In my case, the journal helps greatly.
Starting up the journal again and sharing it was critical for me to understand what I was going through.
But unlike in 2017, I realised very early on that I would also need to seek advice from a real expert. I have, therefore, being seeing Dr. Hoffman, a psychiatrist at the MUHC specialised in patients going through intense medical treatments.
I would most probably not have chosen him as a psychologist, but because of his long experience, he was able to prescribe the right anti-stress and anti-depressant medication that I feel was critical to keeping me mentally sane.
6. The importance of second (or subsequent) opinions
Gather advice from different people, preferably from different places. This is especially true when critical decisions need to be made. It reassured me to know that all the doctors in Malaysia and Canada whom we had consulted shared the same diagnosis and treatment protocol.
More recently, it potentially saved me from possibly unnecessary cycles of chemotherapy and operations. This is thanks to a visit to my urologist who suggested that I meet a testicular cancer specialist at the National Cancer Centre of Singapore. The specialist recommended, with the support of the world’s leading testicular cancer expert in Norway, to stop all further treatment if my scan was clear and my blood sample test was okay; which turned out to be the case.
I was fortunate this time around that Dr. Aprikian, a world-renowned urologist and oncologist that follows my testicular cancer at the MUHC, had doubts early on when he saw lymph nodes appear in my lower abdomen during a CT scan in March 2018. Advancing by three months the next CT and PET scans, he found that these nodes had grown and become cancerous, but had doubts about the nature of the cancer and therefore, submitted my diagnosis to a committee of peers for review.
They unanimously concluded that it is more likely to be lymphoma, than a recurrence of testicular cancer. He transferred me to Dr. Sebag, a wonderful haematologist, who after further tests and sharing the results with other colleagues, confirmed that I had a rare and aggressive form of lymphoma requiring a long and brutal treatment protocol.
All this came as a succession of brutal blows to Elisabeth and I, as she accompanied me to the doctors’ appointments. However, I always felt well advised by medical experts in one of the most reputable teaching hospitals in North America.
7. Lovely things happen in trying times
Despite the ordeal, I am so thankful for many things. It brought our family closer together. Back in September, as a young adult, Chiara was growing more distant and independent as is the case for most people her age. But with the recurrence of my cancer, she realised the importance of family, and that brought us much closer before she furthered her studies.
I realised how unsupportive I was when Elisabeth had cancer 15 years ago. I finally apologised to her as it was something that had lingered in her heart for years.
We spent Christmas as it was intended to be spent – a special moment of love and care, instead of fighting and waiting only to open presents.
The experience also brought me closer to many friends, families and acquaintances. The messages of support were heartwarming and profoundly impactful to my wellbeing.
This lesson could not be more important and more true. You are living in extraordinary times, in this case that starts from a very negative premise. However, like anything extraordinary, there tends to be the extraordinarily bad, but also the extraordinarily good. Little is lived in the middle. And as I wrote in 2017, I have so many things to be thankful for.
I also cannot speak more highly of all the staff and volunteers at the MUHC who showed not only great expertise, but also tremendous empathy. My core doctors and the nursing staff are the dedicated people that were the psychological support that was necessary to get through this extremely trying experience.
8. Gargle religiously – water, baking soda and salt
This seems weird in this list. But let me say that it was essential to neutralise the mouth to prevent ulcers and canker sores, and to maintain appetite and a positive frame of mind.
The mixture is one cup of water with one teaspoon of baking soda and one teaspoon of salt. Not very appetising, but trust me, a godsend!
This was less important this time, except during my time in hospital during the transplant. Nevertheless, trying to eat properly is so important to recovery that I would not take it out. Canker sores and ulcers in the mouth are unpleasant enough, let alone when they make it almost impossible to eat or drink.
9. Exercise to stay as strong as you can
You will lose weight and energy. In many cases, you will experience hair loss, although that quickly becomes secondary if you are a man.
In between chemotherapy sessions, work to stay healthy and exercise. It is essential to speed up your recovery, especially for your mental wellbeing. Small steps will do and as my doctor told me, your body will tell you fast enough when it cannot go on anymore.
I can say that by working at it, I was just about back to normal after 2.5 months. And in three to four months, I should be fitter and healthier than ever.
Beyond the above comments, I am fortunate to be followed by Maryse, a physiotherapist specialised in cancer recovery. She made a couple of important and powerful statements to Elisabeth and I during one of my sessions. Elisabeth was asking about the importance for me to be followed by a naturopath. Maryse, as were most of the doctors that we talked to about this subject, was guarded in her answers about nutrition and naturopaths.
