Heck of a Year: My Cancer Story (and the Lessons That Came With It)

David Warshaw
1 day ago
31 min read

A personal letter to my clients, colleagues, and friends

First, the most important thing: I’m okay. Take a breath. I’m cancer-free and on the road to recovery with lots of physical therapy. I dodged a bullet. And while parts of this story are hard, it is — I promise —an uplifting one, with a happy ending and a lot of hard-won lessons I’m grateful to share with you.

What follows is the story of how I got here. I’m sharing it because the past year was one of the most significant of my life, and I learned things I want the people I care about to know. I’m also writing it down so I never forget the details.

Here goes — grab a cup of coffee, this one’s going to take a minute.

Chapter One — It Started With a Kidney Stone

Chapter Two — The Warning Signs I’d Been Missing for Years

Chapter Three — Finding the Right Team

Chapter Four — The Surgery — Sunday I Had Cancer, Monday I Didn’t

Chapter Five — Nineteen Days in the Hospital

Chapter Six — Learning to Walk Again

Chapter Seven — The Human Landscape

Chapter Eight — Setbacks — The Dislocation and a Third Surgery

Chapter Nine — The Long Road Back

Chapter Ten — Miracles? I think so…

Chapter Eleven — What I Want You to Take Away — The Money Stuff

Chapter Twelve — What I Want You to Take Away — The Human Stuff

Chapter 1: It Started with a Kidney Stone

In late August 2025, I felt that familiar pain in my side. I knew exactly what it was. I’d had kidney stones in 2007 and 2018 — both required surgery to extract, and neither was pleasant. Intense Pain.

Hospital Visits.

Pain Cocktails.

Extraction Surgery.

I turned to my wife Diana and said, “Get ready for a wild ride.”

I braced myself for weeks of misery. Fortunately, this one was a non-event and passed on its own. What wasn’t a non-event was what the CT scan picked up while looking for the stone.

My urologist called and said the scan had found something in my bone. He wanted me to get an MRI. In the days between, I was nervous — but I figured it was probably a nothing-burger. I tried not to let it consume me. Fortunately, it was only a couple of days.

I did the MRI. And on a Friday morning, I uploaded the results to ChatGPT — something I’d never imagined doing for a question this serious.

Within moments, the words came back: bone cancer.

My heart dropped. Diana and I were terrified.

Chapter 2: The Warning Signs I'd Been Missing for Years

Here’s where the story gets wild.

Back in 2023, while we were living in Florida, a routine blood test showed an elevated alkaline

phosphatase level. When I moved back to New York, my new primary care physician saw the same elevated reading and told me we would monitor it. I didn’t press the issue. I assumed that if it were truly serious, my doctor would obviously tell me. Over the next two years, the number kept climbing.

Then, in the summer of 2025, I applied to increase my long-term disability insurance. With Diana and Sophia depending on me, I wanted more coverage in case I ever couldn’t work. The insurance company postponed the application — specifically because of the elevated alkaline phosphatase. The underwriter wanted an explanation of what was causing the elevated alk-phos levels and frankly, I had no idea. That was the wake-up call I should have given myself years earlier.

I went back to my primary care doctor who referred me to my gastroenterologist, who in turn referred me to a rheumatologist. The rheumatologist said I was fine and to check back in nine months. He even wrote a letter at my behest to the insurance company saying I was fine.

To his credit, the gastroenterologist was concerned about the alk-phos and ordered a HIDA scan, which is used to evaluate the function of the gallbladder, liver, and bile ducts. We eventually determined I also had a dysfunctional gallbladder, which I assumed was the culprit.

It wasn’t. It took a kidney stone — and the imaging that came with it — to find the real answer.

The deepest irony: when I eventually asked ChatGPT what could cause elevated alkaline phosphatase, one of the very first answers was bone or liver problems. I just wish my doctors had taken this more seriously.

We were referred to Dr. Howard Goodman at Northwell Health — an orthopedic surgeon with a great ponytail that I could never pull off because I’m just not that cool. He confirmed what the imaging suggested: there was an aggressive tumor in the right iliac wing of my pelvis.

And then Dr. Goodman dropped the hammer on me…he informed me that this tumor had been growing inside me since 2007.

Let that sink in. Two different hospitals — North Shore University Hospital and NYU Langone — had imaging from 2007 and 2018 that showed something was there. No one ever told me.

In 2007, the tumor was very small. By 2018, it had grown to 2 cm. And now, it was a whopping 10 cm.

Chapter 3: Finding the Right Team

So, yeah, this tumor had to come out stat! Dr. Goodman recommended both a PET/CT scan and a biopsy and that I avoid any strenuous physical activity. Even after surgery, recovery could mean a lifetime of using a cane, crutches, or in the worst case, a wheelchair.

The PET scan came first, before the biopsy. When it came back clear — the cancer hadn’t spread —Diana and I let out a huge sigh of relief. We counted our blessings. We know the reality so many people face: learning their cancer has spread to the point of being incurable, their time suddenly limited. You’re now on the Titanic. That was not our news, and we did not take that for granted.

