Off Our Chests: A Candid Tour Through the World of Cancer

by John Marshall

A surprisingly open memoir coauthored by the married duo of a world-class oncologist and a cancer survivor about love, pain, hope, strength, and resilience while navigating the overwhelming breast cancer advocacy movement.

Off Our Chests recounts the story of Liza and John’s experience with her diagnosis and treatment. Written in alternating voices, Liza details her treatment and the complex decisions she had to make throughout her course of chemotherapy and radiation, including clinical trial participation and an elective double mastectomy, with the added complexity of being treated at the cancer center of which John was the chief of hematology and oncology and dealing with the emotional impact of knowing she may die as a young woman with young children.

John, who lost his own mother to cancer at the age of 13, provides an inside look into the world of cancer care and research, but also the perspective of someone who understands the medicine but was unprepared for assuming the role of caregiver and worried husband. John adds insights into his world of running the clinical operations of the cancer center where Liza would receive her care, commentary on the breast cancer machine, the need for clinical research, the high cost of cancer care, and an easy-to-understand explanation of the clinical and scientific background of oncology.

While they both felt that they were already expert commentators on their own “Cancer Channel” during the course of Liza's illness, they both came to realize how little understanding they truly had of what a cancer diagnosis does to the patient, caregivers, children, family members, and friends. Liza and John share their most intimate thoughts, including many that were previously unsaid - even between the two of them. Both gain an understanding of the other’s life and a deeper appreciation of what it means to be a cancer patient and of the emotional strains of being an oncologist, a job where so many of the patients die on their watch.

Genres: Nonfiction, Health

Audible Audio

Published November 19, 2021

Reviews

[Elizabeth Parker · Rating 5 out of 5]

I would highly recommend Off Our Chests for all readers, even those who may not be intimately familiar with the world of cancer. Though the book does chronicle author Liza Marshall's spell with breast cancer, I found a variety of other compelling themes interwoven throughout the book. Both authors tackle the ethics of aggressive medical treatment, the cost of and access to healthcare, changing marriage and gender roles, the politics of different types of cancer, and so much more.

I found the style of the book particularly effective: the chapters more or less alternate from Liza's first-person perspective to John's, save the last chapter and the epilogue. Liza and John Marshall write in the style reminiscent of The Immortal Life of Henrietta Lacks by Rebecca Skloot: they describe the science of cancer in a way that the reader can easily understand and learn, without overburdening them with textbook facts. I found myself crying reading Liza Marshall's description of what she thought could be her last Christmas, which was absolutely beautiful and almost haunting, yet entirely free from pity. John Marshall's voice develops throughout the book but centers around his struggle with the "objective wall" in medicine, which he must maintain between caregiver and doctor. Some of John Marshall's lectures are interspersed throughout the book, which was another effective stylistic choice.

[Gillian · Rating 5 out of 5]

Disclaimer: this book was written by a friend and I also have breast cancer.

While breast cancer is the reason the book was written it is more about relationships than about cancer per se. Relationships between partners, between colleagues, between family members and between oneself and one's body. Off our Chests is the story of Liza Alexander Marshall (whom I was at school with a long time ago) who develops an aggressive breast cancer and her husband who is an oncologist, specialising in bowel cancer, the poor relation in the cancer research family.

It is the story, written very candidly, from both perspectives of their experience of breast cancer. It is at times very funny, with some anecdotes that only the non-medical wife of a hospital consultant will really empathise with. Liza inconveniently had an important hospital appointment on her husband's clinic day; I inconveniently chose to give birth to twins on my husband's clinic day (my obstetrician had to bleep him to remind him I was in labour). But what makes it an unputdownable read for anyone, whether they have experience directly or indirectly of any cancer or not, is its searing honesty. Read it. You may find it hard, you will find it funny, but you won't regret it.

[Elizabeth · Rating 5 out of 5]

Wonderful writing where Dr. Marshall and Liza Marshall take turns telling their stories based on his position in the oncology world as a renowned cancer doctor and as a spouse to his wife, Liza, and her story and how her treatment and cure fueled a support group called Hope Connections.

[Lisa · Rating 5 out of 5]

Please note I received this book from the publisher at ALA and met the authors.

This is a fabulous book. It is far less depressing than I expected when I started it (and starting the book knowing she survived helped). While cancer is the theme and how cancer teams work/the cancer treatment trajectory, what I found most moving in this book was the discussion of their relationship. The chapters generally alternate with one by lawyer Liza followed by Dr. John. Each discusses what they were going through at each point in the process which was fascinating and inspiring at the same time.

