Wed. 5/22 Michael's Home (and not a second to soon)

It's a testament to the flexibility of the City of Hope transplant team that I am writing this from the comfort of my mountain home (in Cedarpines Park).  Many people have worked diligently to ensure the environment to which I was returning was clean and safe (especially relative to pests and rodents, which are pretty much a staple of mountain living). 

There is still lots of activity to put the finishing touches on my den remodel which makes holding leadership and other meetings at my home office much easier. But I appreciate the fact that the COH team seems bent on carrying out the wisdom of their oft-stated question, 'What the point of curing the body if we destroy the soul?'  My discharge day was truly a day to acknowledge the sophistication of the COH team--they are all amazing in their passion, their training (even the student nurses) and their obvious commitment to excellence and service.

Only having been home a couple of days, I'm already enjoying the benefits of the work being done by so many friends and family over the past few weeks. It's easy to appreciate not being connected to an I.V. pole, sleeping quietly through long periods of time, and all the comforts of home (which one appreciates significantly due to their weeks-long absence.)

I will be followed by the medical team at least weekly for the time being so I'm hopeful I will be enjoying more and more unfettered engagement with the public as the next few weeks unfold.

The actual transplant went about as well as it could have.  I was released at the absolutely lowest number of days possible and the blood counts are returning to normal at the pace expected.  More next Wednesday as I have the first follow-up appointment.

I need to recast my expectations as to what and what kind of work I can accomplish in the next few weeks.  My stamina is less than I'm used to.  For example, I'm counting my time on the eliptical trainer in single digits these days. 

I'm able to participate in most of our regular and leadership meetings but am looking forward to when I'll be able to have more engagement in day-to-day activities (not that the team particularly needs my support). The MCT leadership team continues to carry out day-to-day tasks with excellence and I continue to hear stories of kiddos' lives being changed by interventions carried out through out team of direct service clinicians, family specialists, and parent partner, which really is what this is all about.

What I'm Learning

Mindfulness (the ability to be in the present with 100% focus) matters.  

I'm seeing more and more that staying in the present is the right answer for so many problems and opportunities, though technology and various 'bright and shiny objects' provides plentiful potential distractions.

Swing at the ball you're pitched.

Experiences like this make it easy to focus on what one can't do.  The reality is these times present unique opportunities for doing that which, in more normal times, often gets squeezed out by the urgent.  Tasks at which I can excel during this unique time include: strategic planning, blog writing, reading potential grants, reading growth-producing work from sources like the Harvard Business Review and various supportive materials to our student services (e.g. Gallup's new student-focused strengths materials, and the innovative "Seeking Safety" curriculum which is focused on overcoming the negative impact of trauma).

Sometimes Targets Help to Focus the Mind

Flash Bulletin ****Looks like discharge is going to occur tomorrow, Wednesday, 5/22****

This may seem like no big deal but I have been focused on returning to my life of relative normalcy for the last few weeks so for me it is akin to winning the lottery (not that that necessarily would be a good thing--Look at the research concerning lottery winners and you'll see what I mean.  But I digress.)

Reality is that, barring unforeseen events, I could very likely be wafting my way back to the San Bernardino mountains by midday tomorrow.  Not a second too soon, say I.

Canine Spoiler alert--Not a word to Luke the therapy dog (who is being groomed as I write this). He likes surprises.

Since I'm not long for the COH campus, here are some photos to give you the flavor of life here.

With gratitude to God, Becky (who put up with myriad tasks to get me through this), all the amazing staff here, I stand ready to return to my former life.  Balrog days hopefully over.

Working Toward D/C . (Target: 5/23) . American Paradigmatic Stupidity

We have a concrete target for Discharge--May 23.  I consulted with the attending physician yesterday who assured me in no uncertain terms that I'm not being released until it is safe to do so (this in response to my impassioned plea to return to my pretty good life of supportive spouse, cool Golden Retrievers, amazing friends/spiritual community, team at MCT that I actually LIKE hanging out with, etc.)  So the concrete may not be exactly dry on this concrete target.  But certainly I would appear to be returning to the aforementioned life this week or very soon after.

One thing this cancer experience does for you (the proverbial 'you') is to generate several 'cancer club' benefits (stuff you mere mortals believe but to which you only give lip service and which we addicts and cancer survivors live or die by).

