Little Earthquakes: A Memoir – Facing Terminal Cancer While Bringing New Life into the World and Finding Healing

by Sarah Mandel

“Sarah Mandel has done something remarkable here. I found myself weeping, laughing with delight and moved with love—all in the span of the day it took me to devour this book. Filled with deliciously specific images and metaphors, clear dialogue, and rich explorations of self and others, Mandel has written—among other things—a tender witness statement of and for her body.”—Hala Alyan, author of Salt Houses A psychologist, wife, and mother chronicles her extraordinary journey with cancer while pregnant with her second baby, and the insights into life, death, trauma, and healing that she gleaned—an utterly inspiring debut memoir reminiscent of the intimacy and emotional power of Paul Kalanithi’s When Breath Becomes Air and Kate Bowler’s No Cure for Being Human. When clinical psychologist Sarah Mandel was pregnant with her second child, she began preparing for her maternity leave, juggling the demands of her soon-to-be-new baby with the needs of her patients. Noticing a lump in her breast, she assumed it was most likely a clogged milk duct. But a biopsy revealed it was not. When she went into labor, she learned that she had Stage Four cancer—devastating news that forced her to confront terminal illness as she was bringing new life into the world. But Sarah's illness took a highly improbable turn when, after three months of treatment, her second PET scan showed no evidence of disease. Sarah, however, was unable to celebrate the good news; she was frozen in a dissociated state caused by the emotional whiplash of going from oncology patient to new mother, from a terminal sentence to a shocking reprieve. As a therapist who specialized in trauma work, Sarah had utilized “narrative therapy” to help her patients. Now she Could the treatment that eased her patients’ pain successfully help her navigate her own trauma? Little Earthquakes is a beautiful and thought-provoking debut from a brave and unwavering new voice that captures the mind, sears the soul, and leaves its indelible mark on the heart.

Genres: Memoir, Nonfiction, Audiobook, Mental Health, Unfinished, Biography, Biography Memoir

288 pages, Hardcover

Published April 25, 2023

Reviews

[Kelly Lang · Rating 5 out of 5]

A beautiful and heartfelt memoir of a traumatic diagnosis of breast cancer during the author’s second pregnancy. Sarah tells her story of diagnosis, treatment and recovery with such honesty and bravery.

I have never experienced what she has (do we ever know what it’s like to live in another’s shoes?), but I felt I was walking beside her as she processed her trauma. She mentions walking around New York and being surrounded by people and no one noticed her invisible illness. I related to that being the parent of a brain injury survivor as well as one myself. We all have something plaguing us whether it’s visible or not and need to give each other grace and kindness.

[Ashley · Rating 5 out of 5]

Does each copy sold come w a free box of tissues?

Sarah Mandel is an amazing woman that we are SO lucky to have an entire memoir from. Albeit, one much too short. Readers would have benefitted from books upon books of insight from Sarah. I wish I would have known of her sooner, but I'm happy to have learned of her at all. She's made such a big impact on me in the few hours her audiobook took to finish.

I highly recommend this book, especially if you're a mother.
Definitely consider if you're emotional bandwidth can handle this book before reading it, though. It got so heavy at points that I had to stop and give it a day or two before I could handle starting back up. Which feels so selfish of me so say. Poor me, I can't handle hearing about trying to navigate motherhood while dying of cancer. But it's just the truth, it was a lot to take in.

[Corinne · Rating 5 out of 5]

“Find and hold close those who will travel to meet you as you tell your story. Eventually, your narration will lead you into the present. There you will be greeted by the gift of hope.” ⭐️⭐️⭐️⭐️⭐️

[☆ Katie ☆ · Rating 5 out of 5]

I'm not sure where I initially heard about this book, but it deserves a much wider readership than it has received. I requested it for my library to purchase, so hopefully, more people will be able to read about Mandel's awe-inspiring journey in her own words. She uses this writing exercise as a way to process her trauma, a type of narrative therapy, but the reader will also benefit greatly from hearing her story and gleaning the wisdom and insight she has acquired along the way.

Her cancer diagnosis is terrifying and the bravery she exemplifies is so admirable. She delves deeply into the confusing emotions she experiences throughout every step of this roller coaster - one that she is still on. She explains the process of getting the diagnosis, enduring treatment, explaining her illness to her young daughters, and her difficult path to recovery. We get amazing insight into her clinical psychology work, and her talent for storytelling is undeniable. Her writing is succinct and vulnerable and completely heartfelt, and her resilience is evident on every page.

