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I’ve always been kinda awed by Arnie Witkin. As a young journalist in the 1980s, he was one among the giants of South Africa’s investment industry. So good at his craft that after leaving institutional employment, money flooded into his JSE-listed creation New Bernica Investments. It was a privilege to link up with Arnie again during our three recent years in London. Life in the UK has been good to him and wife Roni, or so I believed until reading this deeply personal letter he sent for publication. Moved by our Biznews colleague Chris Bateman’s fight with cancer, Arnie decided to share his own experience in the hope that, as with Chris’s writing, these can also provide comfort for others facing similar challenges. And just like Mr Bateman, he tells that the secret is a positive attitude. In all challenges, perhaps, not just in overcoming the Big C. – Alec Hogg
By Arnie Witkin*
I was diagnosed with thyroid cancer in 2001 and had to have my thyroid removed. When I received the diagnosis I was obviously shocked, but the endocrinologist assured me that thyroid cancer was relatively benign if it hasn’t spread out of the thyroid – something like 98% full recovery. I was somewhat relieved.
About an hour before the scheduled operation the anaesthetist came to my ward and said that he’d like to take me to the ICU and explain to me what would happen. We met my nurse, Margaret from Pretoria (I was in London) and he explained that I would have two drains attached to my chest. I would have the blood pressure machine attached to my arm and a blood/oxygen device attached to my finger. My heart would also be continually monitored and every hour or so I would have bloods taken.
When I saw all the attachments I thought that I would be extremely claustrophobic when I recovered and I was worried that I would panic. I devised a mantra that I would say the minute I came around. I practised it many times with Roni, my wife, before going in to the operation. As soon as I came around I said it to myself:
I’m in good hands
Surrender to the process (let go)
I will get through this
The surgeon had informed me that it was possible that they may not be able to save the parathyroids and he said that there were other risks, depending on what they found.
The first thing the surgeon said to me was, ‘The good news is that we managed to save the parathyroids.’ I wasn’t exactly certain what the parathyroids were for, but I felt relieved. He then said that unfortunately the cancer had spread to the recurrent laryngeal nerve and that they had to sever it.
I was so relieved about the parathyroids that I didn’t think about what this meant. I had an oxygen mask, and could only speak in a very soft whisper. The reason for this is that the recurrent laryngeal nerve controls movement of the left vocal cord, which was now paralysed.
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In fact for three years I spoke in a high pitched whisper until I had an operation to correct it. As you know I still speak with a hoarse voice. As an aside, I was on the boards of six companies and chairman of three of them. At the board meetings they used to bring me a microphone and a portable amplifier!
The operation, which should have lasted about two hours or so went on for over four hours as the surgeon tried to scrape the cancer off the nerve, but was unable to do so. My wife and eldest son were waiting to see me and were quite frantic the longer it lasted. My son, age 25, was crying when they finally let them see me for a few moments.
The whole night I repeated the mantra to myself. It worked wonderfully. I did remain calm and the words ‘safe’ and ‘in good hands’ were reassuring. I managed to ‘let go’ and when I said that I was strong and would get through it, it gave me determination.
The next morning my son came to see me before work. Realising that he was likely to be quite distraught when he came into the ward and anxiously asked me how I was I said: “Tickety boo. I had a much better night than I had expected.” He was visibly relieved.
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A business associate was going in for a major heart valve replacement – a factor of the complexity of my operation. I gave him the mantra. When he had recovered six weeks later he called me to say that I had saved his life. He came around and the machine was breathing for him. He started to panic and he repeated the mantra.
The most important aspect for him was ‘surrender to the process.’ He had started to fight the machine to get back control, but he managed to let go and let the machine breathe for him. He asked if he could give this mantra to everyone he knew who was having an operation.
Another friend had to have complicated back surgery. He too started to panic, but for him ‘safe’ and ‘good hands’ steadied him. The others were also important and he too said that it helped him enormously.
I had to have very painful radiotherapy on my throat. For six weeks I could hardly swallow. The pain was so great that sometimes I would just burst out crying. I didn’t want to go to the hospital every day but decided that ‘the beam was my friend’ because it was going to make me better.
I decided that I had to have a strategy for coping. In theory there is no such thing as no strategy. Your action is your de facto strategy. I wanted to have a considered strategy. I wrote down the following, which I still use today:
Number one strategy for coping, which may sound trite, is ‘Count my blessings.’ When I thought about how lucky I was to have such a wonderful family and to have had an interesting life and to be fairly successful it took my mind off the pain and the fact that I had no voice.
Second was ‘Never moan or complain.’ This is different from a factual statement of ‘I’m not doing so well today.’ I discovered that moaning and complaining just makes you and the person you are complaining to feel helpless. Cancer (and other illnesses) are family affairs. They affect everyone in the family, especially a spouse.
Third was to try to have a sense of humour. I used to say before business meetings, ‘Don’t let the softness of my voice detract from the seriousness of my purpose.’ It was funny but set the tone for the meetings. Your voice is your authority and I had to make sure that my authority wasn’t undermined.
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My wife and I went to the hospital and I whispered at the reception that we had come to see the speech therapist. The receptionist looked straight past me and answered to my wife that she was on the second floor. I wore colourful shirts and I used to say, ‘The loudness of my shirt makes up for the softness of my voice.’
Fourth was to take responsibility for my situation. This is other side of the coin of not moaning and complaining. I couldn’t blame God, or the government, or my parents or my wife or children.
Fifth was acceptance. What I couldn’t change I had to accept. It is fine to try and change things and one should never give up, but there are some things that are physically impossible to change. I accepted the reality and had to work with it.
Sixth was to repeat a mantra, about six or seven times a day, that a therapist friend of mine gave me and which I still use today when I’m not feeling great
I looked in the mirror and said aloud:
‘I love you exactly as you are.’ This made me feel loved, like a small child being hugged by a parent and at the same time I felt that I was the parent doing the loving
‘I care for you in this difficult time.’ I had to acknowledge that the time was difficult and that a bland statement that everything will be fine didn’t acknowledge how tough it was
‘I am strong. I will get through this.’ This was for grit and determination and to try to muster some steel. Whenever I said it I felt stronger.
These strategies all worked well for me, but of course may not be for everyone.
My cancer returned in 2009 and had spread to my lungs. I was on a chemotherapy drug for 19 months with difficult side effects. Also in 2009 I got prostate cancer which is far more complicated. I worked full time on my strategies for coping – sometimes they didn’t work and then I had to accept my sadness. Fortunately it usually didn’t last too long and I got back on track within a couple of days at most, usually much sooner.
I was in remission for 8 years but last June my lung metastases returned and I am back on the drug.
Fortunately the side effects aren’t as bad as in 2009. I play golf three times a week, so all must be good. When the virus hit I got really scared because I am in the highest bracket of vulnerability. My mortality came into sharp focus and I had a number of panic attacks – not helped by the collapsing stock market! My strategies were working overtime, with limited success on some days.
As I write this, at almost 76, I’m feeling strong and positive, with no thought of dying. My family are loving and when I feel strong, so do they.
Cyril Ramaphosa: The Audio Biography
Listen to the story of Cyril Ramaphosa's rise to presidential power, narrated by our very own Alec Hogg.