“You live life longer once you realize that any time spent being unhappy is wasted.”
—Ruth E. Renkl.

The day was September 17, 1997. I had noticed a small lump in the front of my neck. The mass had affected the way I swallowed for some time, and I frequently had dismissed it. This particular night I had gone to sleep with a feeling it required action.

During this time, I was serving as a physician in the United States Navy. I had attended an undergraduate university on the East Coast and then returned home to the Midwest to attend medical school. Once I’d graduated from my residency and fellowship, I’d entered active duty and had begun teaching at a Navy hospital. While there, I’d come to know a caring resident who was well trained in medicine. That morning, I sought him out.

On September 18, we began exploring possible causes for the mass. Tests included an ultrasound of my neck, blood work, and a chest X-ray. The thyroid function studies were normal. The ultrasound picturing the mass in my neck was solid; thus, the mass was a cause for concern. With that information, I went to another friend who was an ear, nose, and throat specialist. This doctor recommended a thyroid scan and a fine-needle aspiration to remove tissue from the mass for examination and evaluation.

The next morning, before I attended to my own patients, I went to the pathology area where I had a series of needles placed in my neck to withdraw fluid for the biopsies. Results came back normal, but the nodule showed “cold,” not “hot” on the thyroid scan. A cold thyroid scan signaled that the bump was probably malignant. Based on this, we decided to proceed with surgery to remove half of my thyroid gland. Although no cancerous cells were detected in the tissue taken in the fine-needle aspiration, we decided the best action was to remove the mass. We scheduled the surgery for September 26, coincidentally, my sister’s birthday.

Although I was familiar with the medical aspects of the procedure, the personal, emotional experience of dealing with an uncertain diagnosis was foreign to me. I had to take another step into the unknown, and I was scared. We each must face uncharted paths at times; yet to move on with life, we must acknowledge our fears and take that first step into the unknown. As men, we frequently take the steps alone. Yet, the help and support of friends comforts us when we need to move forward if we let them, so I felt good that the surgeon I’d have was a friend of mine.

On Jenny’s birthday, Dan removed half of my thyroid gland and, shortly after surgery, told me that the mass was benign— it contained no cancer cells. He also told me that operating on me as his friend had proved challenging. As surgeons, we make dozens of decisions during the course of an operation. When the patient is close to us, the emotion tied to our personal connection often intensifies the pressure to perform and increases the difficulty of decision-making. The nerve that allowed me to talk was located in a difficult-to-reach space on the right side of my neck. Because of that, Dan decided to leave a portion of the gland intact to protect my voice. Thankfully, this hadn’t proved to be a difficult choice since the mass was considered benign. I was on my way to recovering my health.

My recovery period was slightly uncomfortable without acute pain. I was glad to be back home with my wife, Carolyn, and my daughter, Demmi, early the following week. The surgery affected me the same way I respond to an airplane flight—it took awhile before my ears cleared and my normal hearing returned. For days, I felt like I was underwater, and my voice sounded strange. Throughout my life, I’ve typically kept many of my concerns to myself. As a man, I’ve felt I needed to be strong.

The recovery period after this surgery was one of the times I did share—I confided in Carolyn, telling her my concerns and fears. I came to realize strength was sharing my fears.

• What do you share with the people important in your life?
• What does it mean to let them get close?
• How does your life broaden by letting them close?

As my ears cleared, I told Carolyn I was glad to arrive on the other side of the surgery. But life brings us many unexpected surprises. Two days later, the phone rang at home; Dan was calling and in a quiet voice asked me to sit down.

(I always get a little concerned when somebody tells me sit down to receive news. Why wouldn’t we tell people to stand up and get ready for action? Instead, we say “sit down,” as if they’re expected to passively accept the bad news. Sure a chair provides support, but when it comes to getting us ready for a new situation, it might be better to say, “Stand up and get ready for action. I have some news that requires us to get busy!”)

