Who Should Know I Have Lung Cancer?

When I first learned I had lung cancer I was devastated. This kind of a diagnosis and the prognosis for recovery feels like a death sentence. Thing is, I did not commit any crime. Smoking was an addiction. I could not quit - try (many times) as I did. I wish I had never started. I don't mind being a hypocrite telling my kids not to smoke. Anyway, I gambled and lost and now I have to pay the price.

The first thing I had to deal with after the diagnosis was "who to tell." My wife and I talked about this a lot. I am somewhat well known in my little community because of my civic involvement, the fact that I am marketing myself and my name, and taking care of hundreds of households. I don't know what my long-term prospects are. Luckily, a year ago I took on a young man, Ryan Rupert, as a partner in my practice. I say luckily because, not only is he doing a good job in selling our services, he is in a position to easily take over my practice and serve my existing clients if I am disabled. And because of the kind of business I do (managed money) my clients' investments are well served every day, whether I am there or not.

The uncertainty of what happens next makes it all the more difficult. How sick am I going to become? Will I be able to work during treatment? If treatment does not work, what happens next? How will the disease progress? At what point will I not be able to effectively take care of business? What should I tell people who are thinking of engaging me about my health? Am I morally obligated to tell them I have a substantially reduced life expectancy? Should I tell my clients why I am not in the office on Fridays (because of chemo) or should I let them continue to believe that I am out golfing.

My wife and I concluded together that it is best that we keep this matter as private as possible and tell people on a "needs to know" basis. The only Morgan Stanley people who know about this at the moment are: Ryan Rupert (my partner) Rick Wright (Punta Gorda office manger) Kevin Mahoney (the Ft Myers/ Punta Gorda Branch Manager); Mike Petramolo (The SW Florida Complex Manager) and Michael Outlaw (the Southern Regional Manager). If I am going to be missing a lot of work, I need Ryan to know so that he can cover; I felt Rick Wright should know why I am not in the office. I needed Kevin to know, because he is my P&L reporting relationship; and Mike Petramolo should know because he is the one that hired me and I had immediate questions about my contract with Morgan Stanley. I have not told anyone else in the office. Since all this occurred, Rick Wright as been reassigned to Bonita and Brian Mariash has taken over as the Punta Gorda Office Manager. That is a problem for me. Brian has already heard something through his connections in the medical community that I am very sick. He has reported this to Rick Wright, who in turn let me know someone is talking. I confronted Brian about this and told him that it is a felony to disclose medical information; Brian swears he was talking to Rick only about office scuttle butt and had no medical worker source. Who knows what the truth is, but it does demonstrate how difficult it will be to keep this thing secret. I have elected not to tell Brian anything more, since Kevin (his boss) knows and is very sympathetic with my situation.

As far as having to reveal this information to my clients, I have concluded I would rather not for now. Frankly I don't know what good it would do to tell them now. While my long term prognosis is not very good as a general statistical measure (only a 20- 30% chance of living 5 or more years) the fact of the matter is that the statistics reflect a population that is significantly older than I am and a population that would likely have other complicating conditions. I do not have diabetes, COPD or other lung disease or breathing problems, etc. This helps me. On the other hand, I am at stage III A and I have lymph node involvement and I am inoperable. That works against me. Realistically, I think I have a good one year survival rate and only a fair 5 year survival rate (so there is no need to rush out and tell the world...I have time.) In six months, I will know better and if at that time the prognosis is worst, I will have come up with some sort of transition/succession plan. My main concern is that, while I am being treated, my clients are being properly served. I do not have a dedicated sales assistant, but Kevin has promised to work on this for me. In the meantime, I am leaning on Ryan to help me. So far I have been able to work without a problem, other than on Friday, when I have radiation followed by chemo. I also have access to my desktop from home. We are moving into new office space and I am hoping I can have a phone that will allow me to forward calls to my cell. So I believe I am well situated in terms of coverage.

So far the side effects have not given me away...but that may not last. The other problem I have is I keep running into people I know at the doctor's office. So far I am batting 1000 in terms of seeing people I know. The first week I went to see Scott Lunin, I ran into one of my former clients. He is 93 years old and did not recognize me. The next time I was at Lunin's office, I saw people I know from Arcadia Rotary...they did not see me as I went hiding in a magazine. Today I did not see anyone I know, but of course, if anyone knows me it does not help when the nurse comes out and yells out your name. Not only does everyone in the waiting room now know who you are, but if they recognize your name, it won't be long before they tell someone. I think they ought to use numbers instead of names -- like at the deli -- when they call to serve you. Anyway, keeping a secret in a small town is hard. It is going to come out eventually. Someone could see this blog, which is in the public domain. It is going to come out...it is only a matter of time. This blog will help as I will be able to direct clients here to see why I have kept this information from them.

Bottom line -- if I had AIDS or any other disease -- I would not feel obligated to disclose the fact to my clients. I don't know with any more certainty today when I am going to die than I did a month ago. Could be tomorrow, could be in 5 or 10 years or longer. I have concluded that I wish to leave my life as normally as I can and do so in a manner that reflects a normal life expectancy. I am not going to go around acting like I am going to die soon. I will plan for the worst, to be prudent, but I am going to act like anyone with a normal life expectancy and then see what develops. As far as getting new clients, I think the same holds. I am selling the team concept to begin with, so I am less concerned.

What about family? It goes without saying that I have to tell my children and immediate family. We made that decision after we got the diagnosis. This blog is really for them. I hope they will read these entries and comment or make suggestions, as I intend to be very open and plain in my writings. I am looking forward to getting your comments. I hope all my nieces and nephews get one thing from this -- don't smoke; live a long and healthy life. I hope my sister Linda quits and Frank. It is not too late.

What about friends? Well I can't tell my friends who live in the immediate area...if I do that I might as well just tell the whole community. So I am electing NOT to tell my friends. If you read this after the fact, I hope you will understand my reasoning. I have to first and foremost take care of my family. I am the breadwinner in my family and I am in a business that is difficult in the best of circumstances. I don't want my clients to panic and "bail" because I may not be here; that does not help them or me. And I don't want to be stuck in neutral, unable to get new clients because of concerns over my health. And certainly don't want my competitors knowing and using this fact against me. So for now, the best answer for me and my family is to keep this a private matter and just go on as we have. If my condition deteriorates, I will have to reconsider what to do, but as long as I can function normally, I don't see a need to make a general announcement. Having said that, I would LOVE to tell my brothers in Rotary, people at St Vincent De Paul, my golfing friends and especially my friends who are still smoking. I'll say now that I am sorry to have had to keep this from you, though I am sure you understand.

What about my friends who live outside the immediate area? I have not yet made up my mind what to say or why I should say anything. I know Linda Oppe and family (who tried to get me to quit for 35 years) are going to say, "I told you so." Maybe Eric Madsen, who is very health conscious will react the same way. They have always been right --I never argued that I should smoke. What they can't really understand is what a powerful psychological and physical addiction smoking is.

Obviously, if you are on this website, you have learned about my lung cancer. I would like to hear your feedback on this matter of who to tell. If I did not tell you directly, let me know you know and how you found out. This blog may be one of the best ways for me to monitor who has learned about my condition.