In the Basement at the VA: Stories from a Cancer Doctor

215-page paperback / 5.5" x 8.5" / ISBN 9781589882133
Publication Date: 5/26/2026 (available for preorder)

"In the Basement at the VA captures the moments when everything hangs in the balance for patients and their families. Through vivid storytelling, it reveals how interconnections, observations, and acts of listening shape care in ways rarely seen from the outside. Clear-eyed and deeply human, it shows that medicine is as much about communication as it is about treatment—and that small choices can carry life-changing weight."
—Danielle Ofri, MD, editor of Bellevue Literary Review, author of What Doctors Feel: How Emotions Affect the Practice of Medicine

When a doctor speaks with a patient, there is nearly always an information imbalance. Patrick Tripp has spent his career treating cancer patients at Veterans Affairs hospitals where the difference in their life experiences—not to mention education, age, income level, and race—adds to the challenge. Tripp’s writing reveals a caring and careful doctor actively working out the best way to share information and make decisions with his patients. The reader is brought into the intimate spaces of the clinic to witness discussions with patients, with their family members, and with specialists conferring on the best path forward.

These conversations are not only about disease and treatment, but about family matters and personal history. Patients recount harrowing experiences fighting in Vietnam, struggles with alcohol and drugs, and previous health crises. A veteran with PTSD tells of roaming his house with a machete in hand. Men dealing with prostate cancer find surprising and humorous ways to discuss sexual function. Brief lessons on the history of cancer treatment and the science behind today’s technology are woven throughout.

Full of compassion and candor, these essays provide examples to aspiring doctors, to cancer patients and their family members, and to all who are interested in how to communicate and connect under difficult circumstances.

MORE PRAISE FOR IN THE BASEMENT AT THE VA:

“In the cancer ward of a VA hospital, where prognoses are often grim and time is scarce, Dr. Tripp practices a form of medicine that resists detachment, in the tradition of great doctors turned authors Atul Gawande and Siddhartha Mukherjee. As a radiation oncologist, he uses powerful tools to see inside the body, revealing disease with clinical precision. But his skill also lies in translation—helping patients understand not only what the images show, but what treatment will mean for their lives. His conversations reveal the delicate balance between empathy and honesty, reassurance and realism, that defines medicine at its most human.”
—Laura Landro, author of Survivor: Taking Control of Your Fight Against Cancer

"In the Basement at the VA is a book of bridges, the stories of veterans stricken with cancer as they deal both with a traumatic past and a traumatic present. Radiotherapy is their bridge between the extirpative precision of surgery and the molecular damage of chemotherapy. Its use in skillful hands is a bridge between technology and empathy, between action and ambiguity. Ultimately, this moving book is a bridge between a doctor and his patients." 
—Carl Nathan, MD, author of An Arrow's Arc: Journey of a Physician-Scientist

READ AN EXCERPT

Patrick Tripp, MD, is a radiation oncologist at the Philadelphia VA Medical Center and the University of Pennsylvania. His stories on narrative medicine have been published by the American Scholar, Threepenny Review, and the London Review of Books. Dr. Tripp lives in Philadelphia. In the Basement at the VA is his first book.