Continuing, Dan told me that while the mass itself was negative for cancer, he’d found a small area of cancerous tissue adjacent to the mass. Further surgery would be needed to remove the other part of my thyroid gland and perform more tests. He had changed his surgery schedule to accommodate my needs on October 3—only two days away. I certainly didn’t have much time to think about it.

In the same conversation, Dan said my chest X-ray had shown a small mass on it, the kind medical science calls a calcific granuloma. Nothing to worry about, he said. It was simply a small area of calcium in the lungs that develops as a result of the environment in which we live. However, when cancer has been spotted, a CT scan is ordered to ensure that cancer has not traveled to the lungs. So we stepped forward to do the tests.

In the meantime, Carolyn and I had decided that August to have another baby. About eighteen days before I had decided to take action on the mass, she had become pregnant. Being pregnant, Carolyn needed my emotional support, and yet, I needed her support. In the worst-case scenario, she would be alone with a child and a new born. Our constant awareness of that possibility in the back of our minds added to the emotional challenges of the time.

Further affecting Carolyn’s capacity to cope with our situation, she had watched her father suffer and die from lung cancer when she was a teenager. When he died, he was about ten years older than I was. I know this deeply affected her, yet she was solidly and lovingly available for me.
My journey was so much easier with her love and support. During this experience, I began to communicate with her better. We both were experiencing similar emotions and concerns. Sharing the fear we each experienced strengthened our bond.

Our teammates make a huge difference in how easily we can go through life’s trials. We want them by our sides through the victories and the defeats. Similarly, in the game of basketball, players need other players they can pass the ball to, get rebounds from, and assist. Basketball would be exhausting if one player had to do everything from getting jump balls and moving the ball down the court to making shots and free throws and retrieving rebounds. In basketball, it’s absurd to think of one player doing it all, yet in life, many people try to do it all without creating a team.

• How do you use the teammates in your life?
• Do you let them into the inner game?
• What is your inner game?
• Do you quickly ask for support, or do you reluctantly ask for support?
• What does it mean to you to ask for support?
• Do you achieve most things with your effort alone? Would less effort be required if you had a team?
• How do you choose your teammates?
• As a man, do you have a team of one?
• How does it feel to think about having a larger team?

My CT scan showed no cancer, just the granuloma, and the surgery took place as scheduled. After several days of monitoring and further blood studies, I returned home. Although I would now need a thyroid supplement for the rest of my life, thank goodness the first part of this journey was behind me. I could get back to living my life.

Because cancer had been found, the parts of the thyroid gland that been left around the nerve on the side with the cancer had to be removed radioactively. For the procedure, I had to be off the thyroid medicine for six weeks. This may sound like no big deal—just stop taking a pill—but, by not taking it, I would become lethargic, tired, and grumpy, and in general, have a short fuse. Not everyone reacts the same, but typically, this is the way people respond. Our family life was challenging. My wife was pregnant and tired. I was lethargic and tired. We both had been through an emotionally challenging medical experience. At times, all I wanted to do was to crawl into a cave and emerge when the game was over. The game was now in overtime, and we needed to function as a team!

Carolyn was there to support me emotionally, and she helped me physically recover. I listened to her and provided help around the house to support her. When I felt isolated and alone, I forced myself out of my cave and forced myself to interact with Carolyn. Despite the hormonal changes my wife was experiencing because of her pregnancy and my stopping the supplemental thyroid (which left me incredibly sensitive to cold just as winter was coming on), Carolyn stood solidly by my side. Although our situation stretched the limits of our support for each other, we would come through this challenging time loving each other the same as ever, if not more.

When I returned to the hospital for radioactive iodine treatment on November 17, I was directed to the eighth floor. I vividly remember stepping out of the elevator and seeing the oncology sign that directs people to where oncologists treat cancer. Without thought, I stepped back into the elevator, assuming I was in the wrong place: a cancer ward. Then I realized, Oh, that’s right. I have cancer.

Once again, I was checked in and resumed my journey toward healing. This was the first time my own mortality became an issue. As a man, I was supposed to be strong and invincible. Seeing that sign made me feel weak and impotent. And yet it was only a sign.

