The Trust Diagnosis

The episode centers on the dilemma of a man with an advanced, metastatic case of prostate cancer. His name is Dan. Every doctor he spoke to had a different opinion on what he should do — or whether it was even worth doing anything at all. His question was: which of these many opinions should I trust? The episode centers on which doctor he ended up committing to, how he made that decision of where to place his trust, and how his choice probably saved his life. What Dan will explain — and he is someone who has spent his life as a crisis communications specialist — is that trust only comes at the end of a careful and intentional process. See omnystudio.com/listener https://omnystudio.com/listener for privacy information.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Malcolm Gladwell?

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• 0:37Speaker 01

  Purchase and seller protections on eligible transactions only. Terms apply. See PayPal.com/risk-management for details.

• 0:53Malcolm Gladwell?

  Pushkin.

• 0:58Malcolm Gladwell?

  I have a friend named Dan. I've known him for years. He's in his 70s, lives outside Washington, DC. He's in the crisis communications business. Companies call him in when they have a big problem. In fact, that's how I met him. I was working on a story about one of his cases, and he called me up. Dan and I talk all the time. And last of all, he said something to me in passing about having to go for a bunch of tests. He didn't say why. It didn't seem like a big deal.

• 1:29Speaker 02

  Last May, my internist told me that he was pretty sure I had prostate cancer. And for me, it was a... I can't say it was a nothing reaction, but it was certainly a very modest reaction. I said to him, "Isn't this the minor league of cancers? And isn't it a rite of passage if you're a man my age?" And that's how I thought about it. And it was reinforced when I... when connected with the urologist, who said to me, "Anytime in the next few months, have an MRI."

• 2:09Speaker 02

  So I thought of it as a minor thing and my first contact with my experts reinforced that. So I didn't even bother to do anything until August, from May to August. And I go from a, so a blood test to an MRI to a biopsy to a PET scan. And then it was, yeah, you got it. And then the next deal was you should just go and get some radiation and some hormone therapy. And it was, and I had to draw it out of the physician and it was a casual matter of fact. And that was sort of dumped in my lap at that point.

• 2:54Malcolm Gladwell?

  But at a certain point, something nagged at him. He wasn't sure why, since everything thus far had been straightforward. So he started calling around.

• 3:04Speaker 02

  But as I was going through it because of my work and friends, I've had lots of health clients and education clients, as you know, I asked somebody just to look at it to make sure there wasn't something. And I, and I was even embarrassed and hesitant to ask because I thought it's such a minor problem. It felt like an imposition and my friend wanted to do it and I, I was even hesitant and reluctant. And a doctor, which I will name Dr. Mastert Emery, looked at it and said, you have a big problem. You have an urgent problem. And it was like that. And he said, if you were my patient, I would have had you in my surgical suite last week.

• 3:49Speaker 02

  But you have an urgent matter.

• 3:51Malcolm Gladwell?

  My name is Malcolm Gladwell. You're listening to Revisionist History, my podcast about things overlooked and misunderstood. This episode, where we explore how and when trust decisions are made, is sponsored by PayPal Open, trusted by consumers built for all business. For over 25 years, they've been at the forefront of commerce, helping merchants of all sizes grow. So wherever commerce moves next, you can rest assured PayPal Open has your back. Head to PayPalOpen.com to learn more.

• 4:24Malcolm Gladwell?

  Over several episodes, we'll dive into the topic of trust, where it comes from, the moment it's earned, and how we decide who to trust or not. And I wanted to start with the story of my friend Dan, who out of the blue one day was told that a problem he thought was routine was actually threatening his life. And who had to decide, under the most emotionally overwhelming circumstances imaginable, who to trust.

• 4:56Speaker 02

  He looked at my files, looked at my data and said, "You have a big problem." And he said, "Others will tell you that you don't, but I'm telling you, you do."

• 5:09Malcolm Gladwell?

