Ryan Altenburg is dying from extensively drug-resistant TB he contracted in Africa. Sitting in quarantine, he contemplates his failures in love and composes five letters to the women whom he never got over and an elegy. He asks his brother to only send the letters upon his death. But his oldest brother Declan sensing Ryan does not want to live, sends the letters to two of the women hoping they will help him find a reason to live. Will they? Or has too much time passed? Five Letters and an Elegy is a deeply thoughtful novella powerfully capturing a young man's desperate struggle to make sense of failed love.