Her main recommendation was to eat properly, as little (in her view) was yet scientifically proven about the impact of alternative nutritional regimens.
She did, however, say that exercise was by far the most important thing to do before, during and after chemo to accelerate recovery. I had read a recently published scientific study that echoed her comments completely. Maryse had also taught me a lot in terms of not overdoing it and doing the right things. Recovery from a transplant is a long and arduous process and going too fast or doing the wrong things in terms of exercise does not help in the recovery process.
And this time, I was able to exercise regularly, walking along the Old Port and the Mount Royal, as well as in Stowe. One thing that went beyond my expectations, was taking up cross-country skiing. It meant so much to me during the chemo phase of the treatment to be able to do so. I loved the challenge and discovering beautiful places on Mont Royal, Stowe and along the Saint Lawrence with my uncle. It brought a peace of mind and had a centering quality that was so important to me in these troubling times.
10. Beware of the financial consequences
In some cases, with less brutal treatment and more understanding bosses, you may be able to manage your state of mind better. But in other cases, you may have to stop working for months, forcing you to leave your current employment. You may also want to completely reassess your life and take a more fulfilling and healthier path. You probably need 6–12 months of financial security to make it through. Thanks to Elisabeth, we were fortunate enough to have something sold, and that has given us some of that security.
One wonderful story of support in financially trying times was told by (then) former vice president Joe Biden regarding former president Barack Obama. When Beau Biden, Joe’s eldest son, was diagnosed with a brain tumour, Joe was unable to continue working as attorney-general of Delaware and as a result, no longer had enough money to support his family. Joe was ready to sell his family home outside Wilmington to help his son and told the president about it.
Given what Joe had been through in losing his first wife and young daughter in a car accident years before and bringing up the rest of the family in that house, the president told him that he would never allow him to sell it and would give all the money that was necessary to help him and his family through the ordeal. Such was the gesture of friendship and support from the top leader in the world.
In the dark moments of politics south of the border, it is heart-warming to re-read the story of Biden and Obama. I failed to mention that during my battle back in 2016, I received a tough blow on December 22nd when my insurance company informed me that they would not cover me under the clause of pre-existing conditions. Fortunately, we were living in Malaysia at the time and the costs, although high, were not outrageous. And one of the Valiram brothers, whose company I was working for, was understanding and allowed us to work out a mutually beneficial financial arrangement to help me cover the costs.
Charles with his recruitment team in Malaysia on Dec 22, 2016.
I cannot thank my lucky stars enough that I have been living in Montreal during this last battle and therefore, extremely well covered by the Canadian Health Care System and McGill’s insurance policy. I cannot even imagine how expensive is the treatment protocol that I have undergone. A real godsend!
Having said that, even under these circumstances, I went from short term disability status for the first six months of my treatment which meant that I received 100 per cent of my salary to long term disability for the next six months which is covered by an insurance company and paid me about 75 per cent of my salary. So it was a little dicey at times, but nothing like it could have been if I was living in the US or even in Canada, without additional insurance.
11. Have a do-able dream and live it
In the movie Bucket List, terminally-ill cancer patient Carter Chamber (played by Morgan Freeman) had a bucket list of places he wanted to visit and things he wanted to do but did not have the means to. Together with another cancer patient Edward Cole (played by Jack Nicholson), they both lived it. It was very special for both men, especially for Edward who until that time was a bitter and intensely disliked person despite his sharp business acumen, wealth and power. It brought out in him humanity, generous spirit and the joy of life he never had before.
In my case, it was a trip to the places that I love and visits to people that I hold dear. On my 35-day journey, I travelled to Paris, Montreal, Stowe Vermont, New York, Verbier in the Swiss Alps and Ile d’Yeu off the West Coast of France. For me, it was the most powerful journey that I have ever undertaken.
Its power came at so many levels:
- The importance of rituals. Until the trip began, I did not understand the importance of rituals in our lives. I lived so much throughout this trip that it is now filled with memories, scents, sceneries, sounds and intense moments of friendship that have made life special and worthwhile.
- The power of relationships. In each place that I visited, I felt like I saw everyone that I hold dear and shared at least one special moment with each of them.
- A disbelief at some of the things that I was able to do. A ski day off Petit Combin in Verbier, a full run on the Cote Sauvage – the first since my chemo finished – and swimming on Easter Monday in freezing cold water in the Anse des Fontaines on Ile d’Yeu.
- An affirmation of what I want to do next. Strongly recommended by my father, I organised 20–25 meetings/interviews with headhunters, business schools, friends, and new acquaintances. These meetings may lead to one potential offer that I would seriously consider. More importantly, I know that my future lies in people development, teaching and executive education. On where and the details of the next role(s), only the future will tell.
