A Project Manager’s Game Plan for Dealing with Incurable Cancer

Segment Forty-Six— More than Two Years In…Common Cold or Cancer Redux?

I have a cold.  Please God, let it be a cold. It has all the trappings of a cold, with the runny nose, bronchitis and coughing/sneezing.  It’s a cold. Nancy is sure it’s a cold, and it just makes sense that it’s a cold. 

There are, of course, some other signs.  My nausea is back with a vengeance.  I’ve dropped five pounds in under a week.  And I’m exhausted and cranky.  (Of course, I’m always a bit cranky, so…) This morning, Nancy reassured me that I have a cold, and I should listen to her.  But the project manager in me goes down two roads—I’m suffering a project setback or this is a risk realized? 

When I’m teaching risk, I sometimes point out the importance of the distinction there. Setbacks are the “stuff happens” of project management. They’re a pain. They were not intended as part of the project and have little or nothing to do with the original execution of the project. You’re driving along on vacation and there’s a 40-mile detour because of local event. That’s a setback.  It’s not part of your project, and you had no realistic way to build it into the plan (save through contingencies).

Lesson Learned: In planning projects, it’s very easy to go down the “risk road” of identifying a host of what are called unknown-unknowns. These are the myriad things that might happen that we really wouldn’t normally consider or even think about. My cold? It falls into the unknown category, in that it’s not unknowable, but in that it wasn’t even on radar (for the risk aficionados, that makes it an unknown-known). We can spend a lifetime worrying about what could happen.  Alien invasions. Famine. Pestilence. Locusts. As a thought leader on risk management, I officially can tell you to STOP THAT!  Will we look clairvoyant if we happen to identify one of these and it comes to pass?  Yes. Will it change the reactive nature of our response? No. All this does is generate a worry list.  And my mother used to remind me of the poem by Jo Petty:

Worry never climbed a hill

Worry never paid a bill

Worry never dried a tear

Worry never calmed a fear

Worry never darned a heel

Worry never cooked a meal

And so on. Burrowing into a laundry list of potential setbacks sucks up a lot of life energy that should otherwise be spent on the mission itself (battling disease or whatever that mission may be).

Risks realized are a completely different story. Risk is a future phenomenon which has not yet occurred, but there’s a likelihood (remote or high) that it could.  It’s on radar. Hop in your car. A last-minute 40-minute detour is a setback. An accident is a risk. (By the way, I recognize that other risk experts would easily contend that this is all risk, and all we’re dealing with here are semantics).  I’ve been warned that my cancer can turn a corner and begin to attack me anew. We know it can happen. There are probabilities associated with that outcome. The beauty of well-defined risk is that we can leverage our understanding of the event, the outcome and the likelihood to manage it effectively.

As I write this, I’m pausing about every two minutes to blow my nose, cough, and go on the hunt for fresh tissues. The question is whether I managing a setback or a risk. Given that the nature of my responses has been driven by the cold, and did not previously exist, I’m coming to the realization that, in my parlance, this appears to be a setback. My oncologist didn’t warn about a propensity for colds, and she’s been very good about sharing warning signs and risks.  And given that I’ve had dozens of colds in my life, I should accept that this one’s not that different and I likely have a boring, vanilla, rhinovirus.

Lesson Learned: Exotic has appeal. Vanilla remains the single most popular ice cream flavor on the planet. We all like to believe that we have acquired something exotic. We should be praying for vanilla. With NET cancer (which, on the liver, represents .003% of all cancer patients), I’d love vanilla. In case you’re wondering if I misplaced a decimal, I did not.  It’s not 3 out of 100 cancer patients.  Not even 3 out of a thousand. But in a pool of 100,000 cancer patients, 3 are likely to have neuroendocrine tumors.  Of those?  Very few have NETs on the liver.  It’s a small subgroup of a very small subgroup.  As a result, there are very few frames of reference for folks like me.  If I wanted to find a support group for my cancer, I’d likely be meeting in a room with a mirror.

Why do I go down into this discussion?  Because I have a cold.  I hope.  Colds are vanilla. We all get them and we all get over them. If that’s what’s going on, I’m a very happy man. I really don’t need the medical community to find another reason to more deeply plumb into the depths of my condition.

Much of this goes back to Occam’s razor, and why we should celebrate dear old 14th Century friar (Sir William of Ockham). Occam’s razor is the philosophy that when multiple possibilities are under consideration, the most likely “right” answer is the simplest and most obvious. The classic supporting axiom is “when you hear hoofbeats, think horses, not zebras.”

In complex environments (medical, professional, personal), there’s a bizarre compulsion to think of the zebra farms. As I go fishing for another Kleenex® to wipe my nose, I’ll take a deep breath and go back to thinking of horses.

Up next? Avoiding Self-Inflicted Injury

If you want to review the previous elements of this e-book or blog, they’re all posted at www.carlpritchard.com/blog If you have insights you’d like to share or comments or conversations, my e-mail is the best way to reach me at carl@carlpritchard.com.  I’ll always get back to you within 24 hours.  Always.  And if you think I missed the mark?  Check your spam folder.  Thanks for joining me on this journey.