The Elephant in the Room is Cancer. Tea is the Relief Conversation Provides.

Crisis Management Lessons From A Personal Adversity

by Pankaj TewariCaregiverApril 21, 2021View more posts from Pankaj Tewari

This post originally ran on LinkedIn.

“When it is dark enough, you can see the stars”

– Ralph Waldo Emerson

The last thing I expected from my devastating personal adversity – unexpected diagnosis of my teenage son’s combination of (not one, not two but three) cancers– was lifelong crisis management lessons. I didn’t realize it then, as our sole focus was to keep him alive which appeared to be a remote possibility, as per the world’s leading cancer experts, at that time.

Till late 2018, I had lived a blessed fairy tale life. Ideal loving family, fulfilling professional career that brought us from India to US, perfect physical and mental health and amazing children in terms of natural abilities and acquired traits. For many years my wife and I used to joke that the universe is rigged in our favor – which made our lives so blissful.

In Nov 2018 our perfect lives were jolted by the unexpected cancer diagnosis of our 18-year-old son, who was just embarking on an exciting college career at the school of his choice. A few weeks of mild fever and facial swelling (which doctors erroneously diagnosed as a mild viral infection) prompted us to take him for an X-ray on our own. For the medically inclined – it revealed a humungous non-seminomatous germ cell tumor in his mediastinum. For the layman, he had a huge tumor, nearly the size of a football, in his chest which was cancerous.

While I was completely devastated and numb on hearing this news, surprisingly my wife’s first reaction was of gratitude. “Thank God – we had the good sense to take him for an X-ray, as any further delay would have been fatal”. The other thing she mentioned was – “We are lucky, we are in the US, not in India or anywhere else in the world, as cancer treatment is best handled in US”. My thought was – if we were truly lucky our beautiful son would not have had cancer.

It was obvious that we had very different viewpoints on the same crisis. She was looking at aspects to be grateful for, and I was only able to see a dark cloud of adversity. It was blatantly clear which approach was working out better. As my son’s condition rapidly worsened in the ICU immediately after his diagnosis, I was descending into deep depression while she remained the calm, composed and more functional parent. Observing her, the lesson I learnt of the power of a deep-rooted ‘sense of gratitude’ in times of a catastrophic crisis was unforgettable. She was handling this devastating crisis far better than I was. I could not help but adopt the same approach and I guess the difference it made was huge – one between sanity and insanity. This was the first major lesson I learnt regarding handling of a crisis which nearly thirty years of professional experience and management education at premier institutes had not taught me – a sense of gratitude.

The diagnosis was indeed shocking, but to our relief the doctors informed us that such tumors can be cured. Or more specifically about 45% of patients diagnosed with this rare tumor have a 5-year survival rate. For us 45% was a reasonable figure to keep us optimistic.

Our relief was short lived. In a few days of this life altering diagnosis, he was also diagnosed with acute megakaryoblastic leukemia (AML-M7). In layman’s terms he also had a rare blood cancer!! That took him straight into medical history league. It was extremely rare to have two unrelated malignancies in the same person. Only 25 recorded cases existed in medical annals with this combination, a universally fatal one and with an average survival of 5 months from diagnosis!!

Much later, after the tumor was excised, they discovered a third malignancy – rhabdomyosarcoma in the tumor which had spread to his lungs.

For someone whose most intense crisis management experience in fifty years of life was limited to saving companies from shutting down due to losses – this was a crisis beyond comprehension. While the sense of gratitude was helping me keep my sanity sufficiently intact to find the best medical options in the world for my son, there was no clear solution in sight.

This is where I learnt my second crucial lesson.

While my wife and I were aware of the dismal prognosis of our son’s disease – the one person who was also fully aware, most impacted, yet least tormented, was our son himself. He was remarkably calm, positive and level-headed when the medical team explained to him (as he had just turned eighteen and was an adult) the complexity of his case and the poor outcome expected. His positivity was so glaring, that I could hear the doctors wondering aloud whether he had understood the magnitude of his diagnosis.

They were mistaken, he had clearly understood the diagnosis and the prognosis. In fact, he was an active participant in discussing treatment options with the doctors.

