Instructions for a Secondhand Heart is a love story with a tear jerking twist: Jonny has lived for months in the hospital hooked up to machines that keep his heart beating — or, as he wryly puts it, he’s a robot with a mechanical heart. In a nearby town, twins Neve and Leo race up a dangerous boulder ostensibly to win bragging rights, but for Neve, it’s a rare opportunity to beat her seemingly perfect twin. When a tragic accident occurs, Jonny finally gets his wish to leave the hospital and return to school, and Neve has to live forever with the guilt over her role in the accident.

The story takes off when Jonny decides to learn more about the boy whose heart has given him a chance at a healthy life. He reaches out to Neve with a cover story, hiding the truth about his link to her family. Neve in turn is tired of being defined in opposition to her twin, and welcomes the chance to be with a guy who she believes knows nothing of her twin and therefore whose relationship with her is completely separate from the rest of her reality.

Instructions for a Secondhand Heart is a pretty good YA contemporary romance that may appeal to fans of The Fault in Our Stars. My main reservation with this book is that I never really felt the chemistry and attraction between Jonny and Neve. Jonny’s attraction to Neve seemed more an obsessive curiosity about Leo, and Neve’s attraction to Jonny seemed more a desire to escape talk about Leo. So when they suddenly profess to real feelings, the reveal felt insincere.

I personally thought Jonny had more of a spark with Em, his best friend from the hospital who is living with cancer and for whom Jonny sketched a superhero alterego who fights off evil blobs. Em was probably my favourite character in this book, and I thought she deserved a much better ending than she got. I thought her friendship with Jonny seemed very strong, and even if he didn’t reciprocate her feelings, he could’ve been more sensitive in how he treated her. The book also includes Jonny’s sketches of both Em’s superhero alterego and Neve, which I thought enhanced the story beautifully.

Jonny and Neve were compelling characters mostly because of their stories beyond the romance. I liked seeing Jonny readjust to life outside the hospital and try to fit in at school. I also felt for him when he tried to join activities Leo did, to somehow make himself ‘worthy’ of receiving Leo’s heart, even though Leo’s life was clearly the wrong fit for his personality. Neve in turn had a prickly, defensive posture throughout, which took her a bit longer to warm up to, but I like how Murray explores the psychological trauma Neve and her family struggle with after Leo’s death. I can sympathize with Neve wanting to stop talking about Leo all the time, and with her corresponding guilt at the desire to forget him even for a moment. These pieces seemed sincere, and the romance felt incongruous in contrast.

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Thank you to Hachette Book Group Canada for an e-galley of this book in exchange for an honest review.