Then came the biopsy. The results took nearly three weeks. Every day felt like an eternity.

During that wait, I drove upstate for a friend’s birthday and ended up telling him the whole story in his car. At that point, I really didn’t have much information yet — it was just a very scary time. I remember his eyes welling up as I talked, and being deeply touched by that. Later, when he shared the unfolding story with his wife, she teared up too. Neither of them could quite believe what was happening. Those moments left a mark on me — how much people care.

When Dr. Goodman finally called me in, the rest of the news was cautiously encouraging too: the tumor appeared to be low-grade and slow-growing. It was not a death sentence. Phew! It was going to be a serious surgery and a very long recovery — but I was going to be okay.

Then came the second opinion.

Dr. Goodman referred me to Dr. Jonathan Forsberg, an orthopedic surgeon at Memorial Sloan Kettering’s Uniondale campus. I asked Dr. Goodman how many of these surgeries he’d done in his career. His answer: five to ten. I appreciated his honesty. When I asked Dr. Forsberg the same question, he told me he’d done four of them the previous month alone. Diana and I looked at each other and knew right then and there he was our guy.

Dr. Forsberg explained the plan for the surgery — a hemipelvectomy (or hip pelvectomy). In English that means they were going to take out my right iliac wing and hip socket and implant a 3D-printed custom titanium pelvis and hip socket, precisely fitted to my anatomy using a series of MRI scans. Due to the 3D printing being a slow and exacting process, the surgery was originally planned for mid-October, then pushed to November, then to December 1st.

That waiting period was its own kind of stress. You have a dangerous tumor inside you that you want out yesterday — but you have to wait because you need your surgeon to get the implant exactly right. Like Dr. Goodman, he stressed no physical activity, no dancing, no sports, nothing. If the pelvis shattered, the cancer could spread and I could die. For someone who loves to dance at every wedding, every bar mitzvah, every family celebration — this was a tough pill to swallow.

During this period, I also met Dr. Robert Maki, who became my primary oncologist at MSK. Our first meeting fell on the Jewish holiday of Sukkot — a holiday of joy, which made what he had to tell us land even harder. He gave me the technical name for what we were dealing with: a rare bone sarcoma — a cancerous tumor of the bone — and not just any bone sarcoma. A chemotherapy-resistant tumor. And get this — it was so rare that there are fewer than 100 documented cases worldwide. Talk about winning the wrong jackpot…

I remember Diana crying. I was just plain frightened — a real sense of dread settled in. I asked Dr. Maki what would happen if the cancer ever came back. He explained I’d have three options: another surgery like the one I was about to have, radiation, or special medication.

On one hand, the tumor had been growing slowly since 2007 and had not spread. On the other, its rare and aggressive nature meant it absolutely had to come out. The technology to even identify this type of tumor was only developed in 2019. The 3D printing technology to replace the affected bone only became available around 2022.

It had been an emotional rollercoaster. Crashing down with the initial diagnosis. Soaring back up when the PET scan came back clear and the prognosis was a hard year, not the end. And now, plummeting again with the news of just how rare and unforgiving this tumor was.

I was living at the precise intersection of a medical miracle and perfect timing.

Chapter 4: The Surgery — Sunday I Had Cancer, Monday I Didn’t

For years I’d had no noticeable pain from this tumor. That’s exactly why I didn’t know about it. But as the surgery date got closer, the pain showed up — with a vengeance.

I remember going to a party not long after meeting Dr. Goodman and — call it disbelief, call it stupid —dancing my heart out. Boy, did I pay for it minutes after. Granted, I didn’t yet understand that a shattered pelvis could actually kill me.

By the weekend before surgery, I could barely pick up Sophia. The pain in my hip would flare up just from holding her. All in all, I was ready for that tumor to come out.

On Sunday, December 1st, Diana and I checked into a hotel near the hospital. My childhood friend Eli came to visit us that night and lifted our spirits. Funny thing: Eli and I first met by getting into a playground fight in elementary school. I wasn’t exactly a fan of his back then. Years later, he was sitting with me the night before a life-altering surgery. You never really know who the people in your life will become — or the role they’ll play when it matters most.

The next morning, I was at the hospital by 7:25 a.m. At 8:30, they administered the epidural — and I was out. I never got the experience of being wheeled into the operating room, of saying hello to the surgical team, of knowing you’re about to go to sleep. I simply woke up around 6:30 that evening.

My first thought: Hooray! My brain is working. I can think. I’m okay. I’m…me.

The surgery had taken over eight hours. Dr. Forsberg removed the tumor-ridden pelvis and hip socket, and replaced both with the custom 3D-printed titanium implant. He told us the surgery was an extraordinary success.

But the day had been brutal for everyone who loved me. I’d lost a significant amount of blood during the procedure and needed multiple transfusions. Diana and my whole support crew had been praying through every hour of the surgery — and the worry wasn’t over yet.

