The Introduction and first segment to this multi-segment blog/e-book can be found at the links at the bottom of this article.
Segment Two – Objectives and the Project Environment
It took weeks to overcome my first cancer treatment. I was completely wiped out. During that time, however, the doctor who had proven to be the worst oncologist I would ever encounter, continued to call. They wanted to set up the next round of treatments. At that point, I believed the cure was worse than the disease, and resigned myself to the fact that I might never get better.
My mistake.
I was encouraged by my wife, family and friends to continue to “soldier on” and find alternatives to the first go-round. In order to do that, I had to know what I wanted from the medical community. I found myself resorting to the original set of unmet needs:
- Will this make me feel better?
- Will this stop the cancer?
- Will this hurt?
If I could find solutions that met those criteria, I would be a happy man. In the course of the next few weeks, I received word that there were two doctors I should check out. One was Dr. Blanche Mavromatis of the University of Pittsburgh Medical Center (Schwab Cancer Center) in Cumberland, MD. The other was Dr. Michael Morris of the University of Maryland Baltimore County in Glen Burnie, MD.
Before meeting with either, I knew I had to clarify my objectives so that they would understand precisely what I needed.
During that interim, with prodding from my wife and family, I also began to eat. Everything. After the better part of a decade living low-carb, I was suddenly given license to eat. Macaroni and cheese. Homemade bread. Potatoes drowning in butter and sour cream. You might notice a trend on those foods. They’re all very white. It seemed that white food didn’t send me racing to deal with personal needs quite as quickly as other foods. I could keep them down, and put on a few pounds.
Dr. Morris was relatively quick to respond. He was clearly anxious to get his hands on my liver. I learned that neuroendocrine liver cancer is rare. Only about 3 in 100,000 cancer patients get that condition. Morris, it turned out, was a pioneer in radiation therapies, and felt this was a great opportunity to show his stuff. (Spoiler alert: It helped a lot).
At the same time, I finally got an appointment with Dr. Mavromatis, who was more into chemotherapies, but they were primarily in pill form! Who knew? There was technology besides sitting in a center getting a drip for three or four hours.
Both physicians got the same set of questions:
- Will this make me feel better?
- Will this stop the cancer?
- Will this hurt?
Their responses were almost identical:
- Will this make me feel better?
- If it works, yes. But it will take time.
- Will this stop the cancer?
- If it works, no. But it will prolong your life. Your cancer is incurable. But the treatments could add another decade to your life.
- Will this hurt?
- No.
After my experience with Dr. F, the answer to the third question was all the more important. And for the two oncologists (who are still my oncologists today), it was an unequivocal response. Dr. Morris did have to explain that there were needles involved, and I’d have to lose any claustrophobia I might have, but any pain would be absolutely minimal.
Collectively, they helped me formulate my project objective:
To extend my life by at least one decade, with a good quality of life and energy, limiting the cancer growth and making me useful for something more than a doorstop at the house.
The sub-objective was not as crucial, but still pretty important, given it’s a major part of what makes me “me.”
To be able to return to a classroom setting, even virtually, and engage my students as I’ve done for the past thirty years—with high energy and vintage storytelling.
Both doctors concurred they were on board with my goals.
Lesson Learned: Distill your goals down to a succinct, clear, simple set of statements that capture the soul of what you’re trying to achieve. Share those goals with the most important stakeholders, including your significant other.
With a shared understanding in hand, Dr. Morris and Dr. Mavromatis (both their real names) became star players in this theater. I use their real names here because they are amazing practitioners and deserve all glory, laud and honor for their commitments to their patients.
The Project Environment
One of the not-so-funny funny things about a Stage Four cancer diagnosis (like any undesired project) is that people will invariably try to shape the environment around it in their own way. It’s important to remember that it’s your environment, rather than theirs. As I mentioned earlier, the license to eat freely was a major positive for me. And yet there were those who were suggesting major dietary changes and holistic eating. Good for them. Not for me. The reintroduction of the Tootsie Roll® into my menu was an attitude improver for me. My environment included a variety of things that others might not perceive as therapeutic:
- Limiting phone calls to 20 minutes (max) for everyone except my sister and my grown children
- Keeping the bedroom warmer than the rest of the house (with a space heater), unlike my history of keeping it like the Arctic tundra
- Crawling around in the dirt in the backyard, digging out rocks for deployment in my drystack stone wall
- Learning to be chauffeured around for any drive longer than 10 minutes
- Baking fresh white Italian bread every other day
- Rejecting conversations with people who wanted to spend more than five minutes in an “organ recital”
On the last one, I became the master of changing the subject. Despite the subject matter of these articles, I really had zero desire, particularly early on, in talking about the nature of neuroendocrine cancer and the rarity of getting it on the liver. As a side note, you’d be surprised how many people know someone who knows someone who is doing some pioneering treatment of cancer. I found my pioneers, and I’m really happy with them. (One person even suggested a return to the evil Dr. F)!
The project environment is yours to make. The people, the physical environment, the times of day, the activities—they are all yours to embrace, unless you surrender that decision to someone else.
Lesson Learned: What goes around comes around environmentally. On the dietary front, after getting a million-and-one suggestions about the need for more kale in your diet, someone will finally come back with alarming good news. The best day at the doctor’s office was the day she expressed concern about my sodium levels and told me to start adding more salt to my diet. THAT is a good day. Whatever brings you joy, no matter how simplistic, is the right thing to be doing to manage your environment.
There are, of course, some environmental considerations over which you have little control. In such instances, it’s important to acknowledge them for what they are. As my wife, Nancy, has said in the past, You cannot fight reality. While she’s right (she always is), you can make your reality more tolerable. As a risk manager, I now think through the possible outcomes any time I head out for any kind of medical intervention. For your projects (like mine), seriously consider the following:
- What will I do if the current effort takes much longer than anticipated?
- Can I accomplish anything meaningful while waiting for the next “shoe to drop?”
I don’t enter into the next step of any process without considering those two questions anymore. I carry an arsenal of alternate activities, ranging from my laptop to a few printed-out Sudoku puzzles (thanks to my mother-in-law, who’s turned us all into Samurai Sudoku addicts). In a three-hour diagnostic center experience, the actual lab work took three minutes. But I filled the void by finishing a presentation, clearing my e-mail box and getting up-to-date on my social media.
And on the last two (e-mail and social media), I was on a forced march to sit in the waiting room, but changed my attitude entirely by sending out a half-dozen gratitude e-mails to let some of my special friends (read: stakeholders) know how much they mean in my life.
And with all of those achievements in hand, and a dead battery in my laptop, I resorted to one of the Sudoku puzzles I had with me to make me feel like Einstein (until I screwed it up, of course).
In the next segment, we’ll look at personal project resources.
If you wanted to read the lead-ins to this segment, they can be found at:
