A sick CEO's full disclosure | Hacker News Reader

A sick CEO's full disclosure

tech.fortune.cnn.com

164 pointsmattmaroon32 comments

One of the things that strikes me as odd is the personal obligation leaders feel to their companies as they prepare to die. In some ways it's understandable since they've invested a huge amount of personal energy into their work, but in a different way it shows that there is little separation between their personal and work life.

I couldn't believe it when my cousin (a CTO of a large company) was dying of multiple meyloma -- he actually was working from his hospital bed until a few weeks before he got an infection and died. That's probably exactly what he wanted, so godspeed. But, seeing that was enough to make me quit my job and try to keep things in perspective. Your customers and colleagues are can be extremely close and valuable, but your family and life you only get once.

An alternative perspective is that it really is intense personal passion for what they do, not a sense of obligation, that drives leaders to do that.

Also, nobody wants to be remembered as someone who checked it of work and let the financial future of his family erode as a result of mentally just left the scene, so to speak. At least, in abstract; clearly, concrete feelings upon terminal illness can be very different.

You get your customers and colleagues only once, too. Maybe he could have chosen better priorities. At least he had some.

Another way to look at it is that it was probably his only chance of human interaction that didn't directly involve his current predicament.

If he wasn't working he'd probably be doing nothing but staring into the air waiting to die. Having to nothing to do but deal with medical staff, and group after group of well-meaning relations who feel sorry for you is probably very mentally stressful.

Continuing to work is also a way to feel you have value as a human being and there is more to you than your illness.

I belong to a number of a groups for people with a deadly medical condition. It is very clear to me that well-meaning well-wishers are often essentially helping to kill people with kindness. Their unstated assumption is you aren't going to get well, death is inevitable. Such thinking tends to help make it inevitable. And hearing that 500,000 times from all the people who "love" you makes it extraordinarily difficult to resist that thinking and therefore resist that path. When you are working, no one is giving you that message. They are saying "I need that report next week", which implies you will be alive next week to deliver it. That's a much healthier message than having everyone visit you daily for fear it might be the last chance they have to speak with you as you might drop dead any second now.

There's also the unspoken assumption that once you find out you're going to die you're going to drop everything, tour the world, meet up with all your loved ones etc. But that's a very Disney-esque view of the world.

We all know we're going to die in 20-60 years. I don't see why people that know they're going to die in 6 months or 2 years from now should be expected to behave any differently than the rest of us.

There's certainly a place for getting your affairs in order, but spending the rest of your days feeling sorry for yourself is a bad waste of time as far as I'm concerned.

Medical care for a serious health issue can be extremely expensive. My sister has been battling cancer on and off for over 11 years and has had 4 separate occurrences. She continues to work. She needs her job because it provides better insurance than her husband's and they need two incomes to pay the medical bills.

You would practically need to be Bill Gates to do the Disney-esque Version of living with a life-threatening medical condition.

    You would practically need to be Bill Gates to
    do the Disney-esque Version of living with a
    life-threatening medical condition.

That or live in a country with a working single-payer health care system. I.e. anywhere in the first world except the US.

It's surprising how the disease crept up on him despite the annual checks. One of the benefits I imagine successful executives must have would be super-duper, executive-level healthcare. All the check-ups and screenings the rest of us miss out on because they're not quite cheap or statistically significant enough to be worth rolling out for the general population.

And yet the CEO of a biotech firm slips through the net.

Does executive-level healthcare exist or is it just in my imagination? Is there any significant advantage to be had if money is not an issue? Or perhaps he already had all these advantages (he already knew about the genetic marker) and that's how come he's in remission now?

It sounds more like he stopped getting checked years ago, and ignored warning signs due to life pressures.

I didn't get that feeling from the article at all. My brother actually has multiple myeloma as well; he's checked every 3 months to see if the blood levels have spiked and a skeletal survey is done every 6 months. It's almost a certainty that the cancer to start eating away at your bones and you not know it between the skeletal surveys.

"So every year Martin would get his blood checked, fearing the 1% to 2% chance that the marker had spiked.

It never did, and Martin slipped into a routine that included juggling long hours at the office, raising three teenage boys, racing cars, skiing, and cycling."

After reading the "slipped into a routine..." part I took it to mean that he stopped getting the annual tests, thinking that he'd done it long enough to satisfy himself that he wasn't going to get the disease. Sounds like I read it the same way sliverstorm did.

Is voting enough, or should we all say "me too"?

IANAD, but my guess is that he was unlucky and the cancer was especially fast to act. Yearly checks might have been too granular, and the marker could have spiked shortly after his last test. Also, I'm guessing that it's rare to even know you have it until you start getting symptoms. How often do doctors run blood tests for random protein markers?

From wikipeida, it looks like the cancer is related to abnormal white cell buildup. If he's traveling a lot, he would be exposed to more sicknesses, and so might have more white cells then usual, so he has more to build up. But then again, IANAD, so this might be completely wrong.

From the story, it is evident that this gentleman has long been aware that he might develop myeloma. This implies that he had been diagnosed previously with a monoclonal gammopathy of unknown significance (MGUS). This may be clinically suspected based on routine bloodwork showing a gamma gap. Once you suspect it, there is a fixed protocol for further investigation. It also sounds like there were lapses in the routine checkups that would help with early detection if this did progress to myeloma. Very unfortunate; this CEO seems like a delightful person and I wish him the best.