After surgery, I was taken to the Post-Anesthesia Care Unit (PACU). Seeing Diana when I came to was pure joy. But the relief was complicated — my blood readings still weren’t good and I needed more transfusions. The team placed a central venous catheter (a line into a major vein in the neck) so they could deliver blood much faster than a standard IV allows.

Here’s the irony of that day: it was the hardest day imaginable for everyone who loved me. They were stressed sick — through the surgery, through the blood loss, through the PACU. Awake and waiting and worrying for hours. Meanwhile, yours truly was high as a kite — and HAPPY.

Chapter 5: Nineteen Days in the Hospital

What followed was nineteen days in the hospital. I’ve described it to people as going to hell and back —and this was at one of the best hospitals in the country, mind you.

The first phase was the most medically intense, but also the most controlled. I had an epidural managing the pain, a catheter, an IV pole, a JP drain pulling fluid from the surgical site, and a wound vac working alongside it.

The JP drain deserves its own mention. My body was producing enormous amounts of fluid as it healed— sometimes 300 to 500 milliliters a day. The goal was to get that down to 30 to 50 before I could be discharged. Well, it never got there. Eventually the doctors made a practical decision: getting me moving mattered more than waiting to hit the desired output number.

All of this equipment turned even the simple things — moving around, going to the restroom — into an ordeal. The nurses had to keep making sure I didn’t get tangled in the lines so I wouldn’t fall.

My hospital uniform was simple: the gowns, their sticky socks so I wouldn’t fall, and some extra-large hoodies I’d ordered on Amazon. I actually didn’t mind the socks.

There was also the nighttime gear. My feet were velcroed to a blue foam pillow to keep my legs from crossing in the middle of the night. I could pull them out if I really struggled, but I didn’t like being strapped in. There was also a boot to keep my right foot straight. The neuropathy made the boot agonizing, so I barely wore it. The whole nighttime setup was extremely uncomfortable.

Because of the hemipelvectomy, I couldn’t sit on anything low. Toilets, chairs, beds — all had to be elevated. When I sat, it was in a special chair called a hip chair.

Even the catheter had an unexpected upside. You could be mid-conversation with a visitor and quietly take care of business without anyone knowing. Kinda funny.

I was on a pharmaceutical cocktail that would make your head spin — Tylenol, Dilaudid, Oxycodone, Gabapentin, Tizanidine, Senna, Colace, antibiotics, blood thinners, and more. The pain management team was constantly adjusting the mix to keep things under control. And to their credit, they did. God bless them.

From day one, Dr. Forsberg made it clear that the two biggest risks were infection and blood clots. Every protocol — the medications, the blood thinners, the drain management — was built around preventing those two outcomes.

One of the most frustrating parts of the early days was that I couldn’t focus. I’d been looking forward to some “me time.” But due to Postoperative Cognitive Dysfunction (POCD), I couldn’t focus for the first several days. No movies. No TV. No books. No podcasts. And worst of all, I couldn’t really work — which is something that brings me a lot of joy.

Fortunately I could still respond to texts and emails. And I could still enjoy music. I vividly remember one sleepless night when music was the only thing keeping me afloat.

Now let’s turn our attention to the PAIN. It came from four distinct sources.

First, the wound site itself — well managed by the team, but never entirely absent. My body was so sensitive that I couldn’t be reclined flat. If they laid the bed down past a certain angle, I had to stop them — the pain hit instantly. Imagine not being able to lie on your back, always having to be at an angle. Over time I could recline more. In the beginning, it was impossible.

One day I coughed — and it sent a shiver of pain through my new metallic body. After that, I held back every cough and every sneeze out of pure terror.

Second, neuropathy in my right foot. At first I couldn’t feel my foot at all. My team told me this

discomfort could last for up to 12 months. It was a weird mix of pins and needles, numbness, and pain.

Third, the hospital bed itself. I’m not a back sleeper. The bed created relentless muscle spasms that turned every night into a battle.

And finally — the IVs. One or two isn’t terrible. Five or six is a different story. My veins were hard to find. Sometimes they got it after two or three tries; other times they had to use an ultrasound machine to locate one.

Sleep was essentially nonexistent. My pattern for nearly the entire stay was ninety minutes of sleep, two hours awake, another ninety minutes, another two hours. I passed the nighttime hours watching movies, listening to music, working — whatever I could.

And then there was the exhaustion. Sleep deprivation plus the medications meant I was constantly fighting to stay awake. People would come visit me in the hospital and I’d fall asleep on them mid-conversation. The fatigue was bone-deep — the kind you can’t will yourself out of. And it followed me home.

The medications caused constipation, which added a layer of discomfort on top of everything else. One Patient Care Technician — or PCT, the staff members who assist the nurses — pushed me hard to make the effort to get to the bathroom rather than rely on the bedpan. My leg was shaking uncontrollably the first time I tried. But she was right. Once I managed it, I felt like a completely different person.

