When Blood Breaks Down

When Blood Breaks Down

Life Lessons from Leukemia

By Mikkael A. Sekeres

A leading cancer specialist tells the compelling stories of three adult leukemia patients and their treatments, the disease itself, and the drugs developed to treat it.





A leading cancer specialist tells the compelling stories of three adult leukemia patients and their treatments, the disease itself, and the drugs developed to treat it.

When you are told that you have leukemia, your world stops. Your brain can't function. You are asked to make decisions about treatment almost immediately, when you are not in your right mind. And yet you pull yourself together and start asking questions. Beside you is your doctor, whose job it is to solve the awful puzzle of bone marrow gone wrong. The two of you are in it together. In When Blood Breaks Down, Mikkael Sekeres, a leading cancer specialist, takes readers on the journey that patient and doctor travel together.

Sekeres, who writes regularly for the Well section of the New York Times, tells the compelling stories of three people who receive diagnoses of adult leukemia within hours of each other: Joan, a 48-year-old surgical nurse, a caregiver who becomes a patient; David, a 68-year-old former factory worker who bows to his family's wishes and pursues the most aggressive treatment; and Sarah, a 36-year-old pregnant woman who must decide whether to undergo chemotherapy and put her fetus at risk. We join the intimacy of the conversations Sekeres has with his patients, and watch as he teaches trainees. Along the way, Sekeres also explores leukemia in its different forms and the development of drugs to treat it—describing, among many other fascinating details, the invention of the bone marrow transplant (first performed experimentally on beagles) and a treatment that targets the genetics of leukemia. The lessons to be learned from leukemia, Sekeres shows, are not merely medical; they teach us about courage and grace and defying the odds.


$26.95 T ISBN: 9780262043724 328 pp. | 5.375 in x 8 in 22 b&w illus.


$17.95 T ISBN: 9780262542258 328 pp. | 5.375 in x 8 in 22 b&w illus.


  • [A] fascinating debut…This is a powerful look at a disease that forces patients to make 'decisions that no person should ever have to make.'

    Publishers Weekly

  • What makes this narrative so compelling is the author's ability to bring readers with him on his rounds as he meets each patient and family member, discusses treatment options, and follows them through weeks of treatment, reviewing lab results and bone marrow biopsies, and, when necessary, discussing next steps such as bone marrow transplants...That three patient narratives should prove so effective a lesson is a tribute to Sekeres as both storyteller and physician.

    Kirkus Reviews

  • With grace and fluency, Sekeres offers more than a scientific portrait of leukemia; he also includes personal stories about the origins of the disease; the complexities of the doctor-patient relationship; and how leukemia treatment, such as chemotherapy, can impact patients along with their families. Sekeres combines literary substance with significant medical information and data. The engaging stories in this book, both personal and scientific, make it a good choice for readers interested in solid literature on medicine, especially cancer research.

    Library Journal

  • A look at leukemia patients' fear, survival and grace while fighting the disease...a quiet chronicle of life with and beyond leukemia, and sometimes life's end.

    Washington Post The

  • Dr. Sekeres accomplishes something that most authors in this genre fail to do: He wrote a book that will capture the imagination of the scientific and medical audiences, along with the lay public...Readers will be elevated by the grace and humanity on page after page.



  • Sekeres nimbly unravels the mysteries of leukemia, while gently probing how human beings navigate the shoals of cataclysmic disease.  Fascinating tales of historical and current research are deftly woven into the poignant stories of his patients. Absorbing and moving.

    Dr. Danielle Ofri

    author, When We Do Harm: A Doctor Confronts Medical Error

  • A remarkably talented physician-author and humanist elegantly tells the stories of his patients.

    Eric Topol

    author of Deep Medicine; EVP, Professor of Molecular Medicine, Scripps Research

  • In this powerful and wonderfully written book that both educates and moves you, Sekeres writes with the authority and compassion that comes with decades of practice.

    Siddhartha Mukherjee

    Pulitzer Prize winning author of The Emperor of All Maladies: A Biography of Cancer

  • Sekeres is our unflinching and compassionate guide into the heart of a complex and often terrifying disease. There are few physicians who are as accomplished as he is and yet whose sentences pulse with clarity, warmth, and humility.

    Jay Baruch

    author of What's Left Out and Fourteen Stories: Doctors, Patients and Other Strangers