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I’VE ALWAYS ASSUMED my financial life wasn’t so different from that of others—and that made writing personal-finance articles a whole lot easier. I, too, wanted to own a home, buy the right insurance, pay for the kids’ college, and amass enough for a long and comfortable retirement.
On top of that, I wasn’t some financial minority—a highly paid executive, or a successful business owner, or the recipient of a hefty inheritance. Instead, I was like most everybody else, trying to turn an everyday paycheck into something that looked like financial success.
But suddenly, I am the oddball. I’m a 61-year-old with perhaps as little as a year to live, and that means my financial life today doesn’t look like that of anybody I know—in seven key ways.
1. I no longer need to worry about funding retirement. That money I diligently amassed over the past four decades? Almost all of it will end up with my heirs. My carefully considered plans—continuing to work at least part-time, buying a series of immediate-fixed annuities that generate lifetime income, delaying Social Security until age 70—have gone out the window.
Of course, I had no clue my life would take this turn, so it makes no sense to regret the thought and money that I poured into retirement planning. Still, it’s sobering to think that I devoted a big chunk of my life to an endeavor that’ll do me scant good.
2. It doesn’t matter how much I spend—in theory. Should I start splurging? Even before my cancer diagnosis, Elaine and I had two trips to Europe planned for later this year. Since then, we’ve nixed one and revamped the other, so the timing fits with my chemotherapy schedule.
When I made changes to our flights, the airlines dinged me for a few hundred dollars. Supposedly, I no longer need to worry about how much I spend, and yet I couldn’t help but be irked. Yes, even now, my frugality still lingers.
In addition to the European trip we kept, we’ve booked three new trips for 2024. None is cheap. But again, even at this late stage, there’s a limit to how wide I’ll open my wallet. I looked at the price of business class flights, and I just couldn’t bring myself to do it.
I’d like to add a few trips for early 2025. I enjoy the planning and I like to have things on the calendar to look forward to. But for now, caution suggests I should wait until I have a better handle on how fast my health is deteriorating.
3. My portfolio’s time horizon just got longer. I’m not a long-term investor anymore, but Elaine and my two kids are, and at this point they’re the ones I’m investing for. The upshot: I have more than 90% of my portfolio in stocks—because that’s the asset allocation that makes sense for them, given where they are in their career and what other investments they hold.
Two days after my diagnosis, I sat down with Elaine and the kids, and talked to them about my estate. One thing I emphasized to my two 30-something children: They’ll be getting their inheritance far earlier than expected—but, if they’re smart in handling the money, they’ll end up as wealthy retirees. With some three decades to retirement, the money that Hannah and Henry inherit could grow eightfold.
How did I get to eightfