In 1999, when Aronofsky turned 30 years old, his parents were diagnosed with cancer. He began reflecting on human mortality, "That was a really heavy-duty emotional time. I know it's a very young age, but turning thirty marks when your twenties are over and you could start considering, 'Wow, one of these days I'm actually going to die.'" While his parents overcame cancer, he began to focus on the concept of a young man saving a loved one from a life-threatening disease. He shared the concept with Handel, his undergraduate school roommate at Harvard University. Handel earned a Ph.D in neuroscience from New York University but was uncertain about a future in neuroscience. He recalled the discussion, "Darren and I just started talking about the story. We kept wanting to talk more about it as the story kept getting bigger. I decided to make some life choices to continue working with Darren, because it was so much fun."