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Emerging from a ‘twilight world,’ Delia Ephron offers a harrowing story of loss and survival

Left on Tenth: A Second Chance at Life

By Delia Ephron

Little, Brown and Company, 304 pages, $29

If you’re expecting a light, frothy read, Delia Ephron’s “Left on Tenth” isn’t your book. You’ll need to brace for (emotional) impact if you pick up this memoir of late-life love and life-threatening illness.

Ephron was the frequent writing partner of her more famous older sister, Nora, who died in 2012 of complications of acute myeloid leukemia (AML). Delia also is a successful humorist, essayist and novelist (“Siracusa,” “The Lion Is In”) in her own right, and she knows how to grip a reader with plot twists and punchy prose.

Her title, “Left on Tenth,” is a double entendre referencing abandonment – and directions to her Greenwich Village apartment. The narrative starts with loss: the illness and death of Ephron’s husband, the playwright and screenwriter Jerome Kass. It morphs into a tale of new romance with an almost-too-good-to-be-true man from Ephron’s past. Then it descends to the familiar terrain of the illness memoir, by turns hopeful and harrowing.

Delia and Nora Ephron

Sisters: Delia Ephron with her sometime writing partner Nora. By Getty Images

The book exists, so we surmise that, unlike her sister, Delia has survived.

Her tribulations are many, but, as she periodically reminds us, so are her resources: She has money, access to top-flight doctors, a steadfast second spouse, and an abundance of devoted friends – so many that it can be hard for readers to keep track. The book is semi-epistolary, filled with email exchanges demonstrating that devotion.

As “Left on Tenth” begins, Ephron learns that her husband’s prostate cancer has taken an aggressive turn. He has been her soulmate and professional sounding board, and they have led a charmed life. “We knew that we belonged together and the fact that we’d found each other was the luckiest thing,” Ephron writes.

When Ephron realizes that their time together will be cut short, she rehearses being without him, a manifestation of anticipatory grief. When he dies, in home hospice, she is 71 and has been enduring high anxiety for years — over his fate, her sister’s illness and death, and her own possible susceptibility to AML.

Luck figures mightily in what happens next. After she disconnects her husband’s landline, her frustrating misadventures with Verizon inspire her to write an op-ed for The New York Times. That gets the company’s attention, and she ends up with her own personal Verizon representative. More important, the piece prompts an email overture from Peter Rutter, a Jungian psychiatrist, widower and long-ago admirer with his own Verizon woes.

It turns out that Nora fixed the two up when they were in college. They had a few dates, of which Delia retains no memory. Now, Peter, though living in the Bay Area, is interested in rekindling that old attraction.

After an understandably cautious start, Ephron plunges into a correspondence leading to impassioned phone calls and a whirlwind, sexually electric, bicoastal romance. The two act like lovestruck teenagers. “I was aware every second of what a gift it was,” Ephron writes.

But trouble looms. Since AML runs in families, an oncologist, Dr. Gail Roboz, has been monitoring Ephron’s blood regularly. And just as her romance with Peter is taking off, she is diagnosed with leukemia.

Peter flies to her side, rearranging his own life, moving his patients to remote sessions. Ephron has no interest in immersing herself in medical details, so Peter shoulders that load, too. He proposes that they marry, and the ceremony takes place in the hospital.

A then-experimental chemotherapy drug, CPX-351 (now called Vyxeos), puts Ephron into remission. She and Peter seize the opportunity to travel to Europe and visit her closest friends, who live in Wales.

But the remission is more short-lived than expected. When the cancer returns, it becomes clear that the best – the only – hope of a real cure is a stem cell transplant, a grueling procedure rarely attempted on those over 70. (For a variety of reasons, Nora didn’t get one.)

Medical technology has advanced, and Ephron no longer needs a perfect (adult) match; instead, she receives a haplo-cord transplant, combining adult stem cells with those from baby cord blood. For patients, it’s an ordeal with no guarantee of success. “Don’t be scared of the treatment,” her oncologist tells her, “be scared of the leukemia.” Those words become Ephron’s mantra.

The cover of Delia Ephron's 'Left on Tenth'

Telling Her Story: Delia Ephron’s latest book is a story of confronting illness and finding love. By brown and co., little

Before the transplant, she endures a brutal chemotherapy regimen. And though the transplant goes well, the aftermath includes terrible side effects and complications. Ephron is nauseous, exhausted, frail. She becomes so emaciated and distraught, so clinically depressed, that she longs for death. “All I want is blackness,” she writes. “An empty screen.”

At her lowest point, Peter and her close friends offer unstinting support. Her doctors encourage her and do their best to alleviate her symptoms. Recovering, finally, at home, she must spend a year “in a twilight world” of semi-isolation and enforced restrictions – an eerie precursor to pandemic lockdown. One imagines that when that crisis arrived, Ephron, resilient and enveloped in love, was more than ready for it.

Julia M. Klein, the Forward’s contributing book critic, has been a two-time finalist for the National Book Critics Circle’s Nona Balakian Citation for Excellence in Reviewing. Follow her on Twitter @JuliaMKlein

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