1)When a Management Consultant and Working Mother is Informed Terminally Ill
 
 
The “off-switch” to my life occurred abruptly: In 2018, I had my regular physical checkup at my usual clinic. The only difference was that a few days later, I received a call from a nurse telling me to come in immediately.
 
At the time, I was a project manager for a consulting firm. I was also raising two daughters, one in first and the other in the fifth grade, and I had a jam-packed schedule. I didn't have any time to spare, but the nurse's tone was unusual, so I managed to make arrangements and made my way to the clinic.
 
Once I was sitting in his office, the doctor informed me that there was a high probability that I had leukemia. The next day I underwent a thorough examination, after which the doctor at the university hospital informed me, "It's acute leukemia.” He then went on to explain how normally they would have admitted me to the hospital immediately, but since I had children, they would allow me to go home, and admit me the following day, while they made the necessary arrangements.
 
Despite showing no apparent symptoms, I was suddenly being told to discontinue my "normal" life.
 
As I nodded my head and wondered how many more years or months I had left to live, the doctor told me, "Leukemia is widely thought to be an incurable disease, but now it is treatable. However, it takes time to complete the lengthy treatment. At least six months is needed." If it is treatable, there is nothing else to do but to try to cure it. Suddenly, a new project entitled the "Leukemia Cell Eradication Project" was born in my mind.
 
But what about the projects I was already heading? What about the children?" I was asked to write a letter of leave of absence informing them that I would be unable to continue my regular duties in the hospital, where I could hardly visit my clients due to the risk of infection. My mind immediately switched from "business continuity planning" to "emergency response planning. My spirits were immediately lifted once I had discarded my to-do list in favor of continuing to live my life.
 
Lean on those things that you can depend on. Don't beat yourself up for overthinking things. Gather accurate information and choose what to discard. Furthermore, I would steadily follow the PDCA cycle of "Plan, Do, Check and Act”. This was a concept I learned through my consulting work.
 
 
2) Think Doctors as Your Teammates: Be Courageous and "Be the Patient Who Speaks Up
 
I was diagnosed with acute leukemia during a routine physical examination in 2018 and was urgently hospitalized without any apparent symptoms. My goal was to "get my life back to normal.” The doctors took the liberty of assuming that they were my colleagues who would help me carry out my "new project" called the "Leukemia Cell Eradication Project".
 
Team building is an integral part of being a consultant for any new business venture. Therefore, I first tried to build a relationship of mutual trust. I actively discussed my medical history and physical condition, asked questions and took notes to better understand the course of my treatment. I demonstrated to my doctors that I would do whatever it takes to cure this disease. After all, doctors are human beings too. I think showing my enthusiasm for the treatme worked to keep both parties motivated.
 
In the team-building process, there is often a "period of confusion.” For example, the first anti-cancer drug treatment affected the left hemisphere of my brain, causing paralysis in my right hand, so treatment was halted after less than two months. I was so disheartened I wanted to get back to my daughters as soon as possible, and my doubts started spiraling, so I sought a second opinion from a doctor at a different hospital.
 
Later, at my next appointment, my primary doctor proceeded to show me the details of the second opinion that had been exchanged between the two doctors. I felt so ashamed that I had doubted my primary doctor, and I openly shared with him my true feelings; that postponing treatment was the hardest thing I had ever had to do. After this exchange, my doctor and I became "unified," and I felt like we were now genuine, trusting teammates.
 
There is a difference between "following treatment" and "remaining silent” about one’s needs. It is natural for a client to demand not only results but also a satisfactory process from a consulting service, and consultants try to increase client satisfaction. Feedback from clients is extremely valuable.
 
I myself have no background in medicine. But at the advice of my doctor, I tried to avoid reading blogs about my illness, which contained stories about depressing experiences of cancer treatments, and to avoid seeking medical information that was overly specialized and could be inacurate, so that I could better concentrate on my own treatment.
 
But I didn't need medical knowledge in order to talk about myself. I know very well what makes me anxious and what makes me uncomfortable. When I gathered the courage to finally talk to the doctor and became a "patient who speaks up," the distance between me and my doctor decreased dramatically. Once I was able to depend on him for my treatment, my anxiety and stress were greatly reduced.
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3) Maintaining Physical Strength Without Eating Hospital Food.
 
Communicating their intentions is the most important issue for patients. If they do not communicate these, they cannot tell what they whish to do.”
 
During my hospitalization for acute leukemia starting in 2018, I kept in mind three things I learned on the job about communicating my intentions. The first is strategic planning. My doctor came to my hospital room twice a day, once in the morning and once in the evening. Because he was very busy, the time given me was a brief five minutes. In preparation for these visits, I would write down what questions I wanted to ask, what information I wanted to communicate, and then organized them accordingly.
 