[Sharon Huether · Rating 5 out of 5]

Sarah a wife, mother and a Psychologist takes the reader on a personal journey to being pregnant with her second daughter and having breast cancer at the same time.
Sarah uses the same narrative therapy for herself as she used for her patients.

"Sarah said "Our lives are a collection of the moments giving our self permission to feel, think, and sense everything.

I want to thank Harper publishers for sending me a finished copy of the book.

[Jeanne · Rating 2 out of 5]

The first half of the book was riveting. Then it went on and on, cathartic for the author, not interesting to this reader. I couldn’t stop thinking about what a different book this would be if the author was not a privileged professional in the medical field.

[Shavaun Guinan · Rating 4 out of 5]

Highly recommend.

[Jessica Lessing Feinstein · Rating 5 out of 5]

This work is outstanding and raw.
I know the author and she is so strong.
Reading this book you will truly understand what an amazing woman she is.
Enjoy

[CaseyArmstrong]

DNF. She lost me about halfway through.

[Kelsey Ruddell · Rating 4 out of 5]

4.5 to be exact — I only wish there had been more!


Sarah Mandel’s Little Earthquakes is as touching as it is beautifully written—a raw, poignant, and deeply human account of resilience in the face of unimaginable hardship. Be prepared for tears to stream down your face, for a heart that swells with sorrow and hope, and for moments of profound reflection on your own life.

Sarah’s story is remarkable—not just because of what she endured, but because of how she shares it. As a clinical psychologist, mother, wife, daughter, and friend, she offers an unfiltered look at the complexities of navigating trauma, grief, and resilience. Even while battling cancer, she found ways to give to others through her writing, and that generosity shines through on every page.

Her words made me pause and reflect on my own hardships, reminding me that while pain is real and valid, perspective can be just as powerful. Reading her story gave me strength as I read about her finding hers. It’s a reminder that even in our darkest moments, there is light to be found—not by dismissing our struggles, but by acknowledging them and validating them fully. Little Earthquakes doesn’t offer easy answers, but it does offer something even more valuable: a shared human experience that makes us feel less alone.

If you’re facing a difficult time, this book will meet you there. It validates pain while gently guiding you toward perspective, resilience, and the quiet blessings that still exist amid turmoil. Mandel’s story is remarkable, and her words are a gift to anyone willing to receive them.

[Zibby Owens · Rating 5 out of 5]

The book is about the author's stage-four metastatic breast cancer diagnosis when she was thirty-six years old, working as a clinical psychologist, and pregnant with her second child. Luckily, after three months of treatment, her PET scan came back completely clean, listed as "no evidence of disease or NED," which meant she was considered a super responder. This book is a must-read for anyone who struggles with trauma or post-traumatic stress, especially related to a health crisis.

This book is inspiring and one of the most remarkable memoirs I have read. Not only did the author talk about the fear and PTSD of her scary diagnosis, but I loved that she also talked about the confusing and uneven emotional process of healing, especially after receiving the good news of her clean scans. The author's writing is filled with honesty and inspiration. The book also discusses what happens in our brains when we experience trauma. You will especially love this book if you are interested in psychology because the author is a trauma psychologist navigating through her own journey.

To listen to my interview with the author, go to my podcast at:
https://www.momsdonthavetimetoreadboo...

[Jodie Siu · Rating 5 out of 5]

A gorgeous and heartbreaking story of terror, miracles, and finding one's way back to life. The author tells her own story while also interspersing brain science and education around trauma, as a kind of roadmap for others. She uses narrative therapy - telling her story to make sense of and integrate what has happened - and illustrates both how it helped her and how others can use it (with the help of a trained therapist for those who have intense challenges and/or need support with the underlying skills like self-regulation and a supportive relationship).

A lovely, introspective book full of kindness.

[Grace Suresh · Rating 4 out of 5]

I found this on “available now” on Libby audiobooks and am glad I listened. Sarah shared her story with vulnerability and clarity and discusses her processing the trauma of a cancer diagnosis along with having a new baby. Sarah is a psychologist and has extensive vocational knowledge in the human experience of trauma. I appreciated her honest narrative, story telling approach as she shared her experience and how she chose to move from dissociation to being present again in her life and with her family.

[Kay · Rating 3 out of 5]

How incredibly sad that someone who is pregnant age 36 is diagnosed with stage 4 breast cancer. I listened to the audiobook. Narration was excellent. Unfortunately this book lost me. Sarah was a psychologist and every chapter (mostly toward the 2nd half of the book) she gives the reader a textbook, scientific reason for her behavior or thoughts. She rambles on about stuff that doesn’t matter. It doesn’t flow with the story and is boring. It made me skim in many places. I googled Sarah just now and sadly learned she passed away in June 2024.

