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As Tommy Rivers Puzey Battles Cancer, His Brother Runs And Reflects

As well-known trail runner and physical therapist Tommy Rivers Puzey battles a rare form of cancer, his brother reflects on the 35-year-old's impact and inspirational life.

There’s no short way of answering the question, “Who is Tommy Rivers Puzey?” To some, he’s Rivs. To others, he’s Tommy. To many, he’s a bearded ultramarathoner with a substantial social media following who has helped runners through his physical therapy practice in Flagstaff, Ariz.

In the past month, the running community rallied to support the 35-year-old and share the details of his inspiring story. In late July, Rivers Puzey was hospitalized with an undiagnosed respiratory issue, after he tested negative for COVID-19. He was placed on a ventilator as the doctor sought answers before he was diagnosed with a rare and aggressive form of cancer called primary pulmonary NK/T-cell lymphoma. His brother, Jacob, announced the diagnosis on July 24 in a tearful Instagram video. A GoFundMe has raised more than $530,000 as of Thursday morning, with all proceeds going toward Rivers Puzey’s family.

Rivers Puzey grew up in Hermiston, Ore., during the state’s peak era of high school running that included future stars like Olympic medalist Galen Rupp, Olympic champion and former world record holder Ashton Eaton and triathlete Jesse Thomas. In high school, he wouldn’t allow himself to beat his older brother, Jacob, in any race, which allowed him to qualify for his only state championship appearance. He did the same thing when he followed Jacob to run at BYU-Hawaii in Oahu. For a while, Rivers Puzey held back on his showing off his talent but eventually started winning local races in Arizona and training to the point of breaking his body. Because he was injured often, he decided to pursue a doctorate degree in physical therapy from Northern Arizona.

Outside of the sport, he’s truly a renaissance man. When he was a teenager, he had a deaf best friend and because Rivers Puzey wanted to help him in classes, he learned sign-language. For two years, he did missionary work in Brazil where he was immersed in the favelas, witnessing violence and other horrors that he still carries with him to this day. Through that experience, he learned Portuguese. In 2009, he married his college sweetheart Steph, who was attending grad school at La Universidad de La Paz in Costa Rica, and so he figured he already understood the structure of Latin languages and took up Spanish by reading the seven Harry Potter books to his daughter. (Oh, and since Steph is Québécois, he learned French.) He also used this time to become a porter and participate in mountain and trail races. 

“He just loves people and he wants people to be seen and heard,” Jacob says. “He just wants to love.”

Ascending Sedona

In an effort to raise more money and awareness for Rivers Puzey’s family, friends in Flagstaff organized a virtual Run with Rivs challenge where participants were called on to run, swim, hike, climb or move around in an effort to emulate Rivers Puzey’s athletic prowess. 

As part of the Run with Rivs challenge, Jacob decided to emulate his brother’s typical commute while pursuing his degree at NAU—an approximate 11-mile run to and from school. Tommy didn’t have a car and would use the runs as a chance to train before doing homework and spending time with family. He would occasionally stop at a Del Taco for a bite to eat and continue on his way, either reading or listening to the day’s lectures on his phone. It became known as Vuelta Del Taco. After his runs from Aug. 1-9, Jacob shared his thoughts and reflections with Sports Illustrated.

The following has been edited lightly for clarity.


Saturday, Aug. 1: 11.51-mile run in the morning, 10.59-mile run in the afternoon

I do the same run every day so there’s a beauty in the monotony of it, but I realized how much he would enjoy it. The last time I ran this much in one week was in 2015 when I ran the TransRockies Run with Tommy. It’s not like I’ve done this regularly in training. In one week and over six days, we covered 120 miles in Colorado. Other than that, it’s been rare for me to have an 80 mile week—including an ultra. This will be a big week for me.

Even though Tommy could complete this 11-mile loop in just under an hour in an all-out effort, it could also take him three hours since he’d want to stop to pick berries to bring home to his girls. Or we’d jump in all these bodies of water. He would have probably tried to get too close to the elk that I saw. I just thought about how much he loves natural beauty.

We both went to college at BYU-Hawaii and took every possible class that we could together. We took two Hawaiian studies classes together and learned about HĀ – the breath of life. One of the things we had to do is cultivate the ʻĀina (the land) by learning Hawaiian chants and dances so that we could breathe our life into the plants through song and dance. I thought about how much Tommy loves nature by digging and planting to create life but also breathing life into the world. There’s another Hawaiian principle of Mana that delves into spiritual and social power. We get our power by giving. When I think about what he’s done in his life, I think about how much HĀ he has breathed into the lives of all of us and his community. That’s where the power and unity of this community that we’re seeing is coming from. When people see him, they can see themselves. So when you see someone that young being that fragile, this helps us appreciate life.