I also couldn’t shower. That was very challenging as I love to shower. Personal hygiene in a hospital is its own kind of awful. Ughh, I hated wearing those gowns. And my appetite was gone — food is one of my real joys in life, and that pleasure was gone too. You don’t feel like a human being.

And then there was the constant waiting game. During the day I had Diana and visitors to help me. At night, when Diana went home to rest and care for Sophia, it was just me. And nighttime hospital staffing is greatly reduced. So you wait for a nurse. Wait to see a PA (Physician Assistant). Wait for medication. If you need a new toothbrush, time to wait. All this when you’re in pain and alone. Waiting for someone to help with something you can’t do yourself — that’s its own kind of frustration. So yeah — this game = definitely not fun.

But you adapt. It takes a while, and it’s hard. But you do. You also have no choice haaaa. But I’ll tell ya — the ability for people to adapt to difficult situations is a real blessing — a special kind of grace.

Chapter 6: Learning to Walk Again

Physical therapy began the day after surgery. The big accomplishment was scooting to the edge of the bed and sitting up. Not standing. Not walking. Sitting up. It was excruciating. I remember thinking: I don’t know if I’m ever going to walk again.

But as time passed, things slowly improved. And I got stronger. The physical and occupational therapists at MSK were exceptional. They pushed me, celebrated every small victory, and kept raising the bar. Some days I’d get an hour of PT and an hour of OT. Sometimes just one or the other. Either way, I was working with a team of pros who clearly loved what they did.

The team also stressed that I do my exercises — with PT and OT, and on my own too.

I started off using a walker to get around. As time progressed, I’d walk a lap or two — slowly, painfully, but walking — around the 4th floor hospital wing. By discharge, I’d even climbed stairs.

There’s a funny story from those walks. One night I asked the head nurse, Alpha, if I could go for a walk. He looked at me like I’d completely lost my mind. “No, you cannot go for a walk,” he said. I was baffled— until I realized he thought I meant outside, in the freezing cold snow. I just meant around the floor. We had a good laugh about that.

The therapists and I all agreed that my next destination from the hospital would be an Acute

Rehabilitation Hospital or Acute Rehab Unit (ARU) — a facility that provides at least three hours of PT and OT per day, five to seven days a week.

Chapter 7: The Human Landscape

The staff overall at MSK was simply incredible. The nurses and doctors worked unbelievably hard, around the clock, caring for very sick people — including me. God bless them. I would get tired just watching them work. There were a few I didn’t click with, which is to be expected with that many people. But only one was notably unkind. Fortunately Diana advocated for me, and I didn’t have to work with her after that. When you’re at your most vulnerable, the bedside manner of the people caring for you matters enormously.

One PCT opened up to me about something deeply painful happening in his personal life. I won’t share the details out of respect for his privacy. But I’ll say this: in a hospital, you quickly realize that the people caring for you are carrying their own burdens too. Compassion is not a one-way street.

I really bonded with a lot of the nurses and PCTs — talking about movies, nursing work, and life. It’s funny: when you’re down and you’re not at your best, you reach back for your strengths. So I’d help the staff with money questions to feel like a productive human being whenever an opportunity arose.

Devon, a nurse and former NYPD officer, took such good care of me. Super professional. We clicked right away, and I always requested him. Another great nurse was from France — she took care of me three nights in a row and always took me on walks.

I was on the fourth floor of MSK — the neuro and orthopedic ward. My neighbors were, in many cases, fighting battles far harder than mine. Some of my roommates had brain cancer. Some could barely communicate. One night I heard a woman down the hall screaming — clearly in great distress — while her poor roommate paced the corridor waiting for things to settle down.

In that environment, self-pity becomes very hard to sustain.

I also met people who stayed with me long after I left. My second-round roommate, George, was a character — a photographer who specialized in shooting heavy metal bands, full of humor and opinions. He even gave me an ETF recommendation. When my visitors heard a voice from behind the curtain chiming in on our conversations, they’d look at me, confused. “That’s my friend George,” I’d say. We’d all chuckle together.

One close family friend carried an enormous box of food to my room — I have no idea how she managed it.

To everyone who visited — by phone, by text, in person — thank you from the bottom of my heart.

A few people deserve to be named here. To my caregivers — Vako, Nutsa, Nickeela, Miss Irene, and Jimmy — thank you. You showed up at all hours, you treated me with patience and kindness, and you turned some of the hardest nights of my life into something bearable. I will not forget any of you.

Dr. Forsberg gets a special shout-out and thanks because he literally saved my life.

And to the entire medical team at Memorial Sloan Kettering: there are simply too many extraordinary individuals to name. The doctors, the nurses, the PCTs, the physical therapists, the pain management team, the people who cleaned my room and brought my meals. Every one of you contributed to the fact that I am here, walking, writing this. Thank you.