  One of the many interesting things about Dan is that if I told you his full name and you Googled him, almost nothing would come up. He doesn't advertise. He doesn't give interviews. He doesn't go to fancy galas. There are no pictures of him anywhere. He's almost invisible. But in the very rarefied world of Fortune 500 companies and CEOs and political bigwigs, everyone knows Dan. Because he's the guy you call when you have a problem you don't know how to deal with.

• 5:39Speaker 02

  For the past nearly 40 years, I have lived at what I refer to as the intersection of bad luck and bad judgment. I help people who have managed to get themselves into really serious trouble. The kind of trouble that is career-defining, can be threatening to the existence of a business, brings a level of scrutiny from the Justice Department or Congress or media that is inescapable. Usually, to borrow the words of Hank Williams, "These are folks who see their name at the top of the page."

• 6:21Malcolm Gladwell?

  And you are, if you're not going to blow your own horn, but literally like if some big shot person gets in trouble, you're like, it's like Ghostbusters. It's like Dan gets the call. You get the first call, as far as I can tell.

• 6:37Speaker 02

  For the last 25, 30 years, I get the call.

• 6:41Malcolm Gladwell?

  Yeah.

• 6:41Speaker 02

  And there have been many times where I will see a story break.

• 6:49Speaker 02

  And I'm automatically processing it, reacting, what do I think? What do I think's going on? And in the back of my mind, I'm thinking, I might get a call. In many cases, I do get a call. And whether it's the General Motors bankruptcy, or the Paterno-Penn State case, or the BP oil spill, the Equifax data breach, you know, either limits on what I can say about what I did, but I get, I get the call.

• 7:16Malcolm Gladwell?

  Now, why do, let's talk about this in a context of trust. So you, you have spent your life walking into boardrooms, executive suites, what have you, to talk to people who, in most cases, you have never met before.

• 7:30Speaker 02

  Right.

• 7:31Malcolm Gladwell?

  So people just know you by reputation.

• 7:34Speaker 02

  Correct.

• 7:34Malcolm Gladwell?

  Why do they trust you?

• 7:38Speaker 02

  It's, it is, it's an interesting thing. I've, I've thought about it sometimes because I've, I've wondered about misplaced trust. The genuine trust comes through the process. It isn't, in the beginning, it's hope. It's, and it's panic and it's fear. And they've been told by somebody that they do trust, this is the guy you need. They, you know, they're in such a difficult spot. They don't know where to turn. They are desperate to find somebody who can help them. You know, an irony for me in my, my medical situation is I used to say to clients, sort of jokingly, that I'm a urologist.

• 8:21Speaker 02

  And that I'm the person you don't really want to see. But when you need to see, there isn't anything more important. You want to see that urologist and you want that problem solved. There is a sense of urgency that is, is focusing in a way that nothing else matters. And then I end up in this situation needing my urologist. But it is, what I, what I know is...

• 8:51Speaker 02

  They know quickly if they can trust me.

• 8:56Speaker 02

  They can tell your tone. The first things you say are so critically important. The manner, your style, your sense of confidence. All those things communicate absolutely instantly. People are processing. Is this a person in the most critical situation of my career? Should I give them time? Should I give them space? Should I pay attention to what they're saying?

• 9:24Malcolm Gladwell?

  And what is it in that moment? Are you... If you had to summarize as simply as possible what you're bringing to them in that moment, what is it?

• 9:33Speaker 02

  It's a good question. It's a hard question. Because as I've explained, I will be the least knowledgeable person in any room I'm in.

