Overcoming Fear - The Secret of Life

One of the biggest challenges for humans is that with our ability to think we developed a deep need to plan for the future, or at the very least minimize risks associated with the future. When I say risk I mean uncertainty as the word risk can take us into totally different universes, from trivial dangerous situations to really bad things. So when faced with potentially dangerous situations we create mechanisms to minimize risks. This has lead us to create mechanisms to try to minimize the uncertainty from all sorts of unexpected events, creating large industries and products such as the financial industry with products like insurance, retirement planning and financial derivatives, the pharmaceutical industry and anti-anxiety drugs, the military industry and weapons, the consulting industry that tries to help us understand what the future will be like and so forth, all of which to give us a false idea that the future is totally in our hands. However the future, as I learned the hard way, is much further out of our control than expected.  .

I am not trying to advocate that planning is not important but quite the contrary, I believe that to live a fully productive, healthy life we need to overcome fear and manage the risks associated with everything we do.

Let me recap what I have done in the last 10 years, all of which with an unknown brain tumor inside my head:

- Quit a great job and sold a fully paid car and apartment to get an MBA in another country (moved from Brazil to the US)

- Left the comfort of being close to family and long-lasting friendships to start from scratch in a new country

- Graduated from the best MBA program in the world (sorry Harvard, Stanford, MIT etc. Carnegie Mellon is the best), where I met amazing people and made long-lasting friendships

- Got married to my wonderful wife and had two amazing daughters

- Decided to stay in the US after graduating and started a new career in Marketing, meeting and working with amazing people and making great friends

- Purchased a house, obviously borrowing lots of money

- Made great new friends and got closer than I had ever been to my American side of the family 

- Completed 2 seasons playing in an adult soccer league 

- As my knees got destroyed by soccer I decided to ride bikes, encouraged by my "older brother" and my uncle

- Joined the Mount Lebanon Caffeine & Cycling Club, where I made great friends 

- To balance all this leg work I started swimming

- I then decided to do triathlons,swimming in 55 degrees water at my first short-triathlon and moving up to complete 3 Half-Ironman events

- Quit a great job and sold two fully paid cars and a partially paid home in the US to go back to Brazil and start-over, now more safely working with the same company I worked at in the US

- Worked and partied hard on every step of the way

Looking back I wonder what my life would be like if I had known that a brain tumor was growing in my head. This is not a self-celebratory blog, it is just to highlighted that my risk profile would have probably been much different. My challenge now is to not let fear overcome my life, and yesterday I reached a milestone: I left the safety of my bike trainer and faced the mad traffic of the city to ride my bike on the road, by myself!

I never thought that such a trivial, taken for granted activity would feel so liberating. I felt like I have finally overcome my fear of having seizures, which I hadn't experienced since my first one last year. Riding where I was I should have been much more worried about traffic, bike thieves or getting lost, but those were simply not in my risk checklist, just like my brain tumor wasn't in my risk checklist when I left Brazil in 2001.

At every stage in life we face decision time, and we should never let our fear of what might happen, which can quite frankly be an infinite list, overcome the joy and feeling of accomplishment that makes us all feel life is worth living and fighting for.

I hope you read this and stop worrying about what can go wrong, life can only be truly fulfilling when we find out how we can be happy if things go right, even if your idea of life going right is a mere bike ride.