• What images do you have of yourself? Do you see yourself as a warrior? As a lover?
• When you look inside, who is the true you?
• How would it feel to be the person you feel at your core?
• What would life be like to live at your core?

Radioactive iodine is just that—radioactive. Health workers who work around the stuff all the time have to keep their distance. So picture this: You’re in a room alone; your only outside contact is through the phone. It just so happens to be a cold room, and the heat doesn’t seem to work. The nurses put a lead board across the door (it’s more like a portable wall made of lead) so that, once you take the pills, you don’t contaminate the hospital workers. The whole experience is like being in a cave of isolation. All you can drink is the ice water that is delivered to the cold room like food gets delivered to a prison cell: someone places the water at the door and walks away. Only then can you approach the table and pick up the ice water. Once you take the pills, you’re considered radioactively hot. You’re not let out of the room until your body has passed the majority of the radioactive iodine. As your body eliminates the medicine, the hospital workers take readings. Once the reading is low enough, you can safely go home. Until then, you are asked to stand at the door and the nurse’s aide scans your body with a device to detect the radiation. The healthcare workers maintain their distance. With each scan, you either pass or fail.

Day after day, I would get my hopes up, sure I would be able to go home that day and emerge from the cave. On many days, I rode the wave of hope back down to the cold room, waiting to be tested later that day or the next. I would fill my day with reading or watching television. I would huddle in a blanket to stay warm, but it never seemed to work. Although this part of my journey was mercifully brief, I had to learn the value of patience.

Mostly, I experienced a huge sense of loneliness in that room. The November wind blowing against the window increased the cold. A heater failed to keep my room warm. The ice water I had to drink chilled me from top to bottom. As the water and ice hit my lips, my body would begin to shiver, and the feeling would intensify as the water and ice made its way to my stomach. The cold permeated my entire body. I have never felt such a total body cold; nor have I felt so alone.

• What are the times you have felt alone?
• How would it have felt to have connected with a friend?
• What does it mean to connect with a friend?
• What strength got you through the lonely time?
• How does it feel to know that you have that strength?

I focused on returning to my family. Concentrating on the outcome I wanted helped me endure the experience. We all have experiences in life on par with this. How we interpret what happens to us makes all the difference; it’s the key to living life in the moment.

While focusing on what is happening to us, we can create a meaning that’s magical by deciding to make it that way. For me, my cancer experience taught me lessons about caring for others. Perhaps you’ve had a wake-up call that taught you to reclaim your physical fitness, that got you to change a relationship, or that pushed you to achieve a goal; or perhaps that wake-up call got you to be the person you truly are. Frequently it takes a huge amount of physical or emotional pain to get us to change our patterns and behaviors.

Athletes who get injured can bounce back and determine to train harder. There are many such sports heroes; Glen Cunningham and Lance Armstrong are two that come to mind. Lance Armstrong used his bout with cancer to train harder and bounced back as an even better athlete. He further expanded who he was and became a champion of cancer survivors and started a foundation. He didn’t sit in his cave and lick his wounds; he took action.

Learning from Life’s Challenges

I was a thirty-four-year old doctor when I had my own battle with cancer; the experience enabled me to resume my career with a fresh perspective on what a patient faces. I also embarked on a journey to get as much out of life as I possibly could. Not surprisingly, one of my favorite movies is The Doctor, the DVD cover of which says, “He was a doctor who thought he knew it all until he became a patient.” William Hurt plays a cardiothoracic surgeon who discovers cancer in his larynx (the voice box). During the course of the film, we see his transformation from an uncaring technical surgeon to a man who values each life and each patient. We also see the changes in his relationship with his wife and son, as well as his relationship with a special friend he meets in the oncology ward of the hospital.

My experience influenced how I interact with my patients; I know that facing choices about treatments that are likely unfamiliar territory will bring their fears to the surface. Yet as I had to trust my doctors, my patients have to trust me—the person across the table– to look after them and care for them.