I truly enjoyed this book, wholeheartedly recommend it, and thank them for allowing passengers along following what for any of us would be a nightmarish journey.

[Samantha · Rating 2 out of 5]

I liked the idea of this book. I liked the back and forth perspectives between chapters, of husband-doctor and wife-patient. But I've never been more grateful that my husband was mine and I didn't have to be married to someone else - Dr. Marshall is super egotistical, his name is listed first everywhere, like this is somehow his story and not HERS. Honestly I was frustrated at the male centering in a book about breast cancer. I even bought the book, hoping to gift it to friends. I think it's going in the goodwill box.

[Jean · Rating 5 out of 5]

Really liked it. It was an unvarnished, clear-eyed look from the inside on what cancer does to a person, her care-giver, and their marriage. The fact that Dr. Marshall is a medical oncologist gives an medical insider's perspective also, which is an added dimension. The biggest flaw is that the book was written quite a long time after the cancer diagnosis and treatment occurred. This book was given to me with a "you must read this" directive, and I had been putting it off, so I'm really glad I finally got around to reading it.

[Connie · Rating 4 out of 5]

A very well written book by a husband and wife about her struggle with triple negative breast cancer. I read this because my Duke book club was reading it for May and having the authors who live in Arlington join us for the discussion. Both John and Liza were Duke undergraduates who met and married in 1984 after her graduation. He graduated from the University of Louisville Medical School and she, several years later from UVA Law School.
Highly recommended!

[Dina Petros · Rating 5 out of 5]

so beneficial to read as the child of a breast cancer patient, i feel like i can understand the cancer experience so much better now, especially because no one alive can specifically tell me what it was like. i am so grateful to this book for helping me come to terms with my mother’s experience with breast cancer, and i recommend this for anyone that knows or is involved with cancer patients!!

[Tory Gentry · Rating 5 out of 5]

Wonderful book! I thoroughly enjoyed the book with the altering POV’s of both Liza and John. I could almost hear their voices as I read through each chapter and learned a lot about cancer and cancer treatment. The book was honest, emotional, and vulnerable. I would highly recommend!

[Mary Lou · Rating 4 out of 5]

Good story of couple who went through the wife's breast cancer journey. Given thru the eyes of the patient and the caregiver. A plus also is that the husband is an oncologist giving his insight into what oncologists experience in the battle to try to cure people of cancers.

[Marwa]

Illness is claustrophobic بيعصروه, plans dreams robbed, pain would always follow short relief, on both sides of the table, emotional paralysis open up love and support

Check yourself for mutations in the BRCA1 and BRCA2 genes

[Bonnie Carlson-Green · Rating 5 out of 5]

Liza Alexander Marshall and her husband, John Marshall have written a tour de force book about their experiences when Liza was diagnosed with triple negative breast cancer. Their book elevates from the usual cancer memoir in that John is a GI oncologist, who had railed against the breast cancer machine and all things pink, prior to Liza's diagnosis. Off Our Chests is a 360 degree look at the cancer experience and a very compelling read. Pick up a copy at your favorite indie bookstore.

[Ashlee McIntosh · Rating 5 out of 5]

One of the best books I've read in a while ;)

[Pepper Schmidt · Rating 2 out of 5]

I found this book to be so annoying I could barely finish it.

[Anshu · Rating 5 out of 5]

Headway - on a couple battling breast cancer together

[Beth Hill · Rating 5 out of 5]

Easy to read nonfiction of a couple's experience with breast cancer.

[Teacher gal · Rating 5 out of 5]

As a breast cancer patient myself, I really identified with what Liza was going through. I’m glad they acknowledge that the level of care she received was exceptional, and the importance of getting a second opinion.
I wish them both well and hope they continue fighting fit cancer care for all.

[Troy T Anderson · Rating 5 out of 5]

Very personal book outlining the 2 sides of cancer by my oncologist and his wife

Sharing this story from both sides is really helpful in gaining a fuller perspective as a cancer patient of Dr. Marshall himself. Very well written, full of lessons for anyone suffering or caring for someone suffering of cancer.

[Nancy Schneider · Rating 5 out of 5]

Written by a personal friend, Liza’s perspectives, as she weathers a triple negative cancer diagnosis, treatment decisions, chemo, radiation, and reconstruction, resonated with me. I especially valued her unique views as the wife of a physician in the cancer world. John , on the other hand, gives voice to the less often heard emotions of the caregiver and spouse.