When Blood Breaks Down: Life Lessons from Leukemia

This fascinating debut from Sekeres, director of the Cleveland Clinic’s leukemia program, follows the stories of three composite characters based on real patients he’s treated during his career. Joan, a 48-year-old mother and surgical nurse, is informed she has a white blood cell count “over 15 times higher than normal.” David, a 68-year-old grandfather, is told that the cure rate for his age group and type of leukemia is fewer than 10%, while Sarah, a 36-year-old in the second trimester of her pregnancy, faces making choices both for herself and her unborn baby. Through reconstructed conversations with the patients and their families, Sekeres explores the different factors that go into cancer care choices, including quality of life and considerations for one’s loved ones. He also looks at how physician opinion influences patients’ decision-making and at how the high cost of medical care can be a deterrent to getting sufficient treatment. Tracing the characters’ progress, Sekeres shows them gaining hope during remission, and experiencing despair at setbacks. Their different outcomes allow him to examine various treatment options, from ongoing chemotherapy, to bone marrow transplant, to hospice. This is a powerful look at a disease that forces patients to make “decisions that no person should ever have to make.” (Apr.)