Chapter 8: Setbacks- The Dislocation and a Third Surgery

I was finally more mobile. Stronger. Making real progress. Dr. Forsberg’s plan was to discharge me by December 14th — and from there, on to the ARU.

Just one problem. The insurance company denied it.

Their reasoning? The physical therapist’s notes said I was walking long distances in the hospital. That alone was enough for them to determine inpatient rehab wasn’t necessary. I was walking with assistance, slowly, in a hospital — not anywhere near ready to go home. By the time we were having that fight, it was too late.

I was frustrated — and honestly, pretty upset. Because of this miscommunication, I remained in the hospital for an additional six days, until December 20th — six days that were wholly unnecessary.

At that point, I was done fighting. I just wanted to go home. So I did. And I was so happy leaving. It was like a new lease on life — a new beginning. I befriended the Ambulette Operators quickly and we started rocking out to music. These guys were really, really cool and I had such a fun time going home.

Being home was incredible. For all the reasons home is home.

The best part was seeing my three-year-old daughter, Sophia — also known as “the Sophinator.” She’d only been able to visit a handful of times, and being apart from her was incredibly hard. Being back with her made everything feel normal again. I was home.

And then… I found myself right back in the hospital.

It was only three days later, at 2:00 in the morning on December 23rd, when my hip socket dislocated.

I’d been moving around — not recklessly, just normally — when I noticed my right foot seemed to be turning inward. It happened three times. I later understood that the hip socket was coming out of place, and the sensation in my foot was a symptom. The pain was excruciating. I called Hatzalah — the volunteer Jewish emergency medical service — and they were extraordinary. They lifted me on a sheet, transported me with incredible care, and took me directly back to MSK. A standard ambulance would’ve been legally required to take me to the nearest hospital. Hatzalah took me exactly where I needed to be.

At MSK, they confirmed the dislocation and performed a second surgery that same day — to the amusement of nurses who’d just said goodbye to me days earlier. “You missed us?” they said. “You’re back so soon?”

Three days later, on December 26th, Dr. Forsberg performed a third procedure. The goals: repair muscle tissue damaged during the dislocation, clean out a potential bacterial infection found during surgery number 2 — a procedure called a washout — and tighten the hip socket to prevent another dislocation.

The infection piece was frightening. I even got my own infectious disease doctor named Dr. Figueroa. He was great. The orthopedic team told us plainly that if it wasn’t managed, the consequences could be severe — up to and including removal of the entire titanium implant, or in a worst case, loss of the leg. Diana and I were petrified. The surgery addressed it successfully. The suspected culprit was Cutibacterium acnes — a slow-growing bacterium known for attacking prosthetic hardware, which is exactly why the team chose the aggressive PICC-line antibiotic route. We got somewhat lucky: it was caught before a biofilm could form, which makes it far easier to treat. As of this writing, the doctors believe there’s less than a 10% chance any infection remains. Dr. Forsberg told me afterward that he’d tightened the socket considerably and didn’t expect it to dislocate again.

This third surgery was shorter than the first — four to four and a half hours versus eight to nine — but it produced the most pain of the entire experience. The original medications weren’t sufficient; they added fentanyl and swapped pregabalin in for gabapentin. The constipation that followed was its own ordeal. I remember thinking I’d forgotten how bad the pain could get, and then it got worse than I remembered. It’s amazing how the body has a merciful way of softening those memories — and then they come back in full force.

Chapter 9: The Long Road Back

I was officially released from MSK on January 8th, and boy, was that a happy day (just like my first discharge).

Home, finally. But home looked different than I’d imagined.

I was sleeping in a hospital bed set up in my office — not strong enough yet to climb the stairs to my own bedroom. We’d also bought an MCombo powered recliner for the living room since I still couldn’t sit on regular chairs. That chair has been a real lifesaver. I woke up three or four times a night, just as I had at MSK, because of the neuropathy in my right foot. Vako, my caregiver, would give me a foot rub during those wakeful hours. I’d sit up for ten or fifteen minutes, then try to sleep again. It was, in many ways, a continuation of the hospital experience in a more familiar setting.

Diana was giving me two antibiotic injections every day through a PICC line — a catheter inserted into my arm to deliver medication directly into my bloodstream — to continue treating the bacterial infection. The PICC line portion ran for a month at home, but counting the hospital course, I was on antibiotics for twelve weeks in total. She was extraordinary. Five to ten minutes every evening, without complaint, on top of everything else she was managing: Sophia, the house, me, and her own wellbeing.

Then there was the brace. Before the third surgery, Dr. Forsberg had warned me: “You’re going to hate me with this brace because it’s going to be really uncomfortable.” I was going to have to wear it for six weeks. It was a custom-fitted device, intricate and cumbersome, designed to force compliance with the movement restrictions protecting the newly tightened joint. Taking it on and off required lying down. Every bathroom trip was a production. It dug into my hip and back every single night. When we watched a movie, I was rarely comfortable, and couldn’t wait to get into bed. So yeah — I most definitely was counting down the days until it could come off.