[Anu]

Heartbreaking. Sarah’s struggles with a terminal disease, the impact it has on her two little kids, a loving husband and parents…it all hits hard. She died from a remission recently and put up a video on her social media account that she scheduled to post after she died. That video captures so much of her vivacity and much of what she writes about in the book. Having lost a parent to cancer, I can understand how hard it must be for her family - I hope they can find peace and a way forward.

[Bonni · Rating 4 out of 5]

I hadn't thought much about narrative therapy before reading this book. I'm glad the author took the time to tell her story. Her writing is lovely and honest. I haven't battled cancer, but some of the conclusions she made about life's challenges helped solidify some of the ways I think about these things. Her perspective doesn't shy away from unfair or difficult feelings but still shines with hope.

[Lauren Steffel · Rating 5 out of 5]

"Little Earthquakes" is a moving and insightful book from both a deeply personal and professional lens. Sarah Mandel writes with great clarity about the process of navigating not only the trauma of a stage 4 cancer diagnosis while pregnant, but the confusing and uneven emotional process of healing, even in the face of great news. The book deftly blends personal and emotional prose with the expertise of a trauma psychologist navigating her own trauma. I unequivocally recommend this book!

[Smitha Parameswaran · Rating 5 out of 5]

How much more does Sarah have to suffer one will wonder. There is no end in sight to this beautiful persons' trauma. I can only hope that she has the strength to face all this. Heartbreaking at its extreme.

Thanks for sharing your journey with the world and I pray that this gives strength to anyone else going through the same

[Jaki · Rating 4 out of 5]

A really interesting take on the cancer memoir (a small but tough genre) - in particular, the perspective of a trauma psychologist unpacking her own trauma was an unusual one. I would recommend making sure you feel emotionally ready for the many twists and turns of this memoir, but if so, I'd recommend reading it.

[Maggie Jackson · Rating 5 out of 5]

“Grateful was not an emotion that I anticipated feeling when I was diagnosed with cancer.”
Didn’t exactly know what this book would be like when I started it! Honestly only knew it was about her fight with cancer. Sarah’s writing grabbed me in and made me feel like I was right there with her.
It was really informative to learn about trauma responses in an almost hands-on way with this book.

[Chelsie · Rating 4 out of 5]

Hm. I am not sure what I make of this one. I think it needs to marinate. Her writing was lovely, and I find myself hoping for more from her while knowing given the situation it is somewhat unlikely. But I’m not sure if I really “loved” it. Giving it 4 stars.

[Stephanie Quinton Giampiccolo · Rating 5 out of 5]

For anyone suffering thru MBC. This is a great read. A reminder that just because it's chronic, science has come a long way to really increase quality of life. It is sad and empowering at the same time. A truly great read and reminder that there is light even after we reach rock bottom.

[Zaiyi · Rating 5 out of 5]

Such a beautiful and touching book to read. We get to tell our own story. We could try to be that outlier and beats the statistics. We are indeed live in world of uncertainty. But, let’s remain hopeful. I, also a super responder, wish Sarah all the best!!!

[Anatoly Molotkov · Rating 5 out of 5]

Sincere and unassuming, painful but impactful, Sarah Mandel's memoir stirs fundamental questions about our places of residence - our bodies - and the way their mechanics may defy or contribute to the meaning of our lives. A gift.

[Monika Elliott · Rating 3 out of 5]

Mandel is a psychologist and she wrote her own trauma narrative. There is a lot of therapy speak and lots of analyzing but overall pretty interesting to hear her tell her story about her cancer diagnosis and treatment.

[Ashley · Rating 4 out of 5]

A very well written journey through cancer and proof that therapy is key. Anyone with cancer or going along side someone else’s battle should read this!

[Kathryn Vercillo · Rating 5 out of 5]

Narrative trauma therapist uses her knowledge of this form of writing/storytelling to help herself through cancer trauma.

[Jan Plain · Rating 4 out of 5]

4.5 stars

[JJ · Rating 3 out of 5]

Eh, the writing jumps around and is not that interesting. I was ready for it to end. What she went through was hard. 2 1/2⭐️

[Sarah Burton · Rating 5 out of 5]

This was absolutely beautiful but intense- I had to take a break from it at times. Definitely would recommend if one felt drawn to it.