His story begins as cliché: an aging jock with nagging lower-back pain. For the better part of a year, he ignores it, convinced he has a slipped or herniated disk. It’s only when he can no longer ride a bike, a lifelong passion, that he makes the doctor appointment. The problem isn’t a disk; it’s a tumor on his spine the size of a softball.

In the summer of 2014, Todd Balf, author of the acclaimed adventure tales The Darkest Jungle and The Last River, was diagnosed with a rare spinal cancer called chordoma. Only 300 cases are diagnosed in the United States each year, meaning that Balf was literally one in a million. During two long and risky surgeries, a team of specialists removed the tumor and buttressed his damaged spine with a scaffolding of metal rods. Having survived the surgery, itself a minor miracle, Balf was told that, with some rehab and follow-up radiation, he would soon be back to his former athletic self. He wasn’t. The surgery had resulted in a spinal-cord injury that left one of his legs partially paralyzed. Give it time, his doctors advised. The nerves might heal.

Thus began Balf’s membership in a tribe. The disabled. He imagined his own disability would be temporary, a short visit to a foreign land. He spent years test-piloting remedies that might spark his spinal nerves back to life. With the same gusto and good humor that he brought to his work as a writer, he searched for the perfect treatment: anti-gravity treadmills, adaptive bikes, endless rehab and trips to the gym, and - why not? - a few long-distance cycling events. His wife and children, long accustomed to Balf’s kinetic energy and sometimes harebrained schemes, cheered him on and hoped for the best.

Then came unexpected surgery to repair broken rods in Balf’s spine, followed by yet another complication: a stroke that jeopardized not only his recovery but his professional career. Balf wasn’t just one in a million. Thanks to his unresolved spine injury, topped off with a stroke, he was now an “n of 1” - a single case study. Before his long medical misadventure, Balf had always relished being one of the healthiest and fittest people around. Now he was unique for all the wrong reasons.  

Complications recounts Balf’s journey from cancer diagnosis to his present-day reality as a man caught between two worlds. Both moving and irrepressibly joyful, Complications is a forthright account of what it’s like to suffer a physical catastrophe and manage the uncertainty that comes with it. What’s the right balance between striving to recover and accepting limitations? Was he still just visiting the land of the disabled, or there for good? Who was Todd Balf now?