My mobility at home was extremely limited. Every movement had to be deliberate — my physical therapist had specific recommendations for how to turn, how to sit, how to stand. I lived in a state of hypervigilance: am I doing this okay? Did I bend too far? Did I just violate one of my precautions? Those questions ran on a loop in my head, both in the hospital and back home. The vulnerability was constant.

And the stakes were real. I’d already learned the hard way what happens when those precautions weren’t followed — the dislocation in December was the consequence of one bad movement. The hospital advice itself wasn’t always perfectly consistent, either: one PT would tell me to turn with my right foot, another would say to turn with my left, and as the patient you just nod and do your best to figure out which is right for the moment. After the dislocation, you can imagine how careful I became.

The pain medications also made me very emotional. I rarely cry as an adult. But on those meds, I’d just cry. The smallest things would bring me to tears. One night I watched The Long Walk at home — what a great tearjerker of a movie! It’s amazing how meds can alter your state of mind.

The exhaustion came home with me too. Sitting at my desk trying to work, I’d nod off staring at the computer screen — then jerk awake, not wanting to be the guy asleep in his own office chair. The meds plus the still-fractured sleep made fighting it nearly impossible.

On January 26th I had one more scare — chest pain in the middle of the night. I called Hatzalah again. They took me to Northwell, where a family friend who’s a physician treated me like his own son. The conclusion: likely gastrointestinal, not cardiac. I breathed a sigh of relief. That pain had hurt, and it was terrifying. I was discharged the next day. A one-day detour.

Before I transitioned to outpatient PT, I worked for about three weeks with Young, a home health physical therapist who came to the house through an agency. Young was professional and kind, and at-home PT was the right fit for those first weeks — I wasn’t strong enough to travel anywhere yet. But honestly, at-home PT is not nearly as powerful as going to an actual outpatient location. The equipment, the space, the energy of being in a room designed entirely for rehabilitation — none of that comes through your front door. Home PT was a necessary first step, not where the real progress happened.

On February 4th, I began outpatient physical therapy at Spear Physical Therapy, located inside the Equinox gym in Great Neck. My physical therapist, Aaron, is exceptional. We clicked immediately. I’d tried another practice first — it wasn’t the right fit. With Aaron, it was. I go three times a week — Monday, Wednesday, Friday mornings — and the progress has been remarkable.

Dr. Forsberg told me early on that outpatient PT was where the real healing would happen. He was absolutely right. Movements that were impossible a few weeks ago are routine now. Strength I thought I’d lost is coming back steadily. The work is ongoing, but the trajectory is clear, and it’s pointing upward.

On February 5th, the PICC line was removed. On February 6th, I took the brace off for the last time. That week was incredible as I was liberated from that brace from hell.

On February 17th, I showered in my own home for the first time. I’d been going to a family member’s house to use their first-floor shower. That first shower in their house and then the one in my own bathroom — oh my goodness, words can’t describe how good they both felt. For different reasons.

On February 25th, my weekend caregiver texted to say she could no longer work for us. The timing turned out to be perfect: that same weekend was the first time I left the hospital bed in my office and slept upstairs in my own bed. I slept through the night, mostly, and felt like a normal person again. Talk about impeccable timing.

On March 3rd, I had my most recent scan. The doctors are monitoring four areas closely, and the first 18 months to two years carry the highest risk of recurrence. Fortunately, everything came back normal. And now it’s a waiting game. But I’ve learned to take it one scan at a time. I can’t control what I can’t control. All I can do is live life to the fullest, and pray.

I met with Dr. Forsberg on April 23rd and got great news. The X-rays looked good and most of my restrictions were lifted. Around that time, I went from using a walker to crutches, which was great — you have a lot more mobility and freedom on crutches. As I write, I can go to restaurants, see movies, use regular toilets and chairs, and just live a normal happy life. Diana doesn’t have to shlep that cushion wherever we go anymore. And more good news — I am aiming to go back to the office full-time in June!

Full recovery is expected six to twelve months from December 26th. I intend to get there.

My barometer for happiness is permanently recalibrated. A good night’s sleep. A hot shower. The ability to bend down. These were never small things. I just didn’t know it.

Chapter 10: Miracles? I think so...

Here’s where I pause, as a God-fearing man, and reflect.

The kidney stones I suffered through in 2007 and 2018 — the ones I was so miserable about, the ones that had me questioning why God was doing this to me — those were, I believe, His way of trying to alert me. The hospitals missed it. But He kept sending the signal.

We never ask “why me?” when good things happen. We only ask it when things are hard.

For seventeen years I danced and played sports and did martial arts — and somehow my pelvis never got injured to the point where the cancer could spread. Talk about having a guardian angel.