• 9:47Speaker 02

  And partly it's because I'm in the rooms on calls, in meetings, in boardrooms with people who are phenomenally experienced, capable, educated, credentialed, leading scientists, engineers, MBAs, lawyers, CEOs, board chairs, tremendously accomplished people. And they have a world of advisors around them. They don't lack for counsel. In-house counsel on the communications front, marketing, legal, outside advisors, business consultants. So what do I bring? I don't have any of those credentials. I bring a depth of experience of being in truly, truly difficult situations hundreds of times,

• 10:31Speaker 02

  where the stakes are so big and the pressure is so great. I think if I have a particular skill, it is synthesizing, clarifying. I hope and believe that I bring a common sense perspective to it, which relates to the clarity. And I want to help them prioritize what they're doing and how they're processing it. And then inevitably, I'm involved in what do you say about it? What do you say? Who says it? When do you say it? How do you communicate that? And that, it can sound easy, but then you've got, you know, all the technical aspects, the factual side of that. You've got the legal considerations, the regulatory considerations. And all those pressures are there.

• 11:15Speaker 02

  How can you help them fight through that and get them to say something that real people can understand? There's an honesty and integrity and a value to it.

• 11:27Malcolm Gladwell?

  In a meeting with a client, have you ever raised your voice?

• 11:30Speaker 02

  No.

• 11:32Malcolm Gladwell?

  You do have, speaking of why it is people trust you, you do radiate a kind of calm and there's something dispassionate about the way you see the world. And I imagine you're dealing with people who are often highly emotional.

• 11:51Speaker 02

  Oh, yeah. I mean, I'm in a room where there's always, there's lots of screaming, there's jockeying. People are desperate to sort of seek an advisory role. Others are trying to get out of it. There are people who are trying to take credit and there are people trying to lay blame. And there's just tremendous emotion. You know, what I know, I'll just tell you a few things I really have never talked about. I need to get to a point where the CEO will tell me anything. And I mean, tell me the personal side. Because the personal emotional toll

• 12:34Speaker 02

  of these things is never really factored in and it plays a huge part in what they're going through. So it's not as much what I say as what I hear. I want them to feel, if they reach the point where they want to truly confide in me, then I know I'm going to play a role. The other thing that I know is it is absolutely essential for me to be candid in my very first conversations, really candid. So you mentioned earlier about you tell them how bad it is. In a sense, I do. I'm not telling them something they don't know. But I want them to know two things,

• 13:16Speaker 02

  that I have a sense of the situation without all the factual command that they have. I have a sense of it and that I am... Going to be absolutely direct with them. I'm not trying to shock, I'm not trying to make them feel worse, but I'm unafraid to tell them what I think. And that's, and those first, literally those first conversations, it's critical to your role.

• 13:46Malcolm Gladwell?

  So you go and see Dr. Master.

• 13:48Speaker 02

  Yeah.

• 13:49Malcolm Gladwell?

  And the tables are turned.

• 13:52Malcolm Gladwell?

  Dan had become the client, the person in a state of emotional distress and confusion, talking to a stranger and trying to decide whether to trust him. We'll be right back.

• 14:10Malcolm Gladwell?

  We spend hours researching products online and deciding what to buy, but there's a split second decision that can make or break a sale. Do you have the trust to hit the buy now button? The way we discover and compare things is evolving, happening faster and influenced by new forms of intelligent advice. But the underlying trust question doesn't go away. If anything, it's more important than ever. That's where PayPal comes in. For more than 25 years, they've been a trusted way to pay. And now PayPal can make the agentic era of commerce work for merchants, letting them maintain control of their brand, their customer relationships. So even as the way we shop changes,

• 14:51Malcolm Gladwell?

  the moment that matters most still feels familiar and deeply dependable. PayPal is built for all business. Get started at paypal.com/business. Purchase and sell our protections on eligible transactions only. Terms apply. See paypal.com/risk-management for details.

• 15:14Malcolm Gladwell?

  This is fascinating though, Dan, because you are in a moment, there's a moment here when you start to treat this problem you're having in the same way that, you actually said this to me. There was a moment when I started to treat this problem, I understood this was no different from the problems I deal with in my work.

• 15:30Speaker 02

  Yeah, that's when this whole thing turned.

• 15:32Malcolm Gladwell?

