In June 2020, Tommy Rivers Puzey was helping a friend through the Grand Canyon when he started feeling off. The headache wouldn’t quit. His heart rate climbed and stayed there. He couldn’t cool down.
He chalked it up to altitude and dehydration. By the time he and his friend hiked back out, he could barely breathe.
Within weeks, the 36-year-old elite marathoner, anthropologist and physical therapist was in a medically induced coma at HonorHealth Scottsdale Osborne Medical Center, his lungs nearly destroyed by a rare and aggressive cancer called primary pulmonary NK/T-cell lymphoma.
The running world spent the next year refreshing his wife’s Instagram for updates. They reposted a now-iconic phrase from her hospital posts: “Stout heart! Rage on! Love deeply! Be kind to one another!”
What happened to Tommy Rivs, as readers still type into search bars years later, is that he survived. What’s less obvious is what he’s been doing since. (We’ve kept tabs on his journey back to running at Marathon Handbook.)
From a coma to a treadmill
Puzey, who goes by Rivs, was once one of the most accomplished American endurance athletes outside the Olympic conversation. His marathon best, 2 hours 18 minutes 20 seconds, came at the 2017 Boston Marathon, where he averaged 5:17 per mile and placed 16th overall. He had finished top-10 in 100-mile mountain races and gone under 10 hours at the Ironman World Championship in Kailua-Kona.
The cancer took most of that fitness away. By the time he was extubated in late October 2020, he had lost more than 75 pounds and weighed around 95. His lung capacity sat at roughly 20 percent of what it had been. Nurses had to teach him how to swallow, sit up and walk again. He has spoken at length, including on the Rich Roll Podcast in 2021, about the three weeks of opioid withdrawal that followed his time on IV pain medication.
He started moving again the way most runners restart after an injury, only worse. Short walks. Hikes with his daughters in the canyon that almost killed him. Then jogs.
The receipts on his comeback marathons are easy to look up. In November 2021 he finished the New York City Marathon in 9:18:57. In 2022 he ran Boston in 6:31:54 and New York in 6:13:54, walking much of both courses. The following year he cut nearly two hours off both, clocking 4:53:44 at Boston and 4:41:57 at New York.
Those are not 2:18 times. They are the times of a man who, by every CT scan in 2020, should not be running at all.
Cancer-free, but not unscathed
Rivs has been frank in interviews that his scans have stayed clean while his lungs have not bounced back. They are scarred from the cancerous nodules that once filled them, and he still works around reduced lung function, weakness and the long tail of months spent in an ICU bed. His doctors have discussed a bone marrow transplant as a longer-term option, though the body has to be in strong enough shape to survive the chemotherapy that precedes one.
His wife, Stephanie Catudal, has written about all of it. Her 2023 memoir, Everything All at Once, published by HarperOne, recounts the 84 days her husband spent on a ventilator, intercut with her own history of losing her father to cancer at 16. The book landed on the New York Times bestseller list. In its pages she calls her husband only by his nickname.
The Puzeys still live in Flagstaff with their three daughters. Rivs continues to post from there, often from the trails around the San Francisco Peaks, and his Instagram audience has grown past 390,000 followers.
What he’s doing now
Since 2022, Rivs has built a second act largely on iFIT, the connected-fitness platform where he leads guided treadmill runs in places like Sardinia, the Canary Islands, Madeira and the Costa Rican coast. His sessions tend to mix walking with running — a run-walk approach that is part coaching philosophy and part his own reality.
In November 2025, iFIT launched Rivs Run Club, a weekly series he leads from Northern California. A new run drops every Monday, starting in the redwoods around Mendocino and Laguna Point with a beginner-friendly walk-to-run progression. The pitch is less about pace and more about showing up week after week, which tracks with how he has rebuilt his own training.
The club has since spilled off the screen. Over Boston Marathon weekend in April, Craft Sportswear and Marathon Sports ran a pop-up at 939 Boylston Street, a block from the finish line. On Saturday, April 18, Rivs and the ultrarunner Tim Tollefson led a free Rivs Run Club shakeout from the store. It was the first public look at the brand’s Rivs Run Club apparel collection, which went on sale in the United States in May at craftsports.us.
Why people still ask
The medical answer to “what happened to Tommy Rivs” is short. A rare cancer in 2020. A long ICU stay. A slow rebuild that is still going.
The reason readers keep typing his name into Google has more to do with how he talks about all of it. There is little of the polish most runners apply to a comeback story. His Instagram mixes coaching clips with loose, sometimes meandering musings on grief, gratitude and the canyons near his home. His wife’s writing does similar work in book form.
He is no longer breaking tape. By his own posts he is still here, still coaching, still running on a fraction of the lungs he used to race with. For a lot of his audience, that turns out to be the story they came for.
Join the conversation
Rivs’ beginner running series through Spain and Morocco (and several subsequent series) on iFit turned me into a runner from a someone who never thought they could or would want to run. He’s been such an inspiration to me and very deserving of this great highlight.
Rivs ran Boston 2027. I had the honor of jogging a portion with him. Bib 7998 time 5:47:45 🖤🖤