The timing extended beyond my health. About a month before my cancer diagnosis appeared in my medical records, I finally pulled the trigger on an additional term life insurance policy — something I’d been planning to do for a couple of years and kept putting off. The medical exam went through, the underwriters reviewed the records they had at the time, and the policy was approved and in force by the time the imaging picked up the tumor. Just one month later, with bone cancer on my chart, I would have been uninsurable for any meaningful coverage. Diana and Sophia have more protection today because I happened to stop procrastinating just in time.

The disability insurance increase was a different story. The application stayed in limbo, and once the cancer surfaced, it was effectively closed.

And the technology itself was perfectly timed:

• The 2019 DNA fingerprinting that identified my tumor type and saved me from chemo.

• The 2022 3D printing technology that gave me a custom titanium pelvis so I could walk.

• The right surgeon — Dr. Forsberg — at the right hospital — MSK — in the right city.

• Moving back to New York from Florida, because Diana and I missed our people here. Clients, friends, family. We came home, and home is where the right doctors happened to be.

Chapter 11: What I Want You to Take Away- The Money Stuff

Heck of a story, right? Yeah — it’s been a rollercoaster I tell ya. This experience has definitely opened my eyes and changed my perspective. A lot of lessons came out of it — so I’ve split them into two chapters. The money stuff first, the human stuff next. Both matter. Let’s begin.

Don’t procrastinate on protection. This is the single most actionable lesson in the entire letter, and I want to say it as clearly as I know how. The disability insurance increase I applied for in summer 2025? Declined — because of the elevated lab value. Window closed. The life insurance I applied for one month before my diagnosis appeared in my medical records? Approved. If I’d waited even a few weeks longer, I would have been uninsurable. Diana and Sophia have more protection today because I happened to stop procrastinating just in time. Disability insurance, life insurance — these are not abstract concepts. They are the difference between a crisis and a catastrophe. If you’re a client of mine and you’ve been putting off a coverage review, please don’t. If you’re not yet a client and you’ve been putting off the conversation entirely — same message. Please don’t wait. The best time to do insurance planning is when you are healthy.

Build a real emergency fund. This is critical advice because emergencies WILL happen in life. With this incident, costs came at us from all over: copays, deductibles, caregivers, parking, hotels, meds. We were able to absorb all of it without touching the long-term plan.

Target 6 to 12 months of expenses in cash. Cash is not a low-returning asset when it’s the thing that keeps your life from unraveling. And it definitely provides peace of mind.

Know what your health insurance actually covers — before you need it. I lost six extra hospital days because the insurance company denied my transfer to inpatient rehab, citing the physical therapist’s notes that I was “walking long distances.” I was, in the hospital, with assistance. That’s not the same as being ready to go home. By the time we were having that fight, it was too late. Read your policy. Understand your network. Know the appeals process. Find out what counts as “medically necessary” under your plan. Pre-certifications, step therapy, prior authorizations — boring words that decide what care you actually receive.

Get your estate planning done — and keep it current. When the doctors told us the worst-case scenarios for that third surgery — removal of the entire implant, possible loss of the leg, the infection turning systemic — I was deeply grateful Diana and I had our affairs in order. Will. Healthcare proxy. Power of attorney. Beneficiary designations on every account, including the life insurance and the retirement accounts. Sophia is three. Who would be her guardian? These are not pleasant conversations. Have them anyway. And once you’ve had them, revisit the documents every few years — because life changes faster than paperwork does. And as a bonus: the very exercise of getting your estate plan done forces you to organize your entire financial life — every account, every beneficiary, every advisor in one place. That’s invaluable if one spouse isn’t the one managing the day-to-day finances.

Hire help. Worth every penny. Vako, the nighttime caregiver, was a financial decision as much as a medical one — and one of the best ones we made. The same principle runs through the rest of your financial life. A good CFP®, a good CPA, a good estate attorney, a good insurance specialist — they don’t cost; they pay. Especially in a crisis. The most expensive thing you can do is try to figure it all out yourself when the pressure is highest and your bandwidth is lowest.

Everything above is about protecting what you have. This last one is about remembering why you have it in the first place.

Spend your money on what matters. Take the family vacation. Go to the expensive restaurant. Enjoy experiences that create lifetime memory dividends. I have a new and very personal appreciation for what a well-lived life actually looks like — and it’s not about having a big IRA balance at age 89. It’s experiences that stay with you, time with the people you love, and the freedom to show up fully for what matters most.

As a financial planner, I always have to guard against the risk of outliving your assets. But… if your plan shows you expiring with three million dollars at 89, it’s time to spend more today and enjoy it while you’re healthy enough. I’m 45, and vacationing is out of the question right now. So I ask you: who wants to see Alaska from a wheelchair?

That’s what I’m here to help you build, and it’s the lens I’ll be bringing to every plan and every review going forward.

Chapter 12: What I Want You to Take Away- The Human Stuff

Alright — onto the human stuff. These aren’t really separate from the money lessons above. They’re the same conversation, just bigger. And in many ways, these matter most.

Get married — or find someone who has your back.

