’s hair off in one fell swoop.

The primary narrative begins as summer is ending: Samantha is a swimmer, and she's in the pool during one of the final swimming sessions of the summer. Swimming means more to Samantha than just a sports activity. In the pool, she can be her true self, in which she is not consumed with OCD thoughts. With the summer swim season ending, Samantha prepares to say goodbye to “Summer Sam,” which is the way she refers to the side of herself that is as relaxed and carefree as she is when not at school. School, and particularly her friendship with the Crazy Eights, exacerbates her OCD tendencies.

On the first day of school, the Crazy Eights wrap Samantha’s locker in festive paper as a surprise to celebrate Samantha’s birthday, which passed during the summer. Samantha meets Caroline, who is unlike the Crazy Eights: Caroline is dressed in loose denim and flannel, and she wears no makeup at all. Caroline tells Samantha that she knows of a secret club that will change her life. Caroline instructs Samantha to meet her on Thursday in the school theater, and she will show her the way. Samantha has weekly Wednesday meetings with Sue, her therapist. Sue is one of the only people who knows of Samantha’s illness. Samantha does not reveal that she has made a new friend with Caroline, but she is excited to meet with Caroline on Thursday to learn more about this life-changing secret club.

When Thursday arrives, Caroline leads Samantha down deep into the basement of the theater, into a hidden room that has walls plastered with poems, written on slips of paper all different sizes. The room is the meeting place for Poet’s Corner, a secret poetry club that meets every Thursday. AJ, the unofficial Poet’s Club leader, is hesitant to include Samantha at first, but over time allows her to join. Meanwhile, Samantha’s friendship with the Crazy Eights is on the rocks. At a birthday party for Alexis, the group goes to a spa where Samantha is ostracized by the group because she is among the least valuable members according to Alexis, the unspoken leader of the group. Samantha has such a terrible time at the spa that she ends up coming home early in tears, at which point Caroline meets her and they spend the rest of the evening writing poetry together.

Once Samantha discovers Poet’s Corner, she taps into her own love of writing. In a manic frenzy after her first encounter with the poets, Samantha spends all night writing poetry, which she is eager to share with the group. Meanwhile, her relationship with AJ intensifies into a crush. The feeling, it turns out, is reciprocated, and they end up coming together as a couple. Samantha’s friendship with Caroline also blossoms, while her relationship with the Crazy Eights becomes increasingly hostile and toxic.

Things seem to be getting better for Samantha. She is no longer performing her rituals around threes as much, and she feels more confident in her skin than ever. She even thinks it might be possible to stop seeing her therapist Sue for a while. After all, she is tired of feeling mentally ill—she wants to be normal, like everyone else. It is a huge devastation, then, when she asks AJ about Caroline and he recoils with horror and confusion. He explains that Caroline died in 2007, and so does not understand why Samantha is asking about her. Samantha insists that Caroline is real, that she was just talking to her. Caroline, it turns out, did die back in 2007, just as AJ said, when she committed suicide. It is later revealed that Caroline did so because she was bullied. When Samantha discovers that Caroline has been a figment of her imagination this whole time, she has a nervous breakdown, believing that AJ will no longer love her now that he sees she is mentally ill.

Once she recuperates, under the guidance of Sue, Samantha comes to understand that Caroline’s appearance was a dramatic coping mechanism that appeared to Samantha in times of stress. Unconventional though it may be, “Caroline” did help Samantha through difficult times, and the teen accepts this. Maybe it is crazy, but Caroline was helpful to her, and Caroline is part of the reason she is now empowered to be a better, happier person. Samantha makes other great strides when she breaks off her toxic friendship with the Crazy Eights. The novel concludes with Samantha accepting herself for who she is—a person who struggles with OCD, but also much more than that—and writing poetry in the theater seats just above Poet’s Corner.