Many months later I asked him as to what was going on in his mind while participating in discussions regarding his potential mortality during his diagnosis and initial treatment. He said he experienced a shift which brought about a ‘sense of surrender’ accompanied by deep peace. He found he had completely accepted the situation and there was no internal conflict. He knew the outcome may not be ideal, but there was only so much we could do, and we were doing it. It brought a sense of calm which gave him the ability to work his way out of this crisis. Through him, I realized that complete surrender also makes one intensely present. Throughout his year-long severe treatment of intense combination chemotherapy cycles, a major thoracic surgery and a bone marrow transplant – in the ICU or cancer floor room – with tubes running from his arm to his heart, he could be seen listening to his favorite songs, watching movies and shows, investing in stocks or working on his admission to business school.

This was a key lesson I learnt in crisis management – complete and unconditional acceptance. I had read of such a state in spiritual books and Zen teachings. I was witnessing it clearly now. Surrender- not as in ‘giving up’ but accepting the situation fully and taking the appropriate action with immense clarity. It was instantaneous learning as I was witnessing this happen, not with some mystic or guru, but with my own son.

I guess the most significant lesson came from the fourth and the youngest member of the family – my fourteen-year-old daughter. It was determined that an allogenic bone marrow transplant was the best chance to save his life, and my daughter was a match. For someone who had been unusually petrified of visiting doctors, taking vaccinations, or even going for a physical – the prospect of going into this procedure which meant a breathing tube down her throat and drilling holes in her hip bone to draw a liter of bone marrow was indeed frightening. And she was more than terrified at the prospect. But she truly personified the definition of courage for us. As Franklin Roosevelt once said “Courage is not the absence of fear, but rather the assessment that something else is more important than fear”, she knew that her brother’s transplant was far more important than her lifelong dread of medical procedures.

What I truly learnt from her, was the power of accepting and acknowledging one’s deepest fears. She did not conceal the dread and at the same time was also absolutely certain that she will go ahead with it despite her fears.

It was an amazing lesson in courage – not just of accepting your fears, but not even pretending to hide them to oneself or others. Through her, I could clearly see that once you accept your fears, they don’t seem to be so much of an obstacle in doing the right thing.

Therefore, the third lesson in crisis management I learnt was – Courage – the ability to openly face one’s deepest fears and act boldly through them.

My son is completely cured and cancer free now. He underwent an excruciatingly intense treatment. He survived several life-threatening situations including a major sepsis shock during the treatment. Outstanding medical care, family support, and help from friends, community, neighbors and colleagues – all contributed to this remarkable recovery in some measure. But like someone from his medical team had once remarked, “he will be fine – because you are such a unique and amazing family”, it was evident that his miraculous and unexpected recovery was built on the foundation of the following crisis management tools that we learnt from each other and deployed effectively

1. A Deep Sense of Gratitude – The ability to find gratitude and a silver lining in the gloomiest of situations. This helps one remain in control of oneself even in the worst of situations and focus on the actions to be taken.

2. Complete Acceptance and Surrender – The ability to unconditionally accept the most unacceptable situation without resisting it internally. This allows one to remain intensely present and take the most appropriate steps to overcome the crisis, as there is no inner conflict.

3. Courage – more specifically the ability to overcome one’s most dreaded fears, not by concealing them but by acknowledging them and making them known. This allows one to take incredibly bold steps which are at times needed to overcome a major crisis situation.

As I mentioned earlier, all my management education and professional career of nearly thirty years never taught me these crisis management tools. The fact that these very tools helped us overcome arguably one of the most severe crises of anyone’s personal life is a testimony to their effectiveness.

While I sincerely hope that no one ever has to face a crisis of such magnitude and complexity, I believe the above attitudes can be more than instrumental in overcoming any crisis in one’s personal or professional life.

All of the posts written for Elephants and Tea are contributed by patients, survivors, caregivers and loved ones dealing with cancer.  If you have a story or experience you would like to share with the cancer community we would love to hear from you!  Please submit your idea at

Join the Conversation!

Leave a comment below. Remember to keep it positive!