Saturday, July 24, 2010

Going deep

I'm not working at Tom, Dick and Harry very much at all these days. So the absence has given me a little perspective on my experience there. 

I remember the best piece of advice I had ever gotten came from a man from India. My friend Sonya Grewal (who, coincidentally, is recovering from her own war with cancer recently) was getting married to this great guy, Mark. So her parents were in town for the wedding and reception. They lived in India and are Indian. Her dad also owned a very successful company. When I met him, it was literally the first week TDH was in business. Before that time and for many months afterwards, the three of us founders would ask anyone who had experience starting up a company for advice. People responded with very good, insightful words of wisdom. But not Sonya's dad. He just said, "Work hard and everything will be fine." Then he went on with another conversation as if to act like it was a no-brainer. 

To this day, it was the best advice I had ever gotten about owning a business. When we started, we had everything going against us. First, we were three boneheads who knew very, very little about anything other than football trivia. Still David's not the best at football trivia, but I digress. We were also starting a business in what was then one of the worst recessions in decades. And finally we were in a business that had other like-companies, tens of thousands of companies that were selling and saying the exact same things we were. But we worked unbelievably hard and somehow, it came out alright. Today, that's the advice I would give to anyone thinking of starting their own business. Work hard and everything will be fine. But you gotta work damn hard.

The second best thing I learned out of TDH is not to be afraid to go deep. This is yet another sports reference. In football, throwing deep holds high risks and high rewards. You either get sacked or score a touchdown. The key is to assess the situation. See if the timing is right, the conditions are favorable and make sure you have a back-up plan if things don't go well. We went deep at TDH because we were leaving a pretty safe gig and trading it in for something that was anything but. At least that's what I thought. It actually turned out to be just the opposite. Owning your own company is actually safer than working for a company. After all, you know when the money runs out when you own the company. When you're an employee, you can get popped at any time and for any reason.

One of my biggest heroes in life is Abraham Lincoln. I've read a handful of books about him. The best by far is Doris Kearns Goodwin's. It's an unbelievable read. Not as good as McCollum's book on John Adams but we all can't be perfect. I was once awed by Lincoln's clear, concise and still creative writing style. I was blown away at his ability to overcome hatred and forgive. And of course, there was his brilliant mind. But after reading the Kearns book, I was most impressed with his timing. People today think Lincoln was a radical but actually he was very, very centrist. And that means everybody hated him no matter what he did. This reminds me of a certain president now but I'm not going to get too political here, not since both my father, father in-law, partners and close family friends are all pretty close to being tea-party marchers. 

But the way Lincoln handled everyone was he waited for the right time to make his move. He waited years to free the slaves. He waited months to fire incompetent generals. He even waited until the right time to be nominated president. Time after time, he waited for the right time to promote his agenda and it was the timing and not necessarily anything he said that got it done. He had a genius understanding of the importance of timing.

It is with this inspiration that I tell you all of my next move. The fine Dr. O'Connor has indeed taken me off my current treatment as it isn't working at all now. We talked for more than an hour about what to do next. Currently, there are about twelve different drug treatment options available to me. All but two of them have about the same chance of any success, which is about 30%. Just so you know, the drug I was on had a slightly higher rate and even though the cancer grew while I was taking it, I am considered a success since it grew under the scientifically accepted rate. It was only supposed to last five months, I went almost double that time.

With basically a 30% chance of doing anything remotely positive, I wasn't exactly thrilled with my choices. Neither was Dr. O. So after much discussion, we realized I was left with two drug treatments that could have better success rates than the 30% drugs but both were high risk and high rewards. 

The first is a treatment only available to me in Europe. I would have to live in Pisa for about a month to get to my first infusion and then come back periodically for other infusions, maybe a couple more months. That seemed like a big pain to me right now. Heck, I never even told my wife about this as I could just see the conversation, "Yeah, it's in Pisa, Italy. You know, the place with the leaning tower. I'd have to find a plane ticket, a reasonable place to live and oh, I'd have to leave you here with three kids during the busiest time of your life for a month." She'd do it but I don't know if it was right. 