On Easter Sunday, I went to my favourite place in the world, la Chapelle de la Meule in Ile d’Yeu. I had the entire place to myself for 30 minutes as the sun rises that morning.For the first time since my cancer reappeared, I prayed for my late mother-in-law (who passed away on Easter Sunday and whose presence I felt intensely), my wife, our kids, our family, our loved ones and friends. Coincidentally, Easter is also a story of rebirth as I felt reborn and ready for the next step in our lives.
Wow!! How moving it was to read through what I wrote back in 2017. It clearly stands out as the trip of my lifetime. With what I did back in 2017, I started thinking during this past summer about doing something similar before returning to work in late September. During the summer, I read a wonderful book set in Tuscany and another one, about Oxford. It got me thinking about a few places and people that were important in my life and that I missed during the 2017 trip.
I had planned the entire trip with Elisabeth for about 10–14 days in September, but my doctors strongly opposed such a journey because of my exposed immune system. So we cancelled these plans, at least for now. One consolation was that my aunt, Jacqueline, decided that if we could not visit her in London, she would visit us in Montreal which was a very special few days.
I was, nevertheless, not to be deterred from doing something special before returning to work. I convinced Elisabeth that it would be great to go up the Saint Lawrence to visit Quebec City, La Malbaie and Tadoussac. I am so glad that we did. It was a trip that went beyond both our expectations.
I want to leave this lesson with a poem by Charles Bancroft that celebrates the Saint Lawrence, especially Tadoussac. It is a fitted way for me to end this lesson on living a dream.
I’ve seen the Thousand Islands
In the beauty of the dawn;
And sailed on Lake Ontario,
When shades of night were drawn;
I’ve wandered in Toronto;
Climbed the “Mount” at Montreal;
Run the great St. Lawrence rapids,
Where the waters swirl and fall.
I’ve slept up in the Chateau,
At Quebec; and known the thrill
Of rambling through the “old town”
And the fort upon the hill.
I’ve felt the sacred beauty
Of the splendor on Sag’nay;
The warmth of homespun blankets
That were made at Murray Bay.
But in my soul’s a hunger
Once again for Tadoussac;
The endless fascination
Of its quaintness draws me back.
I hear again the mission bell
That calls the folks to prayer,
And as I walk the city streets
My heart is with them there.
12. Life will never be the same, but do not give up on it. Press reset and live it to the fullest
This type of journey, no matter how painful, will change the way you look at life. Sometimes, you need trying moments like these to take hold of what had happened and to re-evaluate your life’s priorities. You may not be able to do everything you aspire to do, but hopefully, you will be able to get closer to what you want in life.
I personally would have loved to take a year off. After an exhilarating 10 years in Shanghai, the three years in Malaysia have proven to be the most challenging in my professional life, and as a direct consequence, for my health. A year off would have been great to regain my health, enjoy life and prepare better for the future. However, our financial situation has not allowed me to take a full year. Nevertheless, I am making the most of it with the amazing trip and the additional 2–3 months to organise the future.
Amazing to read what I wrote in 2017 and see where I ended up, exactly where I hoped for. I have to say that it was ‘luck by design’ as I did somewhat make it happen. However, it was still LUCK.
Bringing it all together
The end of my last journal entry is a fitting end to these 12 lessons and finding one’s way in life. I was asked during a lunch a couple of months ago by Damien, one of my new close Montreal friends, what has changed? Taking some time to answer, I told him that not a lot has changed since the major changes in our lives that took place following my last battle with cancer in Malaysia.
It has been more of an affirmation that we made the right choice to move back to Montreal. This has allowed me to work on a project that I am passionate about, for Elisabeth and I to be closer to our kids and my parents and lead much more balanced and healthier life after 15 hectic years in Asia. It will most certainly be made even better now that we have our own country house to enjoy in magical Stowe Vermont.
And as I wrote in 2017, It is a LIFE worth living!!!
I want to end by thanking all of you who have accompanied me through this journey over these last difficult and moving years.
With all my love, Charles
Editor’s note: We first published Charles’ story on 27 October 2017, and updated it on 1 February 2018. When we recently connected with him again, he shared his journey in the past year and the lessons he continues to glean from his battle with cancer. We are happy that he is currently in remission and recovery, and wish him the best of everything ahead!
Ps: Do you know World Cancer Day takes place every year on Feb 4? It is an initiative under which the entire world can unite together in the fight against the global cancer epidemic. #WorldCancerDay #WeCanICan