> It's surprising how the disease crept up on him despite the annual checks.

Depending on the cancer, they can act extremely fast. My father died from a pancreatic cancer, he got about three months after the discovery, and before that he spent under a month with severe back pains (doctors were telling him it was nothing but he forced them to get to the end of it and find out why he was in so much pain).

Considering Mr Martin's myeloma took out a whole vertebra before he hurt enough to go see the doc, I'd say the thing was particularly ferocious, and short of checking every 1-3 months he would only have caught it by luck.

> Does executive-level healthcare exist or is it just in my imagination?

it probably exists, but you have to factor in the long hours and activity which result in both physical stress and not much time to go see the doc', short of having your own on retainer.

> (doctors were telling him it was nothing but he forced them to get to the end of it and find out why he was in so much pain)

A family member is currently unwell, and their immediate family isn't doing a great job talking to the doctors. The doctor basically tells her something using medical terminology that she doesn't understand, and she doesn't follow up.

Previous experiences with doctors, and your story, have re-inforced my belief that if I ever get ill, as far as I'm concerned, that doctor is now my personal tutor and servant, and that I will get clear answers, explanations, and whatever tests might be necessary even if I have to streak up and down hospital hallways screaming and whipping nurses with my IVs.

Can some experienced founders shed some light on how to handle situations when you or your team might not be available for some unavoidable reasons for some time.

There are very few circumstances under which "you or your team might not be available for some unavoidable reasons" that are not due to catastrophic planning failure. What kind of circumstance are you looking at that you cannot put fail-safes in place well in advance? Even death is subject to redundant engineering.

Even death is subject to redundant engineering

Death may be, but shareholder opinion isn't.

No matter how thoroughly Steve Jobs engineers his own departure, the stock will still tank the day he leaves.

Isn't there a shortlist of people who could take the company over without much disruption? I would be surprised if Steve Jobs hadn't been working on training a successor.

If you believe that, you can probably make a killing with Apple stock on that day (provided you are right).

It will take longer than a day for the stock market to figure that the new gal is as good as Jobs, so you can delay your buy for a while.

Such a shortlist may exist, but even if the guy taking over were as good as Steve, I doubt that the stock market would be smart enough to know that. So yes, the stock would take a hit.

Well, in a startup, you have, by definition, very little redundancy. I think it's a valid question.

I agree it's a valid question, I just think framing it in a more concrete way would elicit a better answer. The answers will be very different if we're talking about death vs if we're talking about not being able to use electricity every Shabbat vs. being vulnerable to communication outages vs. mental health burnouts.

Basically I'm saying if you're asking the question, there's a scenario in play there, and the scenario can likely be planned for. Yes, Apple stock will take a diver when Steve Jobs dies or retires, but if there's a strategic plan in place for that exit, the chances of it bouncing back are vastly higher than if there is no plan.

Or put another way: The New York Times has his obituary written. Do you really think the Apple board is less prepared?

Okay, here's a more concrete example.

Let's say I have around 2000-3000 regular users. If there is some family emergency which is unplanned and requires me to be there, I won't be able to maintain anything for about three-four days, except maybe make sure that the servers don't go down.

I would ideally like to let the users know that there's a problem right now. Despite everything, most of them will understand. However how far do I have to go to tell them? Do I send out a little tweet, an email, or put a persistent message on the website?

I know that it varies vastly according to context, but what would be a rough estimate on the best way to handle a situation like this?

> I would ideally like to let the users know that there's a problem right now.

For most services, there will not be - if the servers stay up, the users will never know or care that Oz is temporarily not behind the curtain.

But sometimes it does matter. My husband runs a service where he needs manually process data and commit it every day that $foo is in session. If there's an emergency and he has to go offline, I can keep the servers online; if there's an emergency and we're both called away, there is a trusted 3rd party who does that job. But currently there is no other party who can process data. In that instance, we post a notice on the site saying that Friday commits will not be posted until Monday and apologise for the service interruption.

I would, by the way, never make a public announcement that you are leaving the ship unmanned. That seems like a really poor security decision to me. YMMV.

That's fine for a one-off, rare and unplanned instance. But you better believe that we have a much more robust plan for what to do if he gets hit by a bus. In that instance, there's a named and designated person in place to step up, an insurance policy to pay them (obviously with some delay), a secure and immediate process for transfer of passwords, and a 48 hour plan to execute.

So really what I'm saying is that if you start with the worst case scenario and step back through that, I'm still not convinced that there are sudden departure scenarios you can't successfully address with forward planning.

Thanks for your suggestions. Wish you and your husband the best of luck.

I think this a testament to the power of drive and passion. Doing the best he can for as long as he can is a way for the mentioned CEO, to leave the world with a legacy. Thus, the persistence. I think with such passion, this terrible news is transformed into a phenomenal motivational factor that will hopefully push the company to preform better in shorter time. The stakes are higher because everyone at the company is connected to this personal struggle.

The question is how to lead a firm where everyone considered the work to be a personal struggle without sacrificing so much.

Inspiring, and definitely puts a new light on when the CEO where I work announced he had Non-Hodgkins Lymphoma.

I admire what he did, and the freshness with which he did it. Disclosure was important as highlighted by the uncertainty about Steve Jobs and his illness.

"Life is not about waiting for the storm to pass; it is learning to dance in the rain."

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