"Starfish" stems from Alice's mother's death. Alice was studying Medicine at university when her mother was diagnosed with cancer. Alice, therefore, was in a unique position to care for her mother at home due to her training. The book delivers an honest, open account of caring for someone who is dying from a personal but also clinical point of view. It demonstrates just how much love for someone can hurt.

Subsequently, when Alice's mother died, she attempted suicide. Alice was admitted to a psychiatric unit and the novel follows her as she struggled to live a life without her best friend, her mother. Alice was diagnosed with depression and was transported from working in hospitals to being a patient. She found this transition hard at the beginning and could not comprehend how to live. She received much support from various clinicians and slowly began to rebuild her life.