  When do you have that sense of, oh, this is something I've been doing my whole life?

• 15:38Speaker 02

  Well, so Dr. Master is telling me I have a serious problem, that it needs to be addressed and that I need surgery, but he's not the one to do it. Then I followed up and I talked to two surgeons who said to me, "Surgery is out of the question, can't be done." And that my problem was a lot more complicated, a lot more advanced.

• 16:06Malcolm Gladwell?

  And now the script has flipped, have changed dramatically. We've gone from doctors shrugging to doctors saying, "It's so bad, we don't even think we can do surgery."

• 16:18Speaker 02

  Right.

• 16:18Malcolm Gladwell?

  And when they say that, so what are they telling you your options are at that moment?

• 16:24Speaker 02

  That you're gonna need other, all the treatments that are available. And they kept saying, Malcolm, it's a very interesting thing, because you know, I pay, again, it was my instincts. I listened to exactly what they're saying and the way they say it and the order in which they're saying it. The first thing they would say to me is, "We can keep you alive." And that was meant as a reassuring message, and it wasn't. Not because I feared death, but because I thought, they thought that I feared death. And what I was worried about was quality of life more than length of life.

• 17:07Speaker 02

  And consistently, it was about, "We're gonna keep you alive, we can keep you alive." And then it was, "But surgery's not an option, you're too far gone." And then it was a radiation, extensive hormones the rest of my life, and chemotherapy, and an ordeal that would be, look, I'm grateful for anything, but exceedingly unpleasant, a life that was tremendously compromised. So I talked to these surgeons, and their language was, one surgeon said, "Oh, oh, no, no, no, no, no, no."

• 17:48Speaker 02

  Immediately after he told me, you know, you can say alive, "You don't want the surgery." He said, "I would be, I would not want to do it." But he said, "I'll do it if you want me to."

• 18:01Malcolm Gladwell?

  Oh, goodness.

• 18:03Speaker 02

  And I don't, you know, but he literally said, "I'll do it if you, if you really want me to." And, you know, no one, of course, is thinking of that. A second surgeon that I talked to kept saying,

• 18:15Speaker 02

  And I'm not exaggerating. I think he said it. I made notes seven times in my, I had a video chat with him. He said, "It's at least 90% that I will not be successful." And he said, "It's probably below, it's probably single digits to have any chance of success here." And he was so worried that I wasn't hearing that, he kept repeating it over and over and over again. So after I talked to them, I talked to another doctor who sent to me finally the magical message for me, which is, "You're the only one who can figure out what to do here, Dan. The doctors can't figure this out for you."

• 18:56Speaker 02

  And I immediately understood what that meant. And I was immediately comfortable. I thought, the stress, interestingly, the challenge was great, but the stress receded. I thought, "I know this. I know exactly what he's saying."

• 19:11Malcolm Gladwell?

  What did he mean?

• 19:15Speaker 02

  Not that I had been talking to incompetent doctors, not that I was getting bad advice. You can argue about the elements of it. But that it is a problem that doesn't have necessarily obvious, clear advice attached to it. That what no one had said, which I had figured out, the tests are not clear, they're not definitive, they're not perfect. And that the science is incredibly complicated. And that I could get extremely accomplished people from different fields, oncologists, pathologists, surgeons, looking at this, and they could

• 19:57Speaker 02

  legitimately come to a wide range of different views. I thought, "I've lived my life in that room. I know what that means."

• 20:03Malcolm Gladwell?

  Hmm. So what was your next step? Wait, at the moment he says that, so that's the moment where you say, "Okay, I've been here before."

• 20:14Speaker 02

  No, I know. I know the deal.

• 20:16Malcolm Gladwell?

  He was in a crisis. And what had he spent his entire life doing? Solving crises. What was the change in your perspective at that moment? Did you, so you said, had you...

• 20:27Speaker 02

  Tremendous comfort.

