Left on Tenth

Delia Ephron, a writer and screenwriter, opens her memoir in the summer of 2015, when her husband Jerry Kass's prostate cancer turned aggressive after six years with a terminal diagnosis. Their oncologist sent them home with a do-not-resuscitate (DNR) order. Delia was determined to let Jerry, a playwright and screenwriter, die at home in their Greenwich Village apartment. She reflects on their thirty-seven years together and describes Jerry as her first safe place after a difficult childhood in Beverly Hills. Her mother was emotionally cold and had an alcohol addiction; her father, though loving, had bipolar disorder and also drank.

By September, Jerry could barely walk, and Delia activated hospice care. His last meal was on October 18: Zabar's tuna salad on a bagel. After he collapsed days later, Delia called 911 as hospice instructed, but EMTs and police refused to honor the DNR and health-care proxy, a legal document designating Delia to make Jerry's medical decisions. After Delia broke down sobbing, they eventually relented. That night she slept apart from Jerry for the first time. She woke after 3:00 a.m. and found him no longer breathing. He died on October 22, 2015.

In the months that followed, Delia felt alien in her own life, persistently homeless since Jerry was what made their apartment a home. She planned his memorial, struggled with guilt, and found comfort in her neighborhood and loyal friends.

Ephron provides medical backstory. Her sister Nora had myelodysplastic syndrome (MDS), a bone marrow disease that often leads to acute myelogenous leukemia (AML). Because AML can run in families, Dr. Gail Roboz, director of the leukemia program at Weill Cornell Medicine, began monitoring Delia after a 2008 biopsy showed early warning signs. Nora decided against a transplant and died in 2012.

During her first year of widowhood, Delia scattered Jerry's ashes with friends in Wales and prepared her novel Siracusa for publication. She wrote a New York Times op-ed about battling Verizon over disconnecting Jerry's landline, which unexpectedly attracted male suitors, reminding her how vulnerable widowhood had made her.

Three days after the one-year anniversary of Jerry's death, Delia received an email from Peter Rutter, a psychiatrist and Jungian psychoanalyst (a therapist following Carl Jung's theories) in the Bay Area. Peter explained that Nora had set them up decades earlier when Delia was a college freshman, a date Delia had no memory of. He mentioned striking confluences: His late wife Virginia was also a Jungian analyst who died of lung cancer, their last trip was to Siracusa (the setting of Delia's novel), and he too had battled Verizon over his wife's phone. Stunned, Delia forwarded the email to her friend Jessie, who said Peter was worth getting to know.

Their emails intensified rapidly. Peter told Delia that when she asked how the subject of sexual boundaries found its way to his heart, he said aloud "Bashert," a Yiddish word meaning "destined soul mate." They moved to long phone calls, and Delia learned of Peter's devastating childhood: When he was seven, his mother was killed by a car near their Upper West Side building, and his father forbade the children from ever mentioning her. Nine days after Peter's first email, without having met, Delia wrote: "I MISS YOU."

They met on November 12, 2016. At dinner, Delia blurted, "We're not getting married this weekend," and they both laughed. The next day in Washington Square Park, they discussed falling in love at their age, when death is close. Delia told Peter about her abnormal bone marrow cells and gave him permission to leave if she got sick. Peter replied, "I could never do that." Over the following months, they fell deeply in love and spent New Year's at the Grand Canyon.

On March 9, 2017, at a routine checkup, Delia's blood counts came back abnormal. She had AML. Roboz told her about CPX-351, a new chemotherapy drug in final testing suited to her case. That Sunday morning, Peter said, "We should get married." She said yes. Delia checked into Weill Cornell, and that Saturday, Jessie performed their wedding in the hospital's fourteenth-floor dining room. After the chemotherapy tanked her blood counts and they slowly rebuilt, Roboz delivered the results: "Your marrow is gorgeous." Delia was in remission.

She published a New York Times piece revealing her diagnosis and marriage. But on November 30, 2017, a biopsy revealed early relapse. Roboz told Delia that AML is "like Whac-a-Mole" and the only cure was a bone marrow transplant. Dr. Koen van Besien, director of the stem cell transplant program at Weill Cornell, described an experimental haplo-cord transplant combining adult donor stem cells with umbilical cord blood. Many hospitals would not attempt the procedure on patients over seventy. Delia's odds were 20 percent, later raised to 40. Without the transplant, she had four months to live. She decided to go out fighting.

In February 2018, after conditioning chemotherapy, Delia received the adult donor's stem cells, followed the next day by the cord blood. Ten days later, her marrow began producing white cells. But she then deteriorated, spending five days in the ICU she has no memory of. She begged Peter to let her die. He refused, tracking her climbing blood counts. She texted Roboz: "Please let me go." Roboz arrived and offered a bargain: "Give me forty-eight hours, and if I get somewhere, give me another forty-eight." After maximum diuretics flushed fluid from Delia's lungs, her supplemental oxygen was turned down and her saturation held.

She woke to a bright room, off oxygen, her depression lifted. On May 12, 2018, after seventy-five days in the hospital, she went home. She hired a physical therapist who came five days a week and rebuilt from nothing: learning to stand, climb stairs, and walk to the corner. By July, she needed no transfusions and was producing her own healthy blood.

At a 2019 appointment, van Besien said something Delia heard as a countdown to relapse. She carried the fear for months until Peter insisted van Besien had said the opposite: After two years, the disease was unlikely to return. Peter was right. Delia's brain, conditioned by fear, had flipped positive to negative. Gradually she reentered life, adopting a Havanese puppy named Charlotte and collaborating with a composer on a musical adaptation of The Lion Is In, which coaxed her back into writing. She contacted her stem cell donor, Casey McClaine, who told her, "I was floored that I had the chance to help somebody."

In February 2020, at the two-year milestone, van Besien told her: "This is a social visit. Now your chances of getting leukemia again are the same as mine and I've never had it." Delia and Peter rode the Q train home, the subway once forbidden now reclaimed. Ephron reflects that she was not brave but fortunate: Her disease arrived at a time of scientific discovery, she had great medicine and great love, and an extraordinary amount of luck. She frames her survival as a confluence of new drugs, the haplo-cord transplant, doctors willing to treat patients over seventy, devoted friends, and Peter's steadfast presence. Most happily, she is writing again every day, and the book she is writing is this memoir.