I never asked the doctor anything that could be confirmed by someone other than the doctor, such as the nurse or pharmacist. The goal of the day was clearly set, so that the flow and sequence of questions, as well as what I wanted to convey, were prepared well in advance so that they would stick in the doctor's mind.
 
The second is clarification of priorities. If you are clear in your priorities, your doctor will be more likely to understand your needs. In my case, it was to be discharged from the hospital as soon as possible, return to my normal life, and return to supporting my eldest daughter's entrance exams to junior high school.
 
The third is selecting the right words and phrases for the person to whom you are talking. In my work as a consultant, I communicated with my clients with an awareness of their unique characteristics, such as "the type that jumps to conclusions" or "the type that prefers to to have background information.” I tried to communicated to the nurses whose primary objective was to manage patients’ daily conditions, about my physical and mental condition in clear term.
 
I also communicated my intentions regarding meals, refusing to eat any hospital food during my second hospitalization, which lasted about four months.
 
When hospital food is analyzed from the two perspectives of the Hospital (seller) and the Patient (buyer), using marketing techniques, a clear difference in perspective emerges. The hospital focuses on "safety and nutritional value," "low price," and "on-time delivery," while the patient focuses on good taste, and the joy and comfort of eating. I recall thinking that "I don't care if it costs a little more, if it tastes good," and "I want to eat when I am hungry.” These were the patient’s needs.
 
During the second hospitalization, during which I was allowed to eat the normal hospital meals, I made use of the hospital cafeteria and foods that were brought to me by my friends, which I could eat despite the side effects of anticancer drugs. In addition, I exercised using a bicycle-type training machine to maintain my physical strength.
 
I am grateful to my physician, who trusted me and imposed fewer restrictions on me.
 
4) Lessons from Bad Luck of Serious Illness:
3 Years of Absence from Work, a Major Turning Point in Life
 
I was diagnosed with acute leukemia in 2018 at the age of 43. My 40s were my most active years at work. I also had daughters in the first and fifth grades of elementary school. Many individuals would consider it rather unfortunate that I had to face a serious illness at this point in my career. I too would have considered the "forced termination" of my daily life to be unfortunate. On the other hand, I also feel it was fortunate that I learned how to better deal with my body in my early 40s.
 
For my two daughters, the most important thing was probably that they were able to build relationships with their father and grandparents without their mother. They are now able to observe and judge situations without my influence. With the help of family and my friends who are also active moms with kids, I was able to raise my daughter remotely from the hospital room, and I believe that this helped to create a new and healthy balance for our family.
 
The diagnosis was like a death knell for me. My doctor's words, "Leukemia is curable," and "the cause is unknown; think of it as a car accident," helped me to change my way of thinking, not to blame myself, and to follow some simple life rules that helped me overcome my illness.
 
There were times when I struggled, such as when I was presented with the choice of switching from chemotherapy to a bone marrow transplant. Yet by using a decision-making model that reflects a score based on a set of criteria such as recurrence rate and length of hospital stay, and with further weighting on the criteria, I was able to make the decision not to have a transplant and to discharge myself early in order to support my daughter. The thinking methods and know-how I developed as a consultant were extremely helpful.
 
Before my illness, I was always thinking about how to use my time more efficiently. During the days when Japan was forced to refrain from going out due to the Corona virus, fearing the spread of the virus, I got into cooking and learned that if you take the time, the food could tastes better. I also learned the importance of slowing down, a process similar to that of anticancer drugs, which are effective by multiplying a drug by the amount of time it takes to produce an effect.
 
In the summer of 2011, a full five years had passed since my remission therapy, and after taking a three-year leave of absence, I returned to my workplace and found myself frequently working with colleagues who were completely unaware that I had taken a leave of absence. Eventually, I was even able to go on an overseas business trip, which I had never thought possible because of my fear of contracting Corona.
 
I would like to express my gratitude to those who supported me during my battle with my illness. The shadow that the disease has cast over my life is fading, but my desire to support those who are battling with their own illness is not diminishing. This is something I will continue to do to the best of my ability.
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Makiko Yamazoe was born in 1974. After working for Accenture, KPMA and ERM, she studied in the U.S. and completed a master's degree in Public Administration (Environmental Policy) at Columbia Universtity School of Interantional and Public Affairs (SIPA). In 2006 she returned to Tokyo and began to work for one of the leading thinktanks/consulting firms in Japan. In 2018, she developed acute lymphocytic leukemia, but was able to return to work. In 2019, she published "When a Management Consultant and Working Mother Cares for Her Children with Cancer".
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