These reminds me a bit of the addict who became CEO who shared three principles to live by (see earlier post) which addicts live or die by and everyone else considers and then decides to take them or leave them.  The addicts (and the cancer club folks) have an advantage (for which they have paid dearly). Could you achieve these commitments without going through the balrog days of cancer treatment?  Sure, but, let's get real, it doesn't usually happen.
Do I wish cancer on folks unafflicted so they can benefit from these commitments?  Absolutely not. But if you're doing to have to deal with this really obnoxious thing called cancer in some form, you might as well wring from the bloody experience every last benefit.

People in the 'cancer club' often:
Don't waste time.  They realize the cliche about 24 hours being all we have and time being our most precious resource are actually lasting correct principles (LCP's) which will either become our trusted friends or our destructive enemies.  These LCP's will either make us better or kill us.  A bit like the Ten Commandments.
Don't have a lot of tolerance for 'games'.  I mean by 'games" interpersonal dynamics which are founded in stupidities such as passive aggressiveness, vengeance, fear, or bitterness.  I like the internal self talk I often use, 'don't engage with that, you really can't afford it'.   I can't.
Don't waste energy on 'bright shiny objects'. I am, and always will be, an ENFP (Meyers-Briggs type called 'journalist' or champion).  The joke about this type is that they will always notice (and sometimes waste energy on) the newest bright shiny object.  The ENFP prayer:  ENFP: God, help me to keep my mind on one th--Look a bird--ing at a time. Don't laugh, there's a prayer for your type also.
Quit the Stupidity of Isolation.  What I mean by this is that the American individualism that we breath in unquestioning is, well, just dumbass stupid.  Look in the Bible (if you're among the Christian folk in this audience) and you'll find the majority (except for narrative stories) of the times that God calls someone or even just addresses them (e.g. in the Pauline epistles) are intended as "you" plural, that is, we are to do our best and most significant work in connection with others.

Why make such a big deal about this?  Because, as one of my brochures (for CCX) says, "Isolation sucks."  "Connection rocks."  And to give a 'shout out' to our armed forces, it didn't take long for Army leadership to realize that "The Power of One" was exactly the wrong message.  Now Army messaging is much more about connection and community.  There's even a senior training officer in the U.S. Air Force utilizing Brene Brown's work on vulnerability and daring leadership (all of which is focused on connecting rather than isolating).

By the way, let me respond to the introvert(s) in the audience who will say, 'Fine for you, Mr. Extrovert, but I am not wired for connection.'  Sorry not to sugar coat this for you but . . . Wrong.  The neuroscience says exactly the opposite.  You are wired for connection.  As an introvert, you may work harder for the connection and the resulting connection may be more thoughtful and authentic than us Extroverts who tend to think less and emote more.  Don't believe me?  I just now did a search for "We are wired for connection" and came up with . . . drum roll please . . . 115 million results.  Check out a few hundred thousand if you'd like but the reality is We are wired to connect.

I often say to my clients that on my goal list, I probably have over 50 goals that are incredibly important to me and not one of them has a snowball's chance in hell of coming to completion without connecting with the right people.  And I see that as GOOD news.

That felt good to say.  I wonder how many have ears to hear . . . Feel free to interact; I'd love to see the responses to the 'in your face' stuff above.  Hopefully the response is not to half my audience.

Days 5-8 (Hopefully Day 14+ is d/c)

This is the boring part.  Lots of waiting for what the medical community affectionately calls 'engrafment'--that magical process by which blood cell counts and other lab results return to normalcy.

Been re-reading "Dare to Lead" by Brene Brown.  Biggest ideas thus far:

THE HEART OF DARING LEADERSHIP

1. You can't get to courage without rumbling with vulnerability.  Embrace the suck
2. Self-awareness and self-love matter.  Who we are is how we lead
3. Courage is contagious . To scale daring leadership and building courage in teams and organizations, we have to cultivate a culture in which brave work, tough conversations, and whole hearts are the expectation, and armor . [defensiveness which prevents authentic communication] is not necessary or rewarded

Dr. Brown has some practical ideas here to transform our leadership from control to reward and from defensive to vulnerable and authentic.

Still shooting for a d/c date of approximately 5/23.

I've also been ramping up my sophistication in the cell group (Christian Community Experiments) by reading Joel Comiskey's "How to make disciples in the 21st century".  The biggest takeaway thus far is that American individualism is a major obstacle to creating authentic community experience.

See brochure included in Find post entitled "Michael and the Balrog Days" and go to bottom for brochure.

(Michael) and the Balrog Days +3 to +4

For Lord of the Rings fans, you will remember when the fellowship flees from the Balrog (big ass majorly evil monster) and Gandalf, the leader, ends up locked in prolonged mortal combat with the dreaded monster.  I may well be going through the Balrog phase at present--nausea, fatigue, even a bit of depression (been reading of depressive experiences of the likes of Lincoln and FDR so I push through with a certain amount of 'surrounded by witnesses' hubris), looking forward to achieving "Gandalf the White" status at the outcome.