Like Lincoln, I have to pay particular attention to timing. It didn't seem like the right time now. But it could be the right time in a couple of months. But the key is I can't wait too long. If I get too sick, I won't be able to make the flight or be able to take care of myself for long.

Also, this choice is high risk on a medical basis. For some reason, the only time they tried a similar treatment here in the US, it failed miserably. It's done well in Italy but it hasn't been tried on a lot of patients and hasn't been for a very long time. This is a new type of therapy that involves sending radiation into your body instead of chemo. It's very new. Promising but new. I'd have to go a long way for a promise.

The other high risk/high reward option is even more high risk. I would literally be the first human being to ever try it as a Hodgkin's patient. The drug did really well in the laboratory with other cancers. It works like my last drug, SAHA, in that it kills the cells that help the cancer cells live. Only this cell is a little "further downstream." This treatment is thought to be a good Hodge drug because the cell it kills is very popular with Hodgers. They got more of them than other cancer patients. So far it's doing well with other cancer patients. Dr. O. said he's only seen one other drug to seemingly have better promise and that is the ever elusive and much ballyhood SGN-35. As I mentioned in other posts, I can't get that until the first quarter of the new year at the earliest. But even that one has many, bad, bad side effects.

The thinking here is if this drug does work, chances are it will work better than what I just finished getting, which is really only slowing growth and not really killing growth. If it doesn't work, we should know faster than other drugs since in labs, it has shown to work very quickly. If this happens I may have a better chance at survival because I can hopefully catch it quicker. Because I'll be on it for at least a couple of months, I'll also have a better chance to switch to a couple other drugs that are out there because I will be further removed from similar treatments in the past. For example, I could switch to a more traditional but painful chemo and have a better chance at survival because I will have had almost a year and one half break from chemo. 

And there's always the Europe plan. That would actually be my first choice if I'm still feeling up to it. Give this new drug a short shot and then study up on some Italian.

So that's the deal, complete with a mixed metaphor of Abraham Lincoln and football. As always, I would love to hear your thoughts. I especially enjoy my Asian brethren even when it is translated by Reed Martin. 

One other thing, expect to see a lot more of these posts in the next month. The doc gave me a steroid to help stem the swelling on the cancer while I'm in between trials. The steroid keeps me up at night. 

The good news is, the warewolves don't howl any more. I'm not afraid. I've been through hell. I've seen it. It's no big deal. Sort of like going to the House on the Rock in Wisconsin. It's there. It hurts for a while. Then you're done. 


  1. You've always been a smart guy, Michael, and I can see you've still got it. Just like the hard work you've put into TDH, you're working overtime and then some to beat this thing. You're exploring all options, evaluating, looking at the timing, the big picture, making clear decisions and more importantly are putting those decisions into action.

    I'd venture to say you have gathered and absorbed more knowledge of your cancer than most doctors in the country. That's a testament to your vigilance and hard work ethic.

    Only being a sideline waterboy and cheerleader, I can only say keep doing what you're doing. My daughter just posted this overused quote on her Facebook yesterday, but one that is true regardless of how many times it is used: "Winners never quit and quitters never win."

    You're a winner Michael. Thanks again for taking me and the rest of your cheerleading team with you. We're behind you all the way.

    I am also very glad to hear the werewolves no longer howl for you. Good deal, my friend.

    Side Note: For some strange reason, I felt compelled to bring Marion Butts and Roosevelt Potts into the conversation but unless Reed's Asian translation was incorrect, I simply cannot figure out a way how to do it. Sorry.

  2. The post above translated is: "She getta married. Married? Married! Geez!"

  3. Actually those translations came straight from Google translate - which makes the last one even more amusing...

    And now a chance for Michael to practice his Italian: Avrebbe fare un piano e seguire - questo è ciò che Brian Boitano farebbe


    Fino a quando la prossima volta il mio amico


  4. Knowledge is a treasure, but practice is the key to it.................................................

  5. Pisa and the rest of Italy are pretty awesome, just to throw it out there.

  6. 人生有如洶湧的波濤,如果沒有岩石的阻擋,怎能激起美麗的浪花?......................................................