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An Exercise in Uncertainty: A Memoir of Illness and Hope
In this thought-provoking memoir, an award-winning journalist explores the chaos, doubt, and search for meaning that come with staying one step ahead of cancer for decades.
At age thirty-eight, Jonathan Gluck, a new father with a promising journalism career, was shocked to learn he had multiple myeloma, a rare, incurable blood cancer. He was told he had eighteen months to live.
That was more than twenty years ago.
Gluck isn’t just something of a medical miracle. He’s also part of a growing population. Thanks to revolutionary medical advances, many cancers and other serious illnesses are no longer death sentences but chronic diseases many people live with for years. While doctors continue to look for “magic-bullet” cures, they can now extend many patients' lives by slowing the progression of their diseases one treatment at a time. The result is a strange, new no-man’s land between being sick and being well where Gluck and millions of others reside.
In An Exercise in Uncertainty, Gluck maps this previously uncharted territory. Among the many vexing side effects of chronic illness he explores is uncertainty—never knowing from one day to the next how one’s illness might change them physically, emotionally, spiritually. When you have an incurable disease, how do you cope with knowing that even when you’re in remission, it will eventually return? How do you live with the anxiety, the fear, the near-constant awareness of your mortality? For Gluck, one surprising answer is fly fishing. If you’re looking for peace in your own sea of uncertainty, it might be something else.
As Gluck will be the first to say, cancer has absolutely nothing good to offer, but almost dying has taught him valuable lessons about how to live.
At age thirty-eight, Jonathan Gluck, a new father with a promising journalism career, was shocked to learn he had multiple myeloma, a rare, incurable blood cancer. He was told he had eighteen months to live.
That was more than twenty years ago.
Gluck isn’t just something of a medical miracle. He’s also part of a growing population. Thanks to revolutionary medical advances, many cancers and other serious illnesses are no longer death sentences but chronic diseases many people live with for years. While doctors continue to look for “magic-bullet” cures, they can now extend many patients' lives by slowing the progression of their diseases one treatment at a time. The result is a strange, new no-man’s land between being sick and being well where Gluck and millions of others reside.
In An Exercise in Uncertainty, Gluck maps this previously uncharted territory. Among the many vexing side effects of chronic illness he explores is uncertainty—never knowing from one day to the next how one’s illness might change them physically, emotionally, spiritually. When you have an incurable disease, how do you cope with knowing that even when you’re in remission, it will eventually return? How do you live with the anxiety, the fear, the near-constant awareness of your mortality? For Gluck, one surprising answer is fly fishing. If you’re looking for peace in your own sea of uncertainty, it might be something else.
As Gluck will be the first to say, cancer has absolutely nothing good to offer, but almost dying has taught him valuable lessons about how to live.
304 pages, Hardcover
Published June 10, 2025
106 people are currently reading
2838 people want to read
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Displaying 1 - 28 of 28 reviews
September 8, 2025
Fantastic book
I could not put this down. As someone who has an incurable disease, I found the emotional roller coaster portrayed here, to mimic my own, but also give me hope for how to live life to the fullest, even if I can’t change my circumstances.
This book also acknowledges the difficulties families, spouses and children go through when someone they love is sick.
Very well written by a man who has numerous accolades in the publishing business.
I could not put this down. As someone who has an incurable disease, I found the emotional roller coaster portrayed here, to mimic my own, but also give me hope for how to live life to the fullest, even if I can’t change my circumstances.
This book also acknowledges the difficulties families, spouses and children go through when someone they love is sick.
Very well written by a man who has numerous accolades in the publishing business.
September 9, 2025
Well written with some great descriptions of disease but I have to say if you are IN the throes of uncertainty, I think the book strikes an overall depressing tone. In my opinion it is not going to help you live better in it unless you want a reminder that it sucks for others as much as it sucks for you. I think there is much more to this path of uncertainty than this book offers.
June 7, 2025
Or 10% unhappier.
This is a memoir of the author’s life, in particularly as it relates to his diagnosis of multiple myeloma,* which is a type of blood cancer. The author is an accomplished journalist, and so he approaches it in a journalist-like manner. This is excellent at the points where he is discussing cancer and cancer therapies in general. Emperor of All Maladies is legendary, but I came out of this feeling better informed from that book due to that journalistic edge. Sometimes the tendency towards journalism hurts when the book shifts into interview-mode with some of its participants, which does not match with the rest of the book.