Becky's here now which is a great help on many levels.  One reflects on marriage at a time like this:

• 'in sickness and in health' (from the traditional wedding vows)
• 'this is why they make you take vows' (quote from vulnerable scene in 'West Wing')

Assuming I get through this relative unscathed, better than I went into it, it will be as a result of the efforts of many, not least Becky.

Had some conversations with families here who are having a great deal more challenge than I.  Talking and praying with them is good therapy for us both.

I continue to be inspired by the quality with which the MCT team is pushing on with their responsibilities (and some not inconsiderable ad hoc challenges) as I play my backup role here.

Excited about getting into some planning on some initiatives, I'm hoping to catalyze in the the next few weeks, as the Balrog thing allows:

• Legacy Impact Giving Event & John McGill Concert -- Opportunity for Mountain Community to Give posthumously through their life insurance and other vehicles to causes they care about.  June 9.
• Regional Youth Foundation -- collaborative fund raising with likeminded child-serving org.  Details to follow.                                                                                                                       
• CCX Community Groups Experiments (see attached for latest brochure).

Transplant Day . (Day 0)

Completed the actual transplant today—all of approximately 40 minutes.  Now the game is to provide medication and support to bring lab counts back up to normal and restore normalcy.  Dr. Rosen says to expect feeling ‘like you’ve been hit by a small car’ (rather than a semi-truck). Some rough patches before and after but side effects are largely manageable now.

There is lots of activity around campus getting ready for the Bone Marrow Transplant Reunion on Friday.

I’ve been entertaining myself with a listen to the eminently well-written Leadership in Turbulent Times by the leadership biographical scholar, Doris Kearns Goodwin. Though I don’t believe the current political climate was mentioned once, there are numerous times it’s easy to yearn for the leadership of FDR, TR, Lincoln, or even LBJ which were largely based on honor, truth, commitment to right principles, and authentic relationships. FDR’s heroic battles against polio are a welcome respite to the current challenges both my own and those in the political landscape.

I’m not feeling great at present but am hopeful that the worst is behind and I will soon be home. 

Day -3 through -2

Chemotherapy taking place in earnest now with Day 0 being the long-awaited transplant day. The myriad players at COH  are carrying out their roles with excellence and we're heading toward transplant day with hope and a fairly positive attitude. Room service is excellent and one can get pretty much whatever one desires.  We're trying to lean a bit toward the Cinco de Mayo theme with a quesadilla.  Nausea quite the order of the day.

Becoming acclimated to how one gets 'extras' around here (e.g. workouts in the gym and unrestricted access to B complex vitamins) (which seems to be quite the contraband due to niceties in the pharmaceutical profession).

One plaque I saw recently symbolizes the reality of how things really work around here:

Importantly, we are approaching he actual transfusion date which moves irrevocably toward success and the patient (me) being relatively whole and ready to return to his regular life and, not least, Golden Retriever-and not-for-profit filled life,

So far, my time away has been characterized by the team at Mountain Counseling & Training, Inc.  ably conducting a Wellness Walk and my handyman team (headed by Paul (hauling guy) Shane (Handyman/coordinator guy) and wife (all around make it happen person) working on getting the house in tip top shape for my return.  We also have some cleaning people, Robert and Kimberly Moss, who are working on reducing household contaminants.  In addition we have Structural Termite and Pest Control working to eliminate pests of the microscopic (spiders/ants), submicroscopic and larger size (e.g. rats/mice).

Another bright spot is the Dean Koontz novel, "Watchers", focused on a genetically engineered Golden Retriever named Eisenstein.  Things going pretty well for them now except they are intermittently locked in mortal combat with a mafia hit man and a genetically engineered malevolent baboon, bent on mindless murder.  To say more would require a spoiler alert so I'll let you have your own Koontz/Golden Retriever adventures.  Finished the book this a.m. but you'll have to read it for the conclusion--suffice it to say that I agree with Koontz and his reviewers that it is his best work.  Not that I wasn't also powerfully impacted by "Fear Nothing", an earlier work which is also worth a read/listen.

Coaching Tips (This is the What I'm Learning From My Cancer Part)
Here are some materials I'm working through during my forced convalesence.

