This is NPR's Life Kit, with tools to help you get it together.

Isabelle Stenzel Burns has said a lot of goodbyes. In fact, she says she spent her entire life

practicing the art of saying goodbye. Everybody practices saying goodbye, but for me because I was born

with cystic fibrosis, I went to a cystic fibrosis summer camp and throughout my adolescence and

adulthood I have befriended and loved my peers with cystic fibrosis and sadly I also lost them

one after the other starting at a very young age. Isabelle dealt with a lot of loss early on,

but she didn't face it alone. Anna was my identical twin sister. I did not know life without her

for 41 years. She was my sidekick, my soulmate, my best friend. Sometimes my arch enemy just

because that's what sisters are and we shared a life that was very unique because of our genetic illness.

Both Anna and Isabelle were born with cystic fibrosis, a progressive illness that damages the

lungs and other organs. It was a condition that put them in and out of hospitals constantly.

We both were afraid of death and how long would we live, but we also shared a joint passion for life,

knowing that our time could be limited. We knew from an early age that one of us would die first

and we actually practiced that. Readying themselves for that final goodbye was a big part of their

shared existence. We led sort of a, how can I say it, a confusing life where we prepared for death

and then we were reborn and then we prepared for death and then we were reborn and finally,

finally she was diagnosed with cancer, stage 4 cancer and this was it. We finally recognized that

our journey together was coming to an end. Anna died in 2013. Even though she always knew that day

would come, Isabelle's grief loomed large. The finality and the complete separation of

someone as close as my twin was very difficult, but I pursued things that made me feel close to her.

I also strengthened my relationships with friends and family and of course my spouse and that really

helped me kind of dig myself out of the whole of grief. Today, Isabelle is a grief counselor

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