• 20:28Malcolm Gladwell?

  Yeah.

• 20:30Speaker 02

  It was, it was, I am 100% confident and comfortable making this decision myself. Not because I thought I would be perfect, or that I knew more than the doctors, I knew that I didn't. But that I knew the right process to go through to arrive at the best conclusion I could arrive at. And I, I, it was, it was a tremendous calming experience for me. But I was blessed because of this experience, nothing I'd ever planned on, nothing I would have ever thought about when I started this. But I've been through it dozens and dozens and dozens of times on incredibly complicated, high stakes issues, careers, billions of dollars.

• 21:16Speaker 02

  And that I had a network of people that I could call on for perspective. So I knew I would get good advice. So I just, I, from that moment, I just said, this is my newest case assignment.

• 21:30Malcolm Gladwell?

  First trust was misplaced trust. Second trust stage was, you can trust yourself. I then can trust myself on this.

• 21:39Speaker 02

  I can trust myself in this process.

• 21:42Malcolm Gladwell?

  Yeah. So he started over, doing exactly the thing he always does when he takes on a new case. He read everything there was to read. He went through his medical records with a fine tooth comb, flagging the things that he didn't understand or that needed clarification. He was guided by one of the foundational principles of his work. First facts are always wrong.

• 22:05Speaker 02

  Always wrong.

• 22:05Malcolm Gladwell?

  Always wrong.

• 22:07Speaker 02

  Always.

• 22:08Malcolm Gladwell?

  Great. Describe, explain that a little bit, because it's super relevant here. Because in your case, the first facts are wrong.

• 22:13Speaker 02

  Wrong, wrong.

• 22:14Malcolm Gladwell?

  Why are first facts wrong?

• 22:17Speaker 02

  Well, um, it's, it's the kind of thing I, you know, I had to learn through experience. Again, you're in a room, you have brilliant doctors, brilliant engineers, MBAs, fabulous lawyers, outside counsel.

• 22:34Speaker 02

  You would, so when they're telling you something, you believe it. You're based on their credibility, their integrity, their experience. The problem is, where did they get what they know? In a crisis, it's coming too fast. How's it being processed? How thorough is it? How much can you know? And how's it being interpreted? Who's interpreting it? And sometimes, there could be some obvious bias. Sometimes, there's unintentional bias. But what I always know is, you don't have it all. What you think you have, part of it's wrong.

• 23:18Speaker 02

  And you need to be extremely careful, the decisions you're making, based on those facts and what you're saying. Because you're going to be reversing some of those decisions, you're going to be eating some of those words. And Malcolm, I never even thought about that in my case. I did what all my clients do. Well, I've got serious lab tests, I've got an important experienced doctor, I've got other experts who've looked at it. Surely, these things are right, you can rely on them. And I did, and I was absolutely wrong.

• 23:51Malcolm Gladwell?

  What he learned was that the tests that everyone was using to make sense of his case, where was his cancer? How bad was it? How much had it spread? Were flawed. Not because of anyone's incompetence, but just because trying to get an accurate picture of cancer when you first find it is really, really hard. And that what happens is, when doctors speak to their patients, they sometimes forget to communicate this fact. They pretend that they know something for certain, when they actually don't. Which meant that you couldn't put your trust in the results of biopsies and scans. You were of necessity in the world of subjectivity and judgment. And Dan knew all about the world of subjectivity and judgment.

• 24:35Malcolm Gladwell?

  It was where he had spent his entire career. Then, when he felt that he was at least informed enough to ask the right questions, he put together a list of doctors he wanted to interview, put everything on hold for two months, and had a Zoom call with one specialist after another. So you go out, how many doctors do you interview?

• 24:58Speaker 02

  I had conversations with 18 doctors.

• 25:01Malcolm Gladwell?

  18?

• 25:02Speaker 02

  18.

• 25:04Malcolm Gladwell?