The other problem with the journalism is how the author comes off. I do not complain about coastal media elites as a dogwhistle. I complain about them in a Third Coast, Second City, my Daniel Burnham can beat up your Robert Moses sort of way. With travel and sport writing, complete with a fly fishing metaphor, completes my sort of utter disrespect. There is some mirror-universe review here where I write 800 words on the relevance of the author’s gender* to this writing in comparison to other similar texts. And with the valid prefatory mention of how much insurance sucks - it does - the focus here is on someone getting a high level of care, from a variety of high-skill providers in a hermetic world.
But do not listen to that me: this book rules.
The defining quality is that the author has cancer for 20 years. It has always been deleterious to his life, and he is plain and excoriating about it. But the medical advances that prolong the author’s life and quality of life are happening in real time across the course of the text. He avoids getting too philosophical with it, but he is also aware of the question that medicine raises. As much as there is a social norm of health/sickness, increasingly people live in the slash*. Most of the books I have read that dealt with this treat it as more of an ethical failing or social crisis: the bigotry against the disabled. This book is aware of it, and raises it when appropriate, but is much more interested in the materialist side. Language fails to cover what this new state is and what it means for society. This then is not a philosophical treatise on that novel-ish state, but a description of it, emotional and provocative.
The writing again belays the author’s training. It is foremost accessible, neither plain nor elaborate but what it needs to be when it needs to be to do the job of explaining that it wants to. It moves along at a good clip and the sort of sections and microchapters work well. There is excellent signaling, not foreshadowing but good work in laying the flags out for future events. The ending is weak, thankfully, as the author is alive.
The sort of work and research here is exactly the same that the current U.S. administration has destroyed, and with knock-on effects promising that the sort of world this book explores will not expand and will retract, leading to your friends dying. And while it is easy to complain about the author’s privilege and access to the best experts for instance, the anti-science positions of the administration mean that even the well-off will not be able to reap the benefits, since no one will have done the work. So while this book avoids politics, feel free to use it as an example to your well-meaning idiot friends as to the hope we will not see.
My thanks to the author, Jonathan Gluck, for writing the book, and to the publisher, Rodale, Inc., for making the ARC available to me.
-
* - Conflict of interest(?) disclosure: I have a first-order relative who also has this cancer, and I have been involved in their care. I have also been the bad guy in the relationship with someone with chronic illness. And I am at or near that slash, and, notably, forget that I am sometimes, which feels pretty relevant for the text in general.
This is a memoir of the author’s life, in particularly as it relates to his diagnosis of multiple myeloma,* which is a type of blood cancer. The author is an accomplished journalist, and so he approaches it in a journalist-like manner. This is excellent at the points where he is discussing cancer and cancer therapies in general. Emperor of All Maladies is legendary, but I came out of this feeling better informed from that book due to that journalistic edge. Sometimes the tendency towards journalism hurts when the book shifts into interview-mode with some of its participants, which does not match with the rest of the book.
The other problem with the journalism is how the author comes off. I do not complain about coastal media elites as a dogwhistle. I complain about them in a Third Coast, Second City, my Daniel Burnham can beat up your Robert Moses sort of way. With travel and sport writing, complete with a fly fishing metaphor, completes my sort of utter disrespect. There is some mirror-universe review here where I write 800 words on the relevance of the author’s gender* to this writing in comparison to other similar texts. And with the valid prefatory mention of how much insurance sucks - it does - the focus here is on someone getting a high level of care, from a variety of high-skill providers in a hermetic world.
But do not listen to that me: this book rules.
The defining quality is that the author has cancer for 20 years. It has always been deleterious to his life, and he is plain and excoriating about it. But the medical advances that prolong the author’s life and quality of life are happening in real time across the course of the text. He avoids getting too philosophical with it, but he is also aware of the question that medicine raises. As much as there is a social norm of health/sickness, increasingly people live in the slash*. Most of the books I have read that dealt with this treat it as more of an ethical failing or social crisis: the bigotry against the disabled. This book is aware of it, and raises it when appropriate, but is much more interested in the materialist side. Language fails to cover what this new state is and what it means for society. This then is not a philosophical treatise on that novel-ish state, but a description of it, emotional and provocative.
The writing again belays the author’s training. It is foremost accessible, neither plain nor elaborate but what it needs to be when it needs to be to do the job of explaining that it wants to. It moves along at a good clip and the sort of sections and microchapters work well. There is excellent signaling, not foreshadowing but good work in laying the flags out for future events. The ending is weak, thankfully, as the author is alive.
