Hope chose to go back with Josh the jerk because Tru had told her that he couldn't have any more children. She marries Josh and he cheats on her repeatedly. But she stays with him for far longer than a normal person would have.
She ends up back on the same beach and runs into Tru (after he runs into people who "know " Hope in Africa.) They meet up and declare that they never stopped loving each other. Only for Hope to admit that she has too been diagnosed with ALS. (Puke)
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