Sunday, Aug. 2: 16.5-mile run in the morning, 4.59 mile hike in the afternoon

We had a call as a family this morning so we were able to see Tommy on Facetime. It was hopeful and formative. He looked better and a lot less swollen than the last time we saw him. When they first did the scans on his lungs about a month ago, it appeared to be COVID-like inflammation-type symptoms. The nodules they saw were believed to be regular respiratory issues but it turned out that it was just pure cancer. That has diminished and his oxygen levels continue to improve. He finished the first round of chemo and he’s still sedated so we’re just playing it day by day.

My legs are heavy but I’m doing this because I want it to be a challenge and it’s certainly challenging me. I was thinking about how the running community is really rallying around Tommy and my family for this. We’re already having to deal with bills and notices and there’s people who have come out of the woodwork to support us. Team Run Flagstaff’s Vince Sherry, Northern Arizona cross country coach Mike Smith and Northern Arizona Elite head coach Ben Rosario have busy lives and careers but have made the time to invest and rally people.

There’s a verse from Isaiah that’s quoted in the film Chariots of Fire where the character, Eric Liddell, says, “Even youths grow tired and weary, and young men stumble and fall but those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint.” Even though we grew up in Judeo-Christian tradition, as a runner it’s pretty hard not to love that movie. You can say that God is the one that lifts us up but in a lot of ways, he or she or it relies on others to do the work of God. What everyone is out doing is helping God and Tommy breathe in some strength. Today was a run full of gratitude for the people who have been lifting me and my family up.

Monday, Aug. 3: 11.57-mile run in the morning, 11.51-mile run in the evening

Someone at the hospital sent us a text saying: “Good morning. Tommy is super awake, calm and following commands. He even smiled.” I don’t know what that means. They celebrated when someone saw him wiggle his toes a few days ago. But that’s definitely the best news that we’ve had in a long time. He’s surrounded by people who are positive and believe that he’s making progress. Because they’re the experts, if they’re hopeful then we’re hopeful. Every day seems to be a little bit better.

There’s a couple moments that come to mind when I think of his smile. He adores his daughters and so it warms his heart when he’s coming home from a trip. He’s happiest when he’s at home with his kids or in his garden.

In athletics, he’s always had an incredible memory, so growing up he would constantly be quoting from movies like Nacho Libre or The Princess Bride. In college, we would do a 5K time trial. Tommy showed up barefoot on a long skateboard while carrying his running shoes. He threw his shoes on, barely warmed up and he blew past me with about 800 meters remaining. It was the fastest I had been going faster than I’ve been going ever on that course or for 5K ever at sub-five minute mile pace. He came up next to me and quoting Jim Carey’s scene in Dumb and Dumber where he’s pumping his arms and saying, “It feels like you’re running at an incredible rate.” That made both of us chuckle. He just loves making people laugh. That smile comes out usually when he’s cracking jokes.

Tuesday, Aug. 4: 11.6-mile run in the morning, 11.49-mile run in the evening

I listened to an old episode of my podcast that I did with Tommy. Even though he’s my brother, it took a long time to get him on the show. Oftentimes, he does a good job in writing profound things on Instagram but it’s nice to hear his voice and articulate things in spoken words. He expressed his philosophy on training.

He references Matt Fitzgerald’s book 80/20 and the principle of intensity balance. Tommy did another follow up interview where he dug deeper and spoke about the Vuelta Del Taco run and doing it five days a week. Because of that routine and that consistency, he was able to find a sustainable way of getting volume in without taxing himself more than he had to. When you look at it as work, then it feels like work. When you look at it as just getting to Del Taco to get a burrito, it actually can reduce the stress. He realized his body responded well to that body of volume. As a marathoner, he’d still find himself running into the Grand Canyon to get out of the rat race of life. The way that a lot of people train, they see training blocks as a set time period when they have to get fit and prepare for a race. Tommy preaches that it’s not about cramming fitness or a number of workouts into a certain period of time. It’s about gradually building the durability of your system to handle the training and eventually be fit enough that you’re confident on the starting line. Then, you’ll know you’ll be able to dig deep when you can and not doubt your fitness.

Wednesday, Aug. 5: 11.5-mile run in the morning, 9.85-mile run at night

Today, I actually was able to respond to a few emails. It had been a couple days since I was able to do that. I’ve developed a whole new level of respect for him and Steph for what they went through when he was in grad school with how long he’s gone and how much training volume he’s able to cram in the day. They realized that routine was still beneficial to both of them so he kind of continued doing it after grad school. I admire that they made it work and they stuck to his schedule and found what worked for his family. Man, I didn’t want to get out of bed this morning and I’ve only been doing this for two days. I don’t know how he did it. He gradually built up to doing this daily and then sat through school and was mentally attune between all of it.