  And of those 18, how many told you? Can you kind of quantify what they told you? Like, how many told you surgery or treatment?

• 25:15Speaker 02

  15.

• 25:16Malcolm Gladwell?

  15 told you what?

• 25:18Speaker 02

  Don't do surgery.

• 25:19Malcolm Gladwell?

  Don't do surgery.

• 25:21Speaker 02

  One was split and two said yes.

• 25:24Malcolm Gladwell?

  Tell me about the two who said yes.

• 25:28Speaker 02

  It was, and I never shared the information between the two of them.

• 25:36Speaker 02

  I wanted just objective views. And they both said almost exactly the same thing, almost exactly the same way. And they said, they both acknowledged that I'm certain this will be a distinct minority of views that you're going to hear. If you talk to other people, almost anybody else will tell you not to do surgery and that you can't do surgery, but they're wrong. And a factor in it was, they also both said, "Your chance of beating this isn't great, but it's nonexistent if you don't have surgery."

• 26:20Speaker 02

  And mattered a lot to me. And, you know, in the other calls, again, good doctors, experienced doctors, but saying

• 26:30Speaker 02

  likelihood of being successful, almost nothing.

• 26:34Speaker 02

  Not even, we know from the start, we're not going to be able to get it all out.

• 26:39Speaker 02

  It's going to give you a lot of difficult side effects. Then you're going to have to start these other treatments. The side effects for the follow-up treatments will be compounding with the side effects you're having after surgery. And I remember an oncologist saying to me, "It is the absolute worst course of action you can take."

• 27:00Malcolm Gladwell?

  So what was different about these two guys who disagreed?

• 27:05Speaker 02

  It's a funny thing because it, it really does relate to my life experience and my work. Confident, clear, concise, unemotional, definitive, and convincing. Not just words and manner, but factually the way they presented it. And listening to that combined with... I'd already reached the point with all the information I had, realizing that there were... You know, it's cloudy information and differences of opinion. And I thought, I know that, I'm comfortable with that now.

• 27:49Speaker 02

  And that I thought, based here... You know, I don't think I ever took a science class in high school or college, but the science convinced me there was a very good chance that these doctors were wrong, that these tests had flaws, that some of it just didn't add up in the ways that it had been looked at. And I combined my own instincts, my own reading and information with the way these two doctors talked, and I thought, I'll bet my life on them.

• 28:31Malcolm Gladwell?

  Dan ended up choosing a surgeon at Duke University. He wasn't a prostate specialist. He was just someone who did complex cancer cases of all kinds. He was used to looking at things that seemed impossible. He has a different lens.

• 28:46Speaker 02

  Yes.

• 28:47Malcolm Gladwell?

  He's seen a broader range presumably of problematic surgeries.

• 28:52Speaker 02

  And again, that's something I can relate to. I'm in rooms... You know, years ago Malcolm, CEO of Disney, said, "We would never be good at handling a crisis because we've never had one." And I thought, that can't be true. That can't be true. You're Disney. And what I realized in most of the rooms I've ever been in...

• 29:17Speaker 02

  They've never had a bet your career, bet the company crisis. We think that everybody has. You've had all kinds of tests, but for most people, it's a new experience. Or the stakes are so big.

• 29:34Malcolm Gladwell?

  Are you talking about the doctor? So in this case, the doctor had seen.

• 29:38Speaker 02

  Yes.

• 29:39Malcolm Gladwell?

  He seemed real difficult.

• 29:40Speaker 02

  And I have been in hundreds of boardrooms where I'm looking at a CEO and he or she's wondering, is this the end of my career? Is this how I'm going to be defined? Am I going to lose my net worth? Am I going to go to jail? Am I going to be humiliated in front of Congress? Am I going to be embarrassed with my family? That fear is there. And, you know, I've had them say to me, my God, my communications people are under their desks. They're scared to death. My lawyers are arguing with each other. My board, strong differences of opinions there.