The sort of work and research here is exactly the same that the current U.S. administration has destroyed, and with knock-on effects promising that the sort of world this book explores will not expand and will retract, leading to your friends dying. And while it is easy to complain about the author’s privilege and access to the best experts for instance, the anti-science positions of the administration mean that even the well-off will not be able to reap the benefits, since no one will have done the work. So while this book avoids politics, feel free to use it as an example to your well-meaning idiot friends as to the hope we will not see.
My thanks to the author, Jonathan Gluck, for writing the book, and to the publisher, Rodale, Inc., for making the ARC available to me.
-
* - Conflict of interest(?) disclosure: I have a first-order relative who also has this cancer, and I have been involved in their care. I have also been the bad guy in the relationship with someone with chronic illness. And I am at or near that slash, and, notably, forget that I am sometimes, which feels pretty relevant for the text in general.
Read
June 13, 2025Dnf.
September 17, 2025
I don't fear being dead. I fear not being alive. [p. 243]In 2003, Jonathan Gluck was diagnosed with multiple myeloma, a blood cancer, and was told that he had between eighteen months and three years to live. Twenty-two years later he published a book about his illness.
Gluck's survival was due to the first-class medical care that he received, which included expert physicians, some of whom were directing cutting-edge clinical trials (which are now under threat, thanks to Donald Trump's cutbacks on medical research). His path was anything but easy, as he faced multiple recurrences of the cancer, and treatments that took a physical toll on him while putting his marriage to extreme tests. We hardly need to be told that cancer is a disease that nobody wants to get, but Gluck's lurid description of treatment centers serves to emphasize the point:
During my radiation treatments, I have seen patients with skin burns so severe they look like arson victims. During my treatment sessions, I have seen a gentleman wet his pants in his chair while he was sleeping; a woman collapse on her way to the bathroom, split her head open and bleed all over the floor; and toilets covered in splatter from diarrhea. During my hospital stays, I have seen patients who were bald, emaciated, and as pale as the hospital white blankets they were wrapped in to keep warm. I have heard moans, screams, and sounds I frankly don't know how to describe. Cancer wards have been called houses of horror. I wish I could dispute the characterization [p. 243].Although multiple myeloma is a relatively rare -- and currently incurable -- cancer (Tom Brokaw is a famous patient), there are sure to be some readers who turn to Gluck's book for suggestions about dealing with it. Although he details many of his treatments, the absence of an index makes them difficult to keep track of. Nevertheless his book is a solid testimony to the possibility of long-term survival: A diagnosis of multiple myeloma is no longer an automatic death sentence, at least if you have access to the very best medical care, and the insurance to pay for it.
July 18, 2025
I was not halfway through this book when I began suggesting it to friends. This is so much more than an illness-survived story. It is a lesson about weathering today's medical system, a primer in what patients withstand in the hope of being well, and above all, a profound parable about what matters in life -- whether we are sick or not.
Highly recommend.
The author is a seasoned, award-winning magazine writer and editor, and it shows. The prose is lucid, sharp and concise, full of rich metaphors from the forewarning of a slip on the sidewalk on page one, to the wonderfully sublime final sentence (which is too good for me to spoil it here).
Along the way, there is a rich story of a man beating cancer for 24 years and counting. The story is much more realistic than similar books (I know; I read dozens of them while researching Last Rights). First, this version includes the obstacles to health, like fighting with insurance companies to cover life-saving care. Second, the author never lets cancer eclipse family. Third, it is full of incredibly touching moments (imagine asking your siblings if they will be stem cell donors in order to save your life).
At one point, Jon beats the disease into submission, a hard-won victory, only to come home and realize his illness has been a huge strain on his wife. Their marriage is in trouble. Fortunately they fight to overcome that problem too. Likewise he wrestles constantly with when to tell his two young children.
The takeaways from this book are many. One is that even the worst kinds of cancer can be beaten, or quieted enough that a person can live with it for decades. Two, a person's perspective on jobs and money changes when his time might be limited. Third -- and this was the part that touched me most -- family, children, marriage, and enjoying nature become a far higher priority when they could be shortened.
I'm told the Scots have a saying: "Be sure to live your life, for you're bound to be a long time dead."
This book is a good way to learn how.
Highly recommend.
The author is a seasoned, award-winning magazine writer and editor, and it shows. The prose is lucid, sharp and concise, full of rich metaphors from the forewarning of a slip on the sidewalk on page one, to the wonderfully sublime final sentence (which is too good for me to spoil it here).