Shortly after I ran TransRockies with him, I remember feeling really fit. Less than two weeks later, I ran the North Rim Ramble, which is a marathon at 7,900+ feet in Jacob Lake, Ariz. I managed to run under three hours but it just felt like I was cranking out a long run. The race director for that race was Chris Martinez, who was a well-known figure in the sport for some time. He went through chemo and then went into remission and that was only a year or two ago. The cancer came back, and to my understanding, he decided not to go through chemo again. He had been messaging me and just passed away fairly recently. It was hard to see Chris suffer. As we were mourning and trying to help his wife, we got the diagnosis for Tommy. When I stopped on my run to record a video, I messaged his wife to offer my support. It’s not awkward or embarrassing because we certainly feel loved and supported. I know Tommy wouldn’t feel right about the amount of attention that he’s getting because he knows so many other people are suffering from so many other things silently. This has opened my eyes to try and help others through difficult times because I didn’t realize anything could mentally, emotionally and physically break me as much as this has—and he’s still alive. I’ve always thought of myself as an empathetic person, but this has added layers of empathy and understanding that I never thought I could possess.

Thursday, Aug. 6: 11.5-mile run in the morning, 11.48-mile run in the evening

Yesterday was really uncomfortable because I ended up going in the middle of the afternoon since it was the only time I could be free. It was really hot and I was sore. My legs were sore and I thought of him and how he didn’t have a choice when it came to doing these runs.

I live in a tourist town in Canmore, Alberta, Canada, so some of the restaurants have daily specials and last night was wing night at one of the local pubs. My son loves his uncle Tommy and I know he would have partook in something like this, so we went and ate a bunch of chicken wings and then I had to run after putting the kids to bed. It was a bit uncomfortable but some of the runs that we used to do were in the dark and in the morning. Tommy has spoken a bit about how his time in Costa Rica changed his philosophy in training. He was taking care of his daughter but also started working as a porter, who would help transport people’s bags up and down a mountain. I went out there for about a week when he was finishing up his time there and we would go for a 2 a.m. run carrying tourists’ luggage up to the hostel. We stayed there a few nights and some of the guests would stay up a little later than usual. Tommy would bring out his guitar and play music for them under candlelight. Last night on my run, I remembered how someone asked him to perform Cat Stevens and he did. He also performed “Heart of Gold” which is one of the first songs he learned under the guitar.


Friday, Aug. 7: 11.14-mile run in the morning, 11.55-mile run in the afternoon

I was pretty tired in the morning because the runs have been wearing on me. My second actually felt better than several of the other runs earlier in the week. Things started and I found a good groove. I’ve been thinking a lot about different races that Tommy and I have run together. In particular, I thought about the Black Canyon 100K in 2014 or 2015, which was my first 100K and I was trying to qualify for Western States. Only the top two finishers would earn their spots.

Tommy had been coming off an 18-month recovery from a major fracture in his leg. It had been a long winter in Flagstaff, where we were both living at the time, and it was the opposite when I got to the Black Canyon Trail near Phoenix. I ended up leading for the first 55K of the race and I ran close to my 50K personal best but had another 50K to go so I was out in the lead for a bit. At one point, I blacked out and I bearhugged a Saguaro cactus. My hands and knees were totally bloodied and trashed.

When I came to consciousness, I had only been passed by one guy but was still in a qualifying position. I crawled to the next aid station and Tommy was just sitting in a lawn chair with Steph and his girls. He honestly had not run a step in like 18 months. I looked at him and in his eyes I think maybe he was thinking, Awww man. Dude, I can’t run. But, he knew how much this meant to me. He put his shoes on and paced me. He crumpled up potato chips in a bag and bird fed them to me. He made me submerge myself in puddles. I had some serious heat exhaustion going on but he stood by me.

Tommy sacrificed his own recovery and helped me get to the finish line. I still finished in the top 10 and I think my time was still under the previous course record because it happened to be a really fast year. I didn’t end up qualifying but he didn’t let me skip a beat. He was like, You need me. I got you. That’s just how he’s always been. It was a really positive time for me and I’m really grateful for that time we spent together.

I’ve also thought of other races where he’s been there and hopped in for me—legally or not. His first marathon experience was the Honolulu Marathon. I was racing and he jumped in at Mile 10 after being out two nights in a row trying to get into a U2 concert. He was maybe planning on running just 5K with me but I was falling off the pace group that I wanted to be with so he would grab water and fuel for me at aid stations as often as he could. It was totally illegal but we didn’t know any better. That was my last race in Hawaii before I moved off the island. He had just finished up his regional cross country championship so maybe those 15 miles were the longest run of his life up until that point.

