You’re on, Cowboy!

After nearly losing my business before it started, going through two divorces and being humiliated on national television by Oprah Winfrey, my life became great by the time I was in my 50s.

I had met my third – and current – wife Margaret. She was my soulmate.

My pharmacy business, Maxor, which started with a $20,000 loan I couldn’t afford at the time, had grown into a multi-million dollar business.

I was on top of the world.

Now I was still the first to admit that I had a prominent self-reliant streak that at times bordered on stubborn. And my preference was to address problems on my own rather than to seek outside consultation. I acknowledge this character trait, but rarely in my life has someone been so apparent to point it out as Margaret.

One of the first things she did after we got married in the summer of 1994 was insist on getting frequent physical exams to ensure we were healthy. I knew this was important. But being in the pharmacy business and knowing a considerable deal about health care and human health, I always assumed my body would tell me when it needed help.

I also hate going to the doctor.

I acquiesced and we finally went to the Mayo Clinic in Scottsdale, Arizona, in 2003. We spent two days getting a complete physical. We had colonoscopies, hearing and eye exams, X-rays and a variety of blood and other tests.

On the second day, Margaret and I were separated when we received our blood test results. The doctor had a troubled look on his face as he broke the news to me: I had a very high white blood count. I knew what that meant. I wanted her to get the details along with me, so she joined me.

“My blood pressure’s great and I have very little chance of dying from a heart attack,” I told Margaret, trying to disguise my emotions with humor. She didn’t laugh. Margaret saw the fear on my face. I told her that my white blood count was extremely high. She knew exactly what it meant.

We stepped back into the doctor’s office as he confirmed what we already knew. There are three reasons why white blood cell counts are high. The first is that you have an infection, the second is that you have some form of leukemia, and the third is you have a kind of lymphoma. I didn’t have an infection, so that narrowed the choices down to leukemia or lymphoma, neither of which were pleasant. Margaret sternly asked the doctor not to mince words with us, that we both knew medical tests well, and to explain further. He replied that I had an extremely high percentage of lymphocytes, but we wouldn’t know if it was a lymphoma or a leukemia until further testing.

That night Margaret and I prayed for the lesser of two evils a high white blood count can indicate. We also prayed for the safety of our new grandson, Josh, who was born the same day I received the news. It was hard being joyous about a new grandson while in limbo of knowing how severe my ailments were. We hoped that it was, Chronic Lymphocytic Leukemia or CLL, because a person can live a good life with CLL and die from something else. A lymphoma, on the other hand, can kill you quickly.

Lymphoma is the most common type of blood cancer. It is the seventh most common cancer in adults and the third most common in children. There are two main types, which are Hodgkin’s Lymphoma (HL or Hodgkin’s disease) and all other lymphomas are considered non-Hodgkin’s lymphomas or NHLs. To differentiate the two, there are physical markers that can be identified via microscopic examination of a tissue biopsy sample. There are five subtypes of Hodgkin’s disease and about 30 subtypes of non-Hodgkin’s lymphomas. Depending on what kind of subtype of lymphoma a person has will dictate whether they have a life expectancy of two years or 50 year. To find out what subtype I had, we went to the world renowned MD Anderson Hospital in Houston, Texas. Before we left, we let all of our family know to prepare them in case we came home with bad news.

Margaret and I flew to Houston, where they set up a variety of tests. We had to start from scratch. They took blood samples, put me in a PET scan, did bone marrow biopsies, and conducted specialized tests that I was wholly unfamiliar with. The most painful test was the bone marrow biopsy, a technique using a needle nearly the size of a pen that pierces your hip to acquire a sample of hip bone marrow. While that hurt, it wasn’t nearly as uncomfortable as the PET scan, which was a claustrophobic nightmare that took a full hour of being immobile in a large, whirring, unworldly machine.

After nearly a week of testing, the lab results were in. Dr. Barbara Pro, an MD Anderson physician specializing in lymphoma, tried to break it to me as nicely as she could.

“You don’t have to come back for a month,” Dr. Pro told us. “But you need to make the most of your time, spend it with people you love and get your affairs in order.”

I asked her if that meant I could get a doctor’s note to go cowboy on the ranch for a few weeks? She smiled, said yes, then looked at me with sadness in her eyes and told me that the results indicated mantle cell lymphoma, the last words that I wanted to hear.

My heart sank and Margaret gasped. Mantle cell lymphoma (MCL) results from a malignant transformation of a B lymphocyte in lymph node follicle. The transformed lymphocyte grows in an uncontrollable manner, which results in the accumulation of lymphoma cells and the enlargement of the lymph nodes. The lymph nodes can become so large they can be considered tumors. MCL cells can travel through the bloodstream and the lymphatic channels to easily spread into other lymph nodes or tissue such as the marrow, liver and gastrointestinal tract.

Dr. Pro told me that I needed to be back in a month and that I needed to prepare to stay at the hospital for at least six weeks to aggressively attack the cancer with chemotherapy.

The diagnosis changed my entire outlook on life. Only 20 percent of the people who are diagnosed with MCL live longer than five years. I started wondering things like, “Will this be the last time I ride this horse?” Or, “I wonder if I’ll see this part of the Maxor business grow to success,” and, “I wonder if I get to see my new grandson Josh go to school?” It was a low point in my life, but it filled me with purpose and desire.

I had one month before I started chemotherapy and I wasn’t about to waste it. I rode my best horse at my ranch - called the High Card - moved cows from one pasture to the next because that is what I love to do, and tried to appreciate the sights, sounds and views mother nature gave. I appreciated the small things in life that we so often take for granted. I found myself picking up the phone to talk to friends I hadn’t heard from in years just to say hello. I came to work before everyone else, was more productive, and told my employees of 20-plus years that I appreciated them. Most importantly, it made me realize that living life without recognizing that it is going to end, possibly soon, can make people become lethargic.

Rather than attacking every day like time is a limited quantity, people get in a rhythm, a schedule, where days and motivation seem to slip by without notice. I realized that I was guilty of it too, and that the cancer scare woke me out of it. I don’t typically give heart-to-heart speeches, but I felt compelled to do so with my Maxor employees. I gathered everyone together, pulled out a note, and delivered my speech.