Along the way, there is a rich story of a man beating cancer for 24 years and counting. The story is much more realistic than similar books (I know; I read dozens of them while researching Last Rights). First, this version includes the obstacles to health, like fighting with insurance companies to cover life-saving care. Second, the author never lets cancer eclipse family. Third, it is full of incredibly touching moments (imagine asking your siblings if they will be stem cell donors in order to save your life).
At one point, Jon beats the disease into submission, a hard-won victory, only to come home and realize his illness has been a huge strain on his wife. Their marriage is in trouble. Fortunately they fight to overcome that problem too. Likewise he wrestles constantly with when to tell his two young children.
The takeaways from this book are many. One is that even the worst kinds of cancer can be beaten, or quieted enough that a person can live with it for decades. Two, a person's perspective on jobs and money changes when his time might be limited. Third -- and this was the part that touched me most -- family, children, marriage, and enjoying nature become a far higher priority when they could be shortened.
I'm told the Scots have a saying: "Be sure to live your life, for you're bound to be a long time dead."
This book is a good way to learn how.
October 1, 2025
Topically, this book hit the spot for me. Gluck poignantly describes his personal journey through a dire, incurable medical condition. His diagnosis comes at a high moment in his young life as a new father with an engaging career. Thanks to scientific medical research newly discovered treatments have extended his life far beyond initial predictions. Difficult side effects and uncertain outcomes have resulted in Gluck experiencing extended and various forms of uncertainty. Beyond the existential question of his longevity he addresses financial, career and relationship uncertainties. The expansive nature of these topics provides value to readers navigating various anxieties. Far from a step by step approach to managing ambiguity, Gluck provides an honest personal story of the realities of the human condition.
August 12, 2025
Overall I would have preferred a longer format to these sections. It’s written in more journal format, a shorter play-by-play account of what is happening instead of longer pieces that really get into the exploration of it all. And a lot of the play-by-play can start to feel repetitive due to the prolonged nature of the author’s particular disease. It’s just not a style I am as moved by, but having said that, what this book really does give you is an appreciation and respect for is what really goes into having cancer over such a long time. Because it doesn’t mean simply having cancer for twenty+ years. It means fighting cancer for twenty+ years. Battling. Constant meds and treatments and symptoms. Even reading about it is exhausting.
May 18, 2025
A very well written memoir that reads like a journalist wrote it. Often memoirs aren’t that well written as the writers aren’t professional authors. It immediately caught my attention that it was well written and like any good journalist the writer did their homework. Much of the narrative is his personal story but he surrounded it with his research to further provide the whole “story” on this awful disease that scientists have made so much progress towards a cure but still have a ways to go. Knowing people with multiple myeloma I am very grateful for this book.
Thank you to NetGalley for providing me with an early release in exchange for a fair and honest review.
Thank you to NetGalley for providing me with an early release in exchange for a fair and honest review.
July 21, 2025
This was superbly written and is a great book for those who are going through their own cancer journey or are caregivers of loved ones who are battling the disease. The only parts I found myself rushing through were the fly fishing parts/stories; otherwise, in the twenty-some years he’s been fighting his diagnosis, there is a glimmer of hope that science and medicine continue to advance in beating this treacherous disease. Advancements in immunotherapy are astounding and I can only hope and pray that these treatments accelerate at lightning speed to give those going through cancer in present day even more hope and possibility of conquering it.
July 26, 2025
A good introduction to what it’s like to live as a cancer patient. As the author points out, thanks to advances in medicine—assuming a person has health insurance and financial resources—we live in a wonderful yet a weird time: You can live with a fatal disease for 20 years. So you can keep on living your life, but your higher chance of death, compared to that of someone without cancer, is always hanging over you. And the costs of staying alive go beyond financial, since every treatment involves some combination of needles stuck in you, time spent in doctors’ offices, and side effects that range from debilitating to potentially fatal.
August 15, 2025
Pros :: What an amazing telling of survival, modern medicine and the drive to survive. Jonathan Gluck and his family have the sword of his cancer hanging over his head and that of the families. Not only does it affect his marriage, his children and his financial health. Interspersed are tales of his escaping his body with the flow of fly fishing. The main outline of the story is his dealing with modern medicine, the insurance, his immediate family, his siblings and of course having to wait from test result to test result on if or when his cancer comes back. He was very vulnerable and forth coming with his emotional, financial and marriage.
