Four months post Stage 4 cancer diagnosis. Where has the introspection got me ?

It’s been around four months since I was diagnosed with stage 4 cancer at the age of 35. You can read about my initial freak out here. Since then I’ve done four cycles of chemotherapy, five weeks of radiation therapy and I was hospitalized as a result of two pulmonary embolisms (apparently a ‘bonus’ side-effect of cancer). I also turned 36 and joined the (unsuccessful) fight to legalize assisted dying in New South Wales, Australia. It’s been an interesting few months.

Chemo fun

Between all the treatment there has been a lot of time for reading and reflection. Take it from me that nothing makes you ponder life like a doctor telling you that you have, at best, a 50% chance of being alive in 5 years (and all the medical literature suggests your odds are more like 15%).

Tomorrow I’m scheduled for my ‘big’ surgery — to remove my primary tumor and potentially also the secondary tumors in my liver. I confess to being pretty nervous about it and so to occupy my time today I’ve been trying to distill some kind of insight from these last few months of introspection.

I thought I’d share some of the more ‘generic’ stuff that I captured in my little Cancer notebook. These are just my personal take. There’s a high incidence of cliches and not much you’d call profound, nonetheless I figured someone might find value in them. So here goes…

I was recently in conversation with someone who is borrowing a large sum of money to finance a fairly lavish wedding, when they’re already saddled with a big student debt. How many things do we do simply because of social convention — because we’re worried about what other people will think of us, and how much do these things really matter? I’d suggest the answers to these questions are, respectively, ‘a lot’ and ‘not at all’. Buying a luxury car, or expensive branded clothing, when the standard issue would do perfectly fine. Eating at ridiculously expensive restaurants. Worrying about how your pace of promotion at work will be perceived by others. There are so many things we invest time and energy in, that we worry about, that are just unnecessary. This comes into immediate focus as soon as something significant happens in “real life” — a death, a health scare. Suddenly many of the things we’ve placed so much value on seem painfully trivial.

I’d argue that as long as it isn’t at the expense of something that really does matter, then the occasional splurge, vanity purchase or pet project does no real harm. However all too often these acts are to the detriment of something that really matters. But what “really matters” ?

So I’ve thought about this a bit but I’m sure many will still disagree with my list. I think, at the end of the day, there are really just four things that actually matter.

  • Basic needs — We need food, shelter and safety ahead of anything else. In our comfortable, relatively wealthy bubbles we forget how many people lack these things, or how easily they could be taken from us.
  • Love ones — Any parent would tell you that their kids matter above all else but that importance can equally be felt by a spouse or a close friend. Creating, preserving and investing in these relationships really matters.
  • Community / Society — I mean to use these terms very broadly. A safe & fully functioning civic society is vitally important, otherwise we as individuals will inevitably suffer. Making a personal contribution that develops and advances society, whether through education, institutions, technology etc, really matters.
  • Our environment — You could argue this belongs under the ‘basic needs’ line item but I think it’s worth calling out separately. Does any personal or communal need or any human relationship matter if our natural environment ceases to support our existence. What can matter more than protecting that environment?

I’m trying to use this list to test my decision making now. Am I spending my time, energy and money on things that really matter, or am I acting to the detriment of any of them.

I say above that our ‘basic needs’ really matter, and that’s self evident really — we need food, shelter and safety. However what I’ve learnt over the last few months is that most people underestimate how fragile our hold on these basic needs can be when the unexpected happens. I’ve heard terrible stories of people loosing everything because of medical bills, for example. I’d strongly encourage everyone to build financial buffers into their lives before other discretionary spending. This could range from setting aside some savings to ensuring that you have proper insurances in place. Sounds boring I know, but please trust me, I’ve seen up close how important this is.

Ok so I know it sounds like I’ve suddenly switched genre here, but hear me out. I’ve thought a lot about my kids’ futures recently — in scenarios where I’m still around and others’ where I’m not. Much of my concern on their behalf relates to issues for which there are actually solutions, but where our political systems are failing to agree on and implement these solutions. Think education system reform, access to healthcare, climate change, affordable housing, the chemical contamination of our food chains — there are so many issues. Fractured & polarized democracies, the ‘old white men’ phenomenon, or populist policy catering to the lowest common denominators of society — there are many causes of inaction. In all seriousness I feel like some kind of revolution, or several, is going to be required in my children’s lifetimes in order to course correct, and that’s a scary thought. I have been thinking a lot about what role I can personally play in affecting change, particularly if I manage to survive this cancer for a meaningful period of time.

I’ve always been a planner. Not long before I was diagnosed with cancer and was told I’d be lucky to be alive in five years I had just refreshed my life plan document (yes, I’m a sad nerd…it’s actually a Google docs presentation), replete with detailed milestone goals at 5, 10, 20 and 30 years from now. I stand by the importance of goal setting (having a documented set of aspirations has actually been helpful these last few months), but I now realize that the way I thought about them was all wrong. Every life has twists and turns, some more violent than others. Having broad long term goals is great, but assuming that you can plan the path toward them in granular detail is naive.

About 8 years ago I got an unplanned tattoo on a very drunken night out in Savanah, Georgia (USA). I’ve totally forgotten what the inspiration was but I had the latin phrase ‘viva ut vivas’ tattooed on my shoulder. This translates to ‘live to live’ and given all the recent issues with my health it suddenly seems all the more relevant. It’s basically a reminder that you should live each day to its’ fullest potential. That would be my single biggest piece of advice to anyone. You just can’t assume you have a whole lifetime to do whatever it is you want to do — you need to try and work a little bit of dream fulfillment, or at the very least a bit of joy, into every single day. On reflection I could have done a better job of living like this.

When I’ve pondered my regrets the biggest ones are moments I’ve been an asshole. By this I don’t mean stupid or uncool, I mean treating other people badly. Luckily I consider myself not to have been an asshole on too many occasions, but the handful of occasions I do recall (mainly in my early 20’s) I regret deeply. Life has taught me that assholes eventually lose, even if they win in the short-term. Far better to make yourself an asset — a valuable and liked family or team member, a highly contributing colleague or citizen.

Having someone — a spouse, a child, a good friend — to hold your hand through bad times is so important but I’ve also realized that your darkest moments are very often solitary. For me they tend to come when I’m alone in a hospital bed long after visiting hours. Other times I’m surrounded by people, but the experience itself is very solitary — like the moment you’re laid out on an operating table surrounded by a room of medical folk, but knowing that you alone will have to endure the consequences of what’s about to happen. In these moments I now understand that mental fortitude is really the only thing you can fall back on. Life is full of dark, lonely times and so investing in building your own mental strength is invaluable.

I was so guilty of this just 5 months ago. As a healthy person you forget that there are people who struggle with even the most basic stuff — everything from breathing to peeing can be a challenge for some. My eyes have been opened (by regular doctor and hospital visits and lots of time spent in waiting rooms) to the huge group of people in our society who suffer from chronic conditions, or perhaps were born with a disability. Your average healthy person just has so much to be thankful for from the moment they wake up everyday. Life, and particularly a healthy life, is such a rare and beautiful thing it deserves to be cherished and appreciated but sadly few people truly do.

That’s all I’ve got for now. I did warn you about the cliches and lack of profundity — but I think that’s because life’s basic truths really are quite simple.

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Father of three. Passionate about purpose 1st business. Follow at

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