I say this only half-jokingly. Having a partner who truly has your back — unconditionally, without keeping score — is one of the most important things a person can have. Diana was my rock through every moment of this. I don’t know how I would’ve done it without her. If there was ever a reason to commit to another person, it’s so that you never have to face the hardest days of your life alone. Thank you, Diana. I love you.

Be your own advocate.

Ask questions. Follow up. Request copies of your records. If you have pain or a lab value rising year after year, become Sherlock Holmes and don’t stop investigating until you have closed the case. Don’t assume your doctors are connecting the dots, because mine weren’t. Use every tool and resource available to you so you are informed. I’m a big proponent of AI — including tools like ChatGPT, Claude, Perplexity, and Google Gemini/AI mode. These aren’t replacements for your doctors, but they are powerful thinking partners that help you ask better questions and understand your reports.

And when you’re in the hospital, have someone who can advocate for you when you can’t advocate for yourself. It sounds cliché. But it’s not.

Get a second opinion.

Always get a second opinion for anything serious. Dr. Goodman encouraged me to get one himself — and that recommendation changed everything. I can’t thank him enough for that. But here’s the bigger lesson: Dr. Goodman was honest about his experience. What if he hadn’t been? I could have had life-altering surgery performed by someone far less experienced. Don’t rely on your doctor to suggest a second opinion. Insist on one yourself.

Get a preventative full-body MRI scan.

My tumor was growing inside me for 18 years before anyone noticed. By the time it was found, it had ballooned to 10 cm. That’s not a story I want any of you to live. Elective full-body MRI scans — sometimes called “preventative” or “screening” MRIs — are built exactly for this. In about an hour, they image your major organs, brain, and spine to look for early-stage tumors, aneurysms, and other silent conditions before symptoms appear. The leading providers in the US are Prenuvo, Ezra (now part of Function Health), and SimonMed Longevity. These scans aren’t covered by health insurance and run roughly $1,000 to $2,500 out of pocket — though most providers accept HSA or FSA funds, which softens the blow.

The honest tradeoff: because MRIs are extremely sensitive, they often catch benign quirks and harmless cysts that send patients down stressful, costly follow-up rabbit holes. They can also miss very small developing issues because the whole-body scan uses lower resolution than a targeted MRI. And mainstream medicine still doesn’t recommend them for average-risk people. But if I’d had one in 2018, that 2 cm tumor would have been a 2 cm conversation — not a 10 cm catastrophe. That’s a deal I’d take every day of the week.

My take on the whole thing: I think the pros far outweigh the cons. I’d personally rather be stressed and alive than ignorant and dead.

Show up for the people you love.

In Judaism there is a mitzvah called Bikur Cholim — visiting the sick. I always understood why it mattered intellectually. After five weeks in that hospital, I understand it in my bones. Every text, every call, every visit lit something up inside me that I cannot fully describe. Show up. It costs you very little. To the person in that hospital bed, it means everything.

Know your resources before you need them.

I cannot recommend Hatzalah — the volunteer Jewish emergency medical service — enough. Their Long Island number is (718) 230-1000. They took me exactly where I needed to be when a standard ambulance would have been required to take me to the nearest hospital. Identify your resources now. Don’t wait until you’re in crisis.

Hire a hospital caregiver.

If you or a loved one ever faces a prolonged hospital stay, hire a nighttime caregiver if you can possibly afford it. Vako gave me massages to ease my neuropathy, helped get me things, called for nurses if no one answered my buzzer, and simply kept me company when the nights got very dark. Worth every penny.

Appreciate the small things — and count your blessings.

Walking. Dancing. Sleeping in your own bed. Showering in your own bathroom. Picking up your child. Giving them a bath. These were never small things. I just didn’t know it.

Joni Mitchell sang about this in “Big Yellow Taxi” — that very human tendency not to appreciate what you have until it’s gone. Boy, is that true.

I get a little jealous when I see people walking so easily. But then I remember that six months ago I couldn’t get to the edge of my bed, and I feel nothing but grateful. In PT, a woman in a wheelchair told me she couldn’t wait until she could walk again — and there I was, using a walker. That hit hard. It’s so easy to look at others and feel like you’re lacking. But someone is always looking at you, wishing for what you have.

I am still here. I am getting stronger every day. And I am very glad to be writing this.

My cane arrived on Friday, May 15th — the third step in the PT progression: walker, crutches, cane, then (hopefully) walking normally on my own. I’m four months in, with six to twelve months total expected for recovery. I’m aiming to return to the office full-time in June to meet with clients and prospects. And best of all, life is feeling normal again — going out, dinners, movies, hanging out with people. Things are great.

Gratitude is the mother of happiness.

If you take only one thing away from this entire letter, let it be this. I am a much more grateful person than I was a year ago. Grateful to walk. Grateful to grab dinner with friends. Grateful to shower in my own bathroom. Grateful for a full night’s rest. The rest is commentary.

With deep gratitude and a titanium pelvis,

David

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