• 30:22Speaker 02

  And then, you know, what you also have in those situations is they've got their friends, their neighbors, their country club colleagues, their business peers and friends. Somebody inevitably says to me, my wife's brother's neighbor's cousin says I should do X. You've got it coming in from all directions. So you're trying to figure out, who do I trust? As I've communicated to you before, the facts are wrong. I 100% guarantee you. You don't have all the facts and some of the facts you think you have are wrong. So how am I supposed to make a decision now? And so I end up with this surgeon and he broke it into two pieces. Can I do the surgery technically?

• 31:07Speaker 02

  Absolutely, yes. Is the surgery going to be a success? Different question. Different question. Will it save you? That's a whole separate conversation from can I perform the procedure and succeed at that so that you can have the chance to talk about these other things? So his first was 100% yes. His second was 50/50 that it's going to help you at best. And if the studies are what these other doctors are saying, you do have a single-digit likelihood of success. If they're wrong, you could have 50% or better.

• 31:51Speaker 02

  So it's how do you interpret all the information we have? And then it was also saying to him, I've got to have sort of the free rein to do whatever I think I need to do once I get in.

• 32:03Malcolm Gladwell?

  And how quickly do you move from this is my guy to the actual surgery? What's the time?

• 32:12Speaker 02

  By the time I spoke to him, one of the things I liked about my conversation with him, I was told that you should talk to this guy and he's confident he can help you. When I talked to him, he said, oh, no, no, no, no, I'm not confident. I'm confident I can do this procedure successfully. I can't give you false confidence about your outcome. And that was helpful to me. It was honest. I didn't need somebody. It's another view of mine. People who tell you they can solve your problem, be extremely suspicious, extremely suspicious.

• 32:54Speaker 02

  Your problem is multi-layers, evolved over a long period of time, all kinds of dynamics at play. And so in this case, I knew that he could do the surgery. I'd already factored all the calculations from the others. I knew it was my only really good chance. And I had concluded that the analysis I was getting was flawed from the others. And I just, I said, let's go. And within three weeks, I went from my first conversation with them to having surgery.

• 33:26Malcolm Gladwell?

  Tell me about that first conversation you had with him after the surgery was over.

• 33:30Speaker 02

  The first thing was, there were certain cancerous spots that were in doubt, could he get them? And so I needed to know immediately, did you get them? And he said, yes, got them.

• 33:40Malcolm Gladwell?

  Because the cancer had metastasized?

• 33:42Speaker 02

  Yep, you know, got them. And then it was, you know, how far? And he, you know, he had to, he said, I had to nip, cut, trim, move most of the things inside you.

• 34:02Speaker 02

  I told him, thank you, but I'm as partial to as many parts as I can keep. So he had to do a lot, but he was confident he got everything he wanted to get. And the initial pathology after the surgery was positive, but you don't know. But it was a, it was exactly what he said, which is the surgery was successful. Now we wait on the outcomes.

• 34:30Speaker 02

  And, and I was, I was relieved, but I, I don't want to sound overconfident, but it was what I expected.

• 34:39Malcolm Gladwell?

  And how long? I've forgotten now. There was, there was a six week?

• 34:43Speaker 02

  Yeah, you have six weeks and you get a blood test and my, you know, you get a PSA score. And mine had gone down significantly, was not in a great zone, but a good zone at six weeks. And then at another six weeks, I went down and I, you know, I have my, my text

• 35:07Speaker 02

  from him, which I will keep because it's the only time I've ever gotten a text from a doctor where he used miraculous three times and, and one paragraph to me for the outcome of my test scores.

• 35:21Malcolm Gladwell?

  I believe I got a screenshot of that one.

• 35:23Speaker 02

  Yeah. So, and my, you know, my doctors, the two, they were like kids, high fiving, you know, over the phone to each other. They both joined on a conference call to call me to tell me the results. They were ecstatic.

• 35:41Malcolm Gladwell?