Evolution - Biology, Individual, Society and Me

I am about to finish reading "The Emperor of All Maladies", from Sidharta Mukherjee. What a spectacular book, probably the best I have ever read. I am now migrating to a non-cancer related book from Allan Meltzer, in my opinion the best economist/financial historian in the world, a teacher at the Tepper School of Business at Carnegie Mellon, ardent student and "biographer" of the US Federal Reserve, and most reasonable and knowledgeable defender of capitalism, democracy and the rule of law. His book is called "Why Capitalism?".
It is interesting to see how in the last 6 months I have read books that are seemingly so unrelated on the surface, such as "Neuroscience for Dummies" and "Why Capitalism?", but I see stricking connections on how we evolve as species, individuals and society.
I have found a new interest in biology and realized that I have to learn everything I learned in high school again. Science has evolved enough in the last 20 years that I see a need to go back to basics and study high-school biology to understand several things I learned about cancer. Oncogenesis, Tumor Suppressor Genes, Heat Shock Proteins and so forth, things that I feel a deep need to connect in order to understant what is happening to me and how the drugs I am taking help fight it. I have even formulated a few hipothesis that I feel a need to validate, but before I pose my questions I want to make sure I am not asking trivial questions.
One thing that became clear to me is that cancer can be as deadly as it can be resurrecting. As I studied Neuroscience I learned new theories on how we evolved as species from unicellular organisms to what we are today.
As unicellular organisms grouped themselves to perform tasks, the cells in the inner part of the group of cells faced very different environments from the cells exposed to the outside world. That created a need for cells to specialize. Of course cells, just like people, don't choose what they want to become biologically. Saying that a cell can choose what function to perform is as crazy as me saying that I decided to grow wings.
But the environment takes care of changing cells. Radiation, just to mention one known environmental factor that can change our DNA, and as a consequence the function of our cells, will create new cell functions, creatures and sometimes diseases. Evolution then takes care of the rest.
Imagine that at first all cells in multicellular organisms performed all vital functions. Then radiation hit the group and the cells outside the group could not produce energy anymore, but only filter radiation as cells inside the group focused on building energy reserves and "feeding" the outside cells. These cell groups, with the genetic stability provided by the radiation filtering cells, all of a sudden became more stable, creating a multicellular organism much better prepared to face the enviroment and survive. For another random reason DNA changed again and the inner cells were transformed in two groups, one specialized in digestion and another one specialized in energy storage for tough times. When food became scarce the energy storage cells provided the food for the other cells, enabling this organism to survive while others died in times of scarcity.
Of course this is an overly simplistic view of evolution, but if we think of ourselves as a self-regulated group of unicellular organisms we can look at cancer as a Coup D'Etat of certain cells.
In my case for some reason the cells that are supposed to protect my brain now think they need to take over it, messing up the balance of forces that turns a chaotic unicellular environment into a well organized single entity that is now writting this crazy story.
As I read Meltzer's book I realized how capitalism, in the form of market forces, democracy and the rule of law, performs in essence a self-regulating function for our society. We want a society where individual rights are preserved and never above the collective good. Democracy gives all players the right to choose what is best for society. When a group of individuals tries to take over control at the expense of others, the voters can expel that "cancer" and self-regulate the country, or the "body". This self-regulating mechanism of capitalist democracies has proven over time to be the most effective way to produce prosperity and improve the standards of living, no matter in which society it is implemented, from multi-cultural US or Brazilian societies, to the uniform and conservative Japanese or German societies.
Brazil is now living a wonderful moment. People of all classes are realizing that they can create opportunities for themselves. I met a person at a Trade Show last week, an entrepreneur that was turning garbage into reusable bags. I learned that his office was close to where I lived before I moved to the US. When I told him that I sold my house, car and gathered all my money to get an MBA in the US he said he got goose-bumps. To me that was such a no-brainer (no pun intended), but to a lot of people choosing instability over stability might be a tough choice. I, on the other hand, was blown away by this rags to riches young adult who saw in trash an opportunity to help the environment and make money.
Resurrecting after my brain tumor was just another example of how one can face adversity (or instability), adapt, evolve and move on, always on a path to become better than before. If we all try to become better as we face instabilty we will always strive as humans. Of course if I had the choice I would not have chosen to take the brain tumor road, but now that I am on it I want to come back home better than I was before, and so far I feel much better.

Incredible Week with Family, Friends and Sports!

“The same way Escola Politécnica (my College) develops the professional, sports develop in people the key aspects of their character. It is where one learns to win and lose; it is where one practices solidarity all the time, it is where one nurtures respect for the opponent. AAAP (Athletics Association of Escola Politécnica) does that: it helps to improve the human being. That is why it is indispensable and helpful.”

Senator Mario Covas, January 19, 1993.

With this letter São Paulo’s deceased Senator, State Governor and democratic leader Mario Covas opened our Athletics Association honors book. Before my surgery my College friends, specifically from AAAP, with Livia’s magical touch and help, gave me an incredible gift, a Photo Album with many wishing well notes, pictures of our College days and demonstrations of love. For this and so many other reasons I love my friends and sports and feel so compelled and positive to keep battling my tumor. I was sent to France for surgery in the most upbeat state possible. Mario Covas, who also played basketball at my College, was a prominent political leader that helped shape Brazil’s current democracy. He also shared my passion for sports and hard-work.

This past week was probably the best week since I was diagnosed. If anything it was the closest to normal week since I was diagnosed, despite the fact that I was in my fifth chemo cycle, which continues to be light on my body and I hope aggressive on my tumor. As a matter of fact my tumor continues to remain quiet, not showing any signs of growth.

I worked really hard this week as we had a very important trade show, but my great week started with a conversation on Saturday that really energized me to exercise. I met a talented cancer biologist and shared my story with him and was curious to hear his opinion on exercising and cancer. He had an irrefutable argument to demonstrate that cancer and exercising go in opposite directions. In fact if exercising was a potential cause of cancer high performance athletes would have a higher incidence of cancer, but in fact it is just the opposite. Maybe that is why we have Race for the Cure, Livestrong and so many other fundraising organizations that use sports to help in the fight against cancer.