Cons :: None
Cover art :: 3 out of 5 Would have like to have seen a sword on the cover, as that what Gluck described it like, living with the sword of cancer.
Cons :: None
Cover art :: 3 out of 5 Would have like to have seen a sword on the cover, as that what Gluck described it like, living with the sword of cancer.
August 13, 2025
uncertainty and hope - hand in hand
This is a wonderfully written book, full of medical information and a personal perspective that touches the heart. As a two time cancer survivor, and someone who nursed her husband through terminal cancer, this book reminded me of the many lessons and insights gained through those experiences. Bravo, Jonathan Gluck, both for your bravery and for writing this book and going through all you’ve been through as you struggle with this heartless disease.
This is a wonderfully written book, full of medical information and a personal perspective that touches the heart. As a two time cancer survivor, and someone who nursed her husband through terminal cancer, this book reminded me of the many lessons and insights gained through those experiences. Bravo, Jonathan Gluck, both for your bravery and for writing this book and going through all you’ve been through as you struggle with this heartless disease.
July 1, 2025
A book about living with an incurable cancer could be maudlin or pedantic or trite --instead it is insightful, authentic, and honest --Jonathan Gluck is skilled in his craft. He is a journalist, not a self-help guru, so we get his keen sense of curiosity, commitment to accuracy and thorough, fact-checked research. This is exactly the book I need right now.
July 2, 2025
An Exercise in Uncertainty is a riveting story that includes the reality of living with cancer— the twists and turns, challenges and awarenesses. Gluck provides the reader with vulnerability, truth, science and hope. I couldn’t put it down.
September 12, 2025
Almost 3 years to the day of my second birthday post stem cell transplant in my battle with lymphoma and I can’t believe how much I needed this book. It feels amazing relating so much to something someone else has experienced. I feel heard and understood…finally. Loved every second.
October 9, 2025
A frank, touching, harrowing account of a man’s encounter with multiple myeloma and his survival for decade, thanks to medical advances and sometimes good luck. He and his family and friends have been through a lot and I wish them the best. Like he summed up, you don’t want cancer.
June 16, 2025
My dad passed away from multiple myeloma and one thing he had in common with the author was wanting to live each and every day to the fullest. A good lesson for us all.....
June 28, 2025
Honest, informative, intelligent, emotional, and gripping. Humorous, at times, as well. An extremely human account of living with a terrifying disease.
July 1, 2025
An extraordinary memoir. Full of hope, humor, and just enough science, it’s a page-turner about how to live life. Highly recommended.
August 3, 2025
Terrific! He writes very well!
August 7, 2025
Describes some of my experiences to date perfectly.
August 8, 2025
This is a powerful, extremely well-written book. If you have multiple myeloma, or a family member does, it's must reading. Very highly recommended.
August 8, 2025
A remarkable book of resilience by a remarkable man. We all have our story's to tell and this one is worth a read!
August 18, 2025
If there are five words in the English language I am sure of, they are: You do not want cancer. - J Gluck. Memoir of a 20+ year cancer survivor. Well written, interesting.
September 25, 2025
Excellent Read
Comments from elsewhere. Read this with full compassion. A very well written dialogue of a cancer journey. Thank you for sharing such a personal story.
Comments from elsewhere. Read this with full compassion. A very well written dialogue of a cancer journey. Thank you for sharing such a personal story.
September 17, 2025
Brutally honest memoir of living with an incurable disease. Having a family member with multiple myeloma, I was familiar with many of the treatments mentioned in the book. In many ways, it hit a bit too close to home for me (which I expected). Each patient's journey is unique and theirs alone. However, there is a universal struggle for patients and caregivers... coping with the uncertainty of the future while clinging to hope and continuing to keep going each day.
One important thing to ponder - many of the treatments Mr. Gluck and other multiple myeloma patients currently receive did not exist a decade ago. Clinical research funding for cancer and other life-threatening diseases is critical to help save lives.
One important thing to ponder - many of the treatments Mr. Gluck and other multiple myeloma patients currently receive did not exist a decade ago. Clinical research funding for cancer and other life-threatening diseases is critical to help save lives.
August 29, 2025
Thanks to Random House for the copy. I appreciate the author's work on this memoir - it will help so many people, myself included, to cope with the tension of being present in life while dealing with deep uncertainty, pain, and stress. It is beautifully written, vulnerable, and hopeful. I wish him and his family the best.
Displaying 1 - 28 of 28 reviews