  So there's, there's three trust layers here. There is.

• 35:48Malcolm Gladwell?

  The misplaced trust in the beginning, understanding that you had you had offered, you had extended trust prematurely, both to doctors and to...

• 35:59Speaker 02

  I had assumed that trust was justified. Trust in the doctor, trust in his experience, his approach, and trust in the tests. That was misplaced.

• 36:14Malcolm Gladwell?

  And by the way...

• 36:15Speaker 02

  And I'm more critical of myself than I am of the doctors.

• 36:21Malcolm Gladwell?

  And then the second layer was understanding, I can trust myself in this. This is, I know this. I've done this. I have experience in this.

• 36:31Speaker 02

  Yes.

• 36:31Malcolm Gladwell?

  And then the third layer was, this is the person who I'm going to place my trust in for this surgery.

• 36:39Speaker 02

  It's exactly right. I mean, I trust myself. I don't know how people, that may sound to people. It may sound arrogant or naive or whatever. It's, it was hard earned from decades in rooms where people would turn to me and say, now, what do you think? And if you can't add value or what you're saying doesn't make sense, you're going to be out of that room. You're never going to be around. And my work was 100% referral based. So if they don't have value in the room, I don't have any, I don't have a career. So it was that. And then it was the person and the process he laid out.

• 37:23Speaker 02

  What he said he would do and how he would do it and what the equation was. Putting all that together, along with my reading and analysis, I had a high degree of confidence that it was the right choice. And I can honestly say I didn't lose a moment's sleep. I had no second thoughts. I was certain I had chosen the right course.

• 37:42Malcolm Gladwell?

  The idea that you didn't lose and have a moment's sleep is so... I lost, why is it that I lost more sleep over your condition than you did? I was waking up in the middle of the night worrying about you and you're like sleeping like a baby.

• 37:57Speaker 02

  Once I decided I was truly confident. I can't be confident that it's how it's going to turn out. I was confident that I had all the information I need to make an informed decision, that I had processed it. Thoughtfully, in a way that with the same rigor that I would give to a client. And that it was the best option available. What's gonna be is what's gonna be, but that's what I came to. And with that, I was at peace.

• 38:29Malcolm Gladwell?

  In the span of six months, he went from, "You should get this looked at at some point," to, "You should put your affairs in order," to, "We can't find any more cancer."

• 38:40Speaker 02

  I, I think that I discounted the idea of instincts and intuition in my work. I lived by it. But there was an element that discounted it, that it wasn't credentialed. I didn't bring a Harvard MBA to this. I wasn't a lawyer at a, at a major firm. And I look back now. My instincts, intuition, judgment, were everything in my work. And it wasn't that what I had

• 39:24Speaker 02

  replaced the other people in the room. What I say to people is, "You don't want a room full of people like me, but you want somebody like me when you're going through this." And it is this intuition and instinct and the sense that you've described in Blink of processing and making a decision. And there are thousands of things going on in your brain you don't even know as you're making that decision. And I have lived my life by it and lived my career by it. And trust, so trust is all tied up in that. It's a fascinating field. It is what I did with clients because what they would say to me is, "How do I get people to believe us again? How do I get my customers back?

• 40:08Speaker 02

  How do I get them to give me more time? How can I get them to look at this in a different way? How do I do that? What, what do I have to do?" So it's all of that that plays into it. I just never figured I would end up processing it for myself.

• 40:27Malcolm Gladwell?

  Revisionist History is produced by Nina Bird Lawrence, Lucy Sullivan, and Ben Nidaf Hafrey. Our executive producer is Jacob Smith, engineering by Nina Bird Lawrence, original music by Luis Guerra, sound design and mastering by Marcelo de Oliveira. Special thanks to Kira Posey, Morgan Ratner, and Eric Sandler. I'm Malcolm Gladwell.

• 40:58Malcolm Gladwell?

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• 41:35Speaker 01

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