Coaching resources.  (This is the What You Might Learn From My Cancer Part)
I got to review a training that one of our consultants is going to be presenting to our team tomorrow and I thought a couple of his selected videos worth sharing:
First from Fred Rogers on the Importance of Trust and Investing in our Kiddos

And then there's the always worth sharing classic Ted talk from Brene Brown on the "The Power of Vulurnability. 

And second, on the lighter side, a bit of Star Wars wisdom, when facing a difficult challenge.

Enough for now--hopefully that the days here are only a few more.  I hope We are now in the home stretch as I'm looking forward to getting back to my normal life (and a pretty good life it is too).

Dr. Rosen just stopped by making it clear that he has a vested interest in a positive outcome.

Days "-8" and "-7": First Days In Hospital

First couple of days in the hospital. I've been learning how one designates days in the transplant process.  Yesterday was Day minus eight (-8).  So designated because Day Zero is next Wednesday which is what one affectionately refers to as "transplant day".  Day "-7" (today) inches ever closer to the transplant day.

The goal, in the words of one of the nurses, is to 'give you enough chemotherapy to kill you'.  But fortunately killing the patient is not actually the intent.  It's more about killing the patient's immune system and reducing all immune functions to basically nothing so that new cells can be introduced (Day 0).  Assuming all goes well, that infusion leads to a gradual rebuilding of immune function and one is discharged and sent home to lead a long and happy life.

Yesterday was generally uneventful, filled with driving, administrative tasks, labs, meeting with the attending physician, meeting with the transplant coordinator (who originally hales from Canada), and getting pep talks from the various nurses on Floor 6 of Helford Hospital.  Some "good cop" "bad cop" dynamics at play. Fortunately, nurses have way more "good cop" than "bad cop" going on. Overall, the experience seems to be: a bit of prison, a bit of luxury resort, a bit of monastery, and a bit of medical institutionalization, all with a lot of great people who seem to care a great deal about their patients and their hospital. Room service is quite the highlight.  These guys seem to think that food is a centerpiece of one's success around here.

All seems manageable thus far but the clear message from the nursing staff is, "Don't worry we haven't had a chance to really beat up your body yet", all said in a spirit of love and professionalism.  But one does take solace in the fact that COH has done thousands of these procedures and, by all accounts, is pretty good at it.

Serendipitous (and encouraging) event in the parking lot yesterday:  connected with Dr. Rosen (my main physician and the COH Cancer Director) who expressed interest in following me throughout the procedure (though the attending physician for the transplant is Dr. Herrera). Dt. Rosen is not only exactly who you would want in charge of your cancer care, he is also a great example of a leader profoundly impacting those he serves with his gifts and strengths,  I don't know if he's a practitioner of the Gallups strengths philosophy (as I am) but he absolutely is an example of someone playing to his strengths and bringing his best contribution daily to his myriad stakeholders (of whom I get to be one).

Coaching Tips (This is the What I'm Learning From My Cancer Part)
Two things:  Never alone. Never without a goal . Two things that seem painfully and abundantly obvious on Days -8 and -7:   This transplant thing (and life thing) only works with the right people and it only works with focus.

The Right People--MD's, the wife (never forget the wife), the PCA's (learned today that was Patient Care Assistant), nurses, case managers, housekeepers, recreational therapists, nutritionists and others are all critical parts of this effort and success of this is going to rely on my connecting well with them and benefitting from each of their roles.

Focus--I'm also thinking that generally maintaining focus on the goal(s) is going to matter a lot, I'm a 60-year-old man.  Assuming this goes well I could have ten years or more to serve kiddos (and our counseling team) at a non-profit in the San Bernardino mountains, engage with friends/wife/God/Golden Retriever, have a positive service impact on not-for-profits generally and other leaders in our community, and start a not-for-profit focused on Christian Community Group (CCX) experiments.  I'm thinking those are worth doing so figuring out how to navigate through this particular next few weeks is also worth doing.

Coaching resources.  (This is the What You Might Learn From My Cancer Part)
Before I left the office I presented a new policy to the team that included the following videos, both of which I see as great catalysts for personal and professional growth:
"The Call to Courage" by Brene Brown (on Netflix).  This is a condensed version of a presentation Dr. Brown gave in L.A. recently (which our clinical supervisor got to attend).  Lots here to propel individual growth and professional leadership.
"Great Leaders Do What Drug Addicts Do" by Michael Brody-Waite.  I discovered this in the midst of creating a Performance Improvement Plan policy and decided to use it as part of our strategy for encouraging staff to meet the organization's productivity standards.  Worth a listen/look even if all you get is the three principles that recovering addicts live by (and leaders should live by).