On Monday I called my “older brother”, it had been a while since we last spoke and I knew he would be excited with my progress. I also wanted to share the great news that I am back exercising, as he was one of the people that inspired me to get into biking, leading me into triathlon. He was very excited to hear the news;  he is one of those people that just feed you with energy, cheering me up to work-out as I was. As soon as I hung up I started feeling a light pain in my lower back, which I immediately associated to my spinal bone marrow.

One of the first things my oncologist shared after my first chemo cycle was that I must have a great bone marrow as my blood was nearly unchanged after my first chemo cycle. When I felt the pain I thought to myself, talking to my bone marrow: “if this is how it is going to be I am going to teach you a lesson”. I hopped on my bike and rode hard for 30 minutes. The pain was gone.

Interestingly I felt like the chemo was making me handle exercising better. In fact the next day I went for a run and was on the treadmill for 30 minutes, which enabled me to run 6 km. In essence I ran at my pre-tumor training pace and didn’t feel a thing. I hadn’t run 6 km straight at that pace since I was diagnosed, and to do that felt great!

An interesting fact happened this week too: all of a sudden I started remembering several names from the past. From kindergarden friends I see in school pictures whose names I had long forgotten to my whole basketball team at the club I played for when I was 13 years old.

The brain is just incredible! I used to be a decent student at school and right after I came back from surgery a school friend of mine jokingly said, after I shared I removed a large chunk of brain, that we were finally playing on a leveled field. I never laughed so hard but little did he know that I uncluttered the brain as if I've done a total system recovery!

On Wednesday I went to the gym again after a long day of work and ran for 15 minutes to warm-up and lifted weights. To do that a day after a 6km run, to which I was not used to anymore, made me feel like I am ready to get back to business.

On Thursday I went to my oncologist for a consultation and he encouraged me to keep exercising, I felt so great!

After that I went to a party to celebrate my College’s Athletics Association Birthday. We probably had at least 20 generations of College grads there, every one of which at some point involved in building and maintaining AAAP. To watch how things have evolved made me feel really hopeful about Brazil’s future. The students are much better at fundraising, preserving the history of the organization and most importantly continue to demonstrate the importance of sports to build the character of those that love it.

To my surprise a current student knew about my story and was curious to know how I was doing. He sold to a friend of mine a sweatshirt from my College that I took with me to France for my surgery. My friends gave me it at my farewell party and the student found out about me when my friend picked it up. He was happy to see me well and every smile I get just feeds me up with energy. I got home at nearly Midnight, something I hadn’t done in a long time!

One would think I would be tired on Friday after such a week, but I was feeling great! I worked hard all day and was meeting my cousins for dinner as one of them was at São Paulo from out-of-town. Before they met me at 9:30PM I decided to ride my bike on the trainer and hit another milestone: for the first time since I was diagnosed I rode for one straight hour on the trainer, which is even more painful than riding on the road as there are no downhill roads to rest or landscape to relax the mind.

On Saturday I woke up early and repeated my running/lifting routine, getting me ready to go out and walk around my neighborhood to get Mother’s Day gifts for my mom and Livia. It was a long week and we still had more ahead: we went to a friend’s twin-girls birthday party, dropped the girls at my mom’s house and closed the day with dinner with friends and once again a great time!

At the birthday party I was speaking to a friend who has an 18 years-old son that is also battling cancer. I am confident that he, just like me, will beat this beast. Interestingly when I shared the pain I felt in my lower back she shared that her son felt the same pain during chemo, so my remote hypothesis might be right, I might have put my bone marrow to work as planned.

To close this perfect week Sunday was Mother`s Day and Livia made the best lunch she has ever prepared to celebrate Mother`s Day. Hers and my parents came over with my brother and her brother and sister and we had a great time. We have officially inaugurated our kitchen with an amazing homemade meal.

I was tinkering with the idea of going downstairs to exercise but I wanted to share this amazing week with you with a conclusion: as long as we have a loving family, great friends and a passion to live for we will always be happy. Life is perfect as long as we live it well, despite all the hardship and battles we face.

I have been reading another amazing book that a Pittsburgh friend sent me: "The Sunny Side of Cancer", from Sunny Carney. The power of staying strong as we face our battles will always determine how well we live, whether we have 60 months or 60 years to live ahead. I thought I was having some original thoughts about life but Sunny faces Carcinoid Cancer, a rare and tough cancer, with the same strength and positivity I am facing my tumor, focusing on living life to the fullest and battling her cancer with an uplifting attitude, inspiring me even more to do the same.

Like a friend I still owe a visit to used to tell me when I said I didn`t have time for something he would reply “How can you not have time? What separates us from death?”.  Since then I rarely say I don’t have time for something, I always say I am doing something better instead.

Enjoy your time, I hope you liked this update; life is great and will continue to be no matter what! Focus on the positives and fix the negatives, this is what life is about.