Non-Hodgkin lymphoma (NHL) is a group of blood cancers that originate in the lymphatic system, part of the body’s immune network. According to the American Cancer Society, approximately 80,000 new cases of NHL are diagnosed annually in the United States, making it one of the most common cancers nationwide (“Key Statistics for Non-Hodgkin Lymphoma.” American Cancer Society, 13 Jan. 2026). Treatment typically involves chemotherapy, immunotherapy, radiation, or a combination, and while many patients achieve remission, relapse is a significant concern. In Rewind It Back, Hallie’s father is diagnosed with NHL when Hallie is 19, and his subsequent relapse several years later underscores the disease’s unpredictable trajectory. The persistent threat of recurrence shapes the novel’s emotional landscape, as Hallie remains in a state of perpetual vigilance, bracing for bad news each time her father or brother calls.

Clinical trials offer patients access to cutting-edge therapies, particularly when standard treatments have been exhausted or when a relapse occurs. Hallie relocates her father to Minnesota specifically because a childhood friend of his practices at one of the state’s leading cancer research hospitals, securing him a spot in a trial. However, clinical trials frequently impose significant hidden costs on participants. A 2024 study found that nearly half of early-phase cancer clinical trial participants spent at least $1,000 per month out of pocket, with uncovered expenses including travel, housing, time off work, and non-standard-of-care procedures (Williams, Courtney P., et al. “Understanding the Financial Cost of Cancer Clinical Trial Participation.” Cancer Medicine, vol. 13, no. 8, 2024). Tomforde dramatizes this financial reality through Hallie’s confession that the trial didn’t cover “housing or moving expenses” and that “there was no caregiver stipend” (293), contrary to what she told her father. To bridge the gap, she takes out loans, sacrificing her own financial stability to ensure that her father receives treatment he might otherwise refuse.

The resulting medical debt becomes one of the novel’s central tensions, illustrating a crisis that extends well beyond the world of the novel. A 2022 investigation found that roughly 100 million people in the US carry some form of health care debt, with the burden falling disproportionately on younger adults and those without robust support systems (Levey, Noam N. “100 Million People in America Are Saddled With Health Care Debt.” KFF Health News, 16 Jun. 2022). As a young woman without a partner, a second income, or family wealth to cushion the blow, Hallie embodies this demographic. Her debt forces her to work simultaneous jobs at the design firm and a downtown bar, struggle to pay for groceries, and drive a deteriorating car she can’t replace. By grounding Hallie’s struggles in the realities of cancer treatment costs and inadequate financial protections for trial participants and caregivers, Tomforde offers commentary on how illness reshapes lives far beyond the patient. Hallie’s debt is the result of a healthcare system that often demands the most from those who can afford the least.