That Time I Got Cancer: A Love Story

Book Title: That Time I Got Cancer: A Love Story

Author: Jim Zervanos

Publication Details: Köehler Books, 2022, 228 pp., $19.95, paperback

Jim Zervanos first seeks help when his face turns dark purple after a shower. An MRI shows a puzzling narrowing of the superior vena cava (SVC); physicians initially believe the problem is a clot. A biopsy is impossible because of the location inside the vein, and cancer is not suspected due to the presentation. The attending tells Zervanos, “You’ve stumped some very smart people who do not like to be stumped” (p. 14). That Time I Got Cancer begins when Zervanos is a healthy 41-year-old high school English teacher out on a walk with his toddler son, Nikitas. This is a memoir of his journey with cancer.

The initial chapters are gripping as the medical mystery deepens. Eventually, the team learns he has an atypical lymphoma obstructing his superior vena cava (SVC). They initially believe this condition is inoperable, but a new cardiovascular surgeon, Dr Pochettino, reconstructs the SVC using CorMatrix, a porcine intestine material.

Along the way, Zervanos describes mistakes made by the care team (eg, casually mentioning that his lymphoma might have returned, ignoring the patient’s perspective, contradicting other physicians’ opinions without helping Zervanos navigate those uncertainties, and even playing Jon Secada’s ¹ “Just Another Day Without You” during a venogram at a time when Zervanos believes he is dying from the obstruction). His depictions of these lapses are thoughtful and humorous.

Much more of the book, fortunately, tells the story of what Zervanos’ physicians did right. Most of them are empathetic and competent, sharing decision-making with him; this support helps him get through the initial surgery, the chemotherapy, and a subsequent distressing narrowing of the healing graft to 5 millimeters.

The most engrossing and valuable portions of the book explore the spiritual dimensions of Zervanos’ experience. He relies on his faith, on mindful meditation, and on visits from friends and clergy members. Zervanos forges deep connections with new mentors, including Peter Bloom, a psychiatrist who was a medical school chum of his father’s. Bloom teaches Zervanos a mantra from Jon Kabat-Zinn’s Full Catastrophe Living (p. 106), ² the irony of which does not obscure its higher purpose: “Every day, in every way, I’m getting better and better.”

This spiritual reckoning, along with the helplessness of his illness, changes his interactions with friends who had not yet confronted major illness. In one passage, both sad and funny, his friends are writing about their physical training regimens (ie, red meat, sex twice a day, running 12 miles several times per week): “These friends were caricatures of vitality, while I was a slug.” He responds with, “I’m all about drugs these days. Rituxan, Adriamycin, whole bags of it, right into the vein, bitches. 100 milligrams of prednisone, four days in a row, really gets my blood pumping, the muscles jacked” (p. 126). Throughout the book, Zervanos eloquently conveys the sense of wonder and heightened appreciation for the beauty of everyday life that he developed during this journey. “Such was the struggle I tried to welcome, the price to pay for a life filled with love” (p. 62). Or

A considerable portion of the memoir tracks the impacts on his marriage to Vana, who is as supportive as humanly possible. She endures the emotional challenges of first accepting his terminal diagnosis, then rejoicing at the news that he might survive, all while raising a toddler, visiting Zervanos in the hospital, and missing a job she loves. She feels torn and guilty, unable to meet everyone’s emotional needs. The book is framed by scenes from their marriage, showing the toll cancer takes on both of them.

I already have considered recommending this book to a young man experiencing a devastating illness. However, I am held back by the fact that this patient lacks the extraordinary privileges that helped Zervanos thrive. Those include an exceptional support system, extremely well-connected family members who served as advocates, and access to world-class care. This comparison of situations might be discouraging to my patient. I would instead recommend this book to physicians interested in exploring the spiritual dimensions of catastrophic illness. It will help them deepen their understanding of patients enduring such difficult realities and will help them explore sources of strength they might draw on when facing their own inevitable mortality.