I guess I’ve just been thinking about him because basically if he wasn’t as physically fit and strong as he is, he would have already died because of how strong the cancer is. The doctors have told us that. They’re hopeful that because he’s as strong and fit, there’s hope. It’s still a very bleak diagnosis and prognosis. He’s come out of sedation a few times but he’s not with us. In order for him to be prepared for the next round of chemo, he’s going to need to make some pretty significant gains to overcome some of the challenges. I want to be that guy for him. He’s literally carried me through some of my races before and I want to be able to do that for him. Whether that’s financially or just through thinking of him and praying, I want to somehow reciprocate all the good that he’s blessed me with. That’s what I think the community is trying to do.

Saturday, Aug. 8: 6.18-mile run at 7 a.m., 6.25-mile run at 10 a.m., 6.3-mile run at 2 p.m., 6.6-mile run at 5 p.m.

Today, I’m going to try and do 40 kilometers as my wife attempts to run 100K with 10K loops in our neighborhood. That was her challenge that she chose for the Run with Rivs Challenge and she had never run farther than 60K before last weekend. She ran in college and has competed internationally in mountain running so she wanted to do something beyond herself to rally the community and challenge herself. By putting herself out there, she wanted to try and raise funds through our community. Some of our friends who help organize the TransRockies Run came out to support and there’s random people who came out to cheer. Even with COVID-19 going on, this is a little, safe and socially-distant way of hosting a race without a big crowd or gathering. We tried to do it in a way that’s not brash and more about bringing people together.

My pace in these runs was not something that my normal pace would be. That’s something that I learned from Tommy. It’s not about me today. It’s about others. This helped me think about him and being that encouraging voice. He’s been there so much for me during races. It’s not about me today. It’s about others.


Sunday, Aug. 9: 19.04 miles in the morning

The last run was pretty emotional. We got some news throughout the weekend about oxygen levels and the potential need to put more tubes in him, so there were a couple of scares throughout the weekend. It gets really scary. I went out with an attitude of gratitude and just tried to be there with him by thinking of him. At the same time, it’s really scary thinking of him not being here with us. It’s inspiring to think of the extraordinary life that he’s lived. In the short time that he’s had, he’s filled it with many cool experiences and actions.

When my wife Amy was doing the 100K, there came a point where she turned to me and said, Hey, I need some music. I need something that will inspire me. I was trying to think of upbeat songs that would kind of go with a quick cadence. I put on a couple of songs and she was still struggling through the last few miles. I remembered “Where Is The Love” by the Black Eyed Peas and how Tommy was telling me about his experiences in Brazil. It was one of the few times that he spoke about his time there, aside from when he talked about Açaí bowls or churrascos. He opened up about it with me on my podcast but for a lot of the time, we just knew that we had both just seen stuff that most people wouldn’t feel comfortable bringing into their homes in video or documentary form. It’s heavy stuff that we’ve carried with us. Especially for someone like him, who loves so deeply, it impacted him profoundly. It physically hurt him to see people he knew and cared about have their life taken before your eyes. That happened while he was in the favelas of Brazil. Through it all, he has so much faith and hope in the power of music. I still get goosebumps thinking about how he talked about these voices from all different shades—Afro Carribean, Europeans, Indigenous people and all these shades and blends—coming together to sing this song. I tried to relay that experience to Amy while she was in a really rough spot so I told her the story and we started listening to it on repeat. On my own solo run, I started listening to music for the second half and noticed my pace picked up and I recorded maybe my fastest couple miles of the week. The entire time I just remembered Tommy singing that song to me in Portugese and how beautiful it was.

I hope that over the past nine days if someone has donated or made a sacrifice or pushed themselves as hard as they ever have, they feel that they’re making a difference. Because they are. This is a pretty big depression that our society likely headed toward and so if anyone is going into their pockets and giving, we know it can hurt and so it means a lot to me and my family. I do think that Tommy would get to a point where he’d say, Don’t just worry about me and my family. Ask yourselves what’s going on in your communities and family. I hope they feel appreciated and validated. Hopefully this has taught people a little bit more about themselves and what their limits really are.

Total = Approximately 206.7 miles over nine days


The Run with Rivs campaign raised more than $180,000 for Tommy’s family and recovery efforts. In a video shared to Instagram on Wednesday, Jacob said Tommy appears to be responding well to the second round of chemotherapy and his oxygen levels have been the highest since he was admitted to the hospital. For updates on Tommy’s health, follow @kimpuzey, @jacobpuzey and @steph_outside on Instagram.