Being Thankful and Dodging Bullets: What Makes Me Feel Grateful and What Makes Me Angry This Thanksgiving

Dear Friends,

Thanksgiving is when we pause to take a few moments to appreciate the people who are important in our lives. Beyond my friends, clients, business partners, and especially my family, I am grateful for those who read and find some value in what I write each week.

In many ways, my writing has become more than a passion - it has become the thing I look most forward to each week. It helps me think more deeply and clearly about the world, and the feedback I receive from readers lets me know that I am contributing something people find valuable.

I wish you a wonderful holiday - and hope that you find yourself surrounded by people you love and things you love to eat. And I also hope you find a moment to reflect on the things you are thankful for - and the people you are grateful for having in your life.

This week's essay is a bit longer than most. I hope you will indulge me - and would welcome hearing from you - if you share what things stir when you think about what matters most to you.

Have a happy Thanksgiving - and a great week ahead.

prl

Being Thankful and Dodging Bullets: What Makes Me Feel Grateful and What Makes Me Angry This Thanksgiving

I’m not particularly observant of most traditions. I enjoy a good celebration as much as anyone, but most holidays don’t feel as meaningful to me as they do to many people I know. Thanksgiving is the one exception. I love gathering family around a lavishly prepared feast of festive dishes that my wife Lynn and I have blended from our childhoods, creating our own family tradition. About half the time, we find ourselves at someone else’s home, and those years have made me realize how important the traditions we’ve built really are. 

Thanksgiving is traditionally a time to reflect on what we are thankful for—and to give thanks to the people in our lives for the blessings we enjoy. Offering appreciation to others demonstrates a kind of humility that we could all use more of, especially these days. And swallowing one’s pride to acknowledge people we find difficult to appreciate can be cathartic. 

Being thankful, on the other hand, is more a reflection of good fortune. The humility here lies in recognizing the things we do not and cannot control—such as the circumstances we are born into and the qualities we were born with. It’s the accomplishments that bring us joy and satisfaction, allowing us to step back and be thankful for our own efforts, determination, and values. It’s also about being lucky enough to avoid the random obstacles that life inevitably throws our way. I know this firsthand because I am very grateful to have dodged a bullet with a cancer diagnosis I received in October 2019.

I read an essay over the weekend that made me reflect on my profound sense of gratitude. It was written by Tatiana Schlossberg, the granddaughter of John F. Kennedy, who described a situation I could painfully and vividly relate to in the piece in The New Yorker, published on the 62nd anniversary of her grandfather’s assassination. Our stories are quite different, and hers is far more tragic than mine. My leukemia diagnosis came more than six years ago, with what initially seemed like a grim prognosis. The mind-numbing diagnosis I initially received would have also been tragic if it had been just a few years earlier, when my specific cancer was considered an untreatable and aggressive blood cancer that, for most people, is indolent, usually not aggressive, and generally treatable, though not curable. 

I have people to thank for that. The researchers who developed novel treatments that are not only effective but also target the malignancy without damaging other cells in my body and have few, if any, side effects. Compared to the treatments my mother faced before passing away at age 48, this treatment is a miracle. 

I have to thank the people who fund the research, the patients who bravely participate in the clinical trials necessary for these remarkable treatments to make their way to the public, and my oncologist and the staff of clinicians at MSK - who carefully considered the nuances of the genetic makeup of my rarer form of chronic lymphocytic leukemia (CLL), my overall health, and my desires, and provided the reassurances that kept me feeling hopeful and positive from the very first time I met them. 

Ms. Schlossberg’s experience was initially not much different from mine. She described a suspicious incidental finding at the time of her son's birth. Mine was just routine bloodwork during an annual physical. My initial shock and disbelief were balanced by feeling fortunate that the cancer was caught early. Like Tatania, the following weeks felt like being on a rollercoaster, where everything moves quickly, the peaks come slowly, and the peaks disappear in an instant. The rapid descent causes a sensation in your stomach: a mix of emptiness and nausea. 