• Who relies on you?
• Do you focus on their needs?
• How does it feel to focus on their needs?
• How strong does it feel?

Much as we learn about our own potential athletic abilities from watching players perform in a stadium, we watch others perform in life and in the movies and learn about how we can perform in similar situations.

As you look at your own life, think about the stories you tell yourself—the movie clips that you run—and ask yourself the following questions:

• What stories do you use to justify your past behavior?
• What stories bind you like chains to past reactive behaviors?
• What stories do you tell yourself that limit who you really are?
• Who are you really?
• What lesson can you take from the stories to be that person?
• What was holding you back from changing those stories, now?

You have the ability to change the meaning of those stories and become the person you want to be. Now, you have the ability to live the game of life you desire and deserve. Why not rewrite those stories to empower you into the game of life? It’s time to decide to cut the chains that no longer move you toward your goals. Call it training for a later inning in the game of life.

Here’s an example from my life. In the fall of 2004, I joined an existing small, private practice, but the circumstances were not quite as I had expected. Indirect communication plagued the office, and most of the employees worked in an environment of fear. Despite there being a physician in charge, one of the employees masterfully controlled what occurred in the office. I had anticipated growing a practice that created a positive, empowering work environment for my employees and me. Instead, I found it difficult to change an office environment that had been in existence for quite some time. I initially tried to get the other people to change, working on the manipulative employee to be less controlling and urging others to stand up for themselves. I quickly realized that I could not control their actions; I could only control how I responded. I changed how I communicated and became very direct. With time, the environment changed to one in which direct communication reigned because I had altered how I responded: I only engaged in direct communication with my physician partner, and I did not respond to rumor and directly questioned people when confronted with rumor and gossip. My cancer experience had reinforced that life is too short to live it by other peoples’ rules. Play the game as yourself.

I realized that we can control how we play the game of life, but we can’t control the actions of the other players around us. The way Tiger Woods play golf is a great example of this point. As a masterful golfer, he can control his concentration and technique on each stroke. He has no control over the course and weather, no matter how much he may wish he could. All he can hope to do is control his game and his actions—something he does very well.

• Are there people in your life who you try to control?
• How frustrating is that? How much control do you actually have?
• How free would the game of life feel if you let that go?
• How much more energy would you have to concentrate and master your own game of life?

In the office environment I described, my emotions felt like the waves of an ocean being controlled outside of me. I was trying to control things I couldn’t and, as a result, felt out of control. I frequently was angry and withdrawn. Thanks to my cancer, I had embarked on a journey to get as much out of life as I possibly could. I started by learning to recognize and control my emotions. I realized I had reached a point of feeling victimized and depressed, so I started taking antidepressants. During this time, I learned a powerful lesson; I could control my emotions by understanding the thoughts causing the feelings that result in behaviors. When I realized that, I could change what I focused on, and by focusing differently, I could gain a new perspective. Instead of being focused on why difficult things and challenges always happened to me, I could focus on what I can learn from this. This change in focus altered what I got out of the situation. I flushed the pills down the toilet as a symbol of leaving behind my previous lack of emotional control.

Here are some questions to help you take control:

• How do you identify your emotions?
• If you don’t, why don’t you?
• As you think about your emotions, what do you notice that might be clues to the emotions you are going to feel? Do you notice a knot in your stomach? Do you feel tightness in your body? What clues could you notice in your body? In your thoughts?
• How do you switch your focus from being depressed about your situation to looking at what you can gain from it?

Emotional control doesn’t mean constantly reining in our emotions. It means noticing them and using the circumstances to shift them or using them to notice signals that empower us. Just as tennis players can make many choices about how they swing the racket (modifying speed, power, and grip, for example), we can react to life by deciding how we hit the ball emotionally.

The ups and downs we experience in the game of life mirror the ups and downs that occur in any sport. But we can use them to strengthen us, especially when we share our stories with others and expand the arena in which we play and expand the way we rely on our teammates and even the size of our team.