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I found this book strangely riveting but ultimately preposterous and overtly preachy, and probably better for those over the age of 10, not the 8-12 age range suggested by the publisher.
I should note that it is physically quite cute and charmingly small. The design of the book was clever. The illustrations are few and contain mostly objects or body parts of characters, e.g. the father's legs. This was disappointing because I quite like Jon Klassen's work in other books.
The main character, Steve, wrestles with various life issues essentially alone (with an impression of minimal parental involvement but a trip to the therapist) as his parents are busy with his new brother's (only vaguely alluded to) health problems. He discusses throughout the book his lack of religious environment and confusion about quite how to deal with these pressing issues of life, death, and illness.
The author involves EpiPens so often they were almost a supporting character, but unfortunately got a few things wrong about them -- they do not, as the character in the book says, need to be used on bare skin, and the wrist is not the ideal spot for injection. It is certainly a good idea to have a character with a life-threatening allergy, but I felt this was not handled as well as I would have hoped, especially as he seemed to think it was fine to expose himself to allergens as long as he had the EpiPen in hand.
I felt the entire premise was so patently ridiculous that I could never suspend disbelief. Also, while the idea of imperfection/perfection is an interesting one, its examination felt forced and cheesy in this book.