I have been fortunate. My disease progressed more slowly than it could have, and instead of the usual year or two of monitoring and waiting, mine lasted over five years—during which I never felt ill. The eighteen months I have spent on targeted treatments have not only eliminated the symptoms that initially required treatment but also relieved the anxiety of waiting, wondering how the drugs might affect me, and whether they would even work in my case. I also realized that I had gradually become more fatigued due to the malignancy in my bone marrow and the energy my body used to fight it. I found new energy I hadn’t known I had lost.

Tatania Schlossberg’s story isn’t mine. She has an even more rare and very different type of leukemia. AML (acute myeloid leukemia) is less common, more aggressive, and generally treatable. However, she also has a rare genotype that makes her cancer resistant to available treatments and significantly shortens remission periods. She has undergone treatments that required hospitalization and isolation. She has fought bravely, only to be devastated by remissions that last just a short time. She has had to temper her hope with resignation, accepting that she is dying. A current clinical trial might extend her life long enough for an effective treatment, or eventually, a miracle cure could be the hope we all cling to. So she is using her voice as a writer to do the kind of thing that those with the inclination and opportunity to turn personal tragedy into hope for others do. 

She is speaking out against her cousin, Robert F. Kennedy, the Secretary of Health in the Trump administration, who, despite having no medical training and a tendency for vaccine conspiracy theories, has managed to cast doubt on mRNA vaccines—which have become a potential weapon in the fight to cure cancer—and has stripped funding from the types of research that are the reasons I am alive now and can look forward to a reasonably normal life expectancy. I would like to believe that Kennedy’s agenda is driven by fear and ignorance. He has no medical training, has never worked in government, and knows nothing about creating effective public policy. But against the backdrop of the Trump administration, it feels more like simple, selfish cruelty because you have the power to do so. 

My emotions shifted from compassion to anger when I realized that the very things I am so grateful for are what Tatania Schlossberg needs and may never have. The hope I have for my future was born from things being threatened by Kennedy's incomprehensible power to withhold research funding, cast doubt on science that has advanced medicine to levels that were not long ago unimaginable, and promote ideas considered unfounded and dangerous conspiracy theories by those who understand science and medicine because they have dedicated their lives to discovery as a pathway to miracles. 

Just as I look for reasons to be thankful for outcomes I can't control, I try to resist getting angry. Anger can easily feed itself and seem to take on a life of its own. But it doesn’t change anything. There are many healthier ways to handle fear and uncertainty.

I can, within limits, feel anger toward myself about the poor outcomes I can or should control—and remind myself to also practice self-compassion. This kind of anger feels like a healthy way to motivate myself to accomplish what I might not otherwise. I often need to remind myself to extend the same grace and passion to others when I find myself getting angry at people over things they cannot control. However, I draw the line and allow my anger to surface only toward those whose abhorrent behavior stems from their learned helplessness or, worse, arrogance. I cannot imagine how Tania Schlossberg can contain her anger, considering how angry this makes me. When I realize that her anger is not about her dying but about the greater good and the well-being of others—I feel justified in my emotions, and perhaps I may not be angry enough.

I realize this is why I am thankful for Ms. Shlossberg. I consider people like her—those with the courage and determination to put her needs behind a greater good—to be my heroes. There are a few people in my life I feel this way about. Most aren’t dying in their thirties. Most are men and women leading small- and mid-sized companies, understanding that being a CEO is a commitment to serve the greater good—knowing they benefit when everyone else does too—and that they should do so before they do.

Tomorrow is Thanksgiving.

I couldn’t recall the actual reason we celebrate. It doesn’t commemorate a hero’s life or a significant event in history. The origin story is about our ancestors sharing a feast with the native people of this continent to show gratitude for the bounties of a harvest made possible by learning their farming techniques. But we don’t celebrate agriculture - or even the native culture that we eventually marginalized and largely sought to exile and erase. So, what is it we are supposed to give thanks for?

It was Abraham Lincoln who established Thanksgiving as a federal holiday in 1863. I believe he understood that we should be thankful for the promise of America—and take responsibility for realizing and protecting that promise. He clearly recognized that it would require people to access their better angels and for rivals to learn how to get along. He demonstrated a rare kind of political courage, the kind most people look for on battlefields. And like those who sacrifice their lives there, he also died young, felled by the violence of a bullet he couldn’t dodge. 

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