Letters

If you look closely, you can see that the faces are made up of "I Love You"

This sketch was inspired by the movie My Japanese Wife... (the lady in the picture's not Japanese, though)

For those who have never watched it, the movie is about a Bangladeshi man and a Japanese woman who were married for 15 years, and the only way they have ever communicated with each other is through letters and photos, since both of them were very poor. Also, many difficult obstacles come in the way of them meeting.
And at the end of the movie, the wife has cancer, yet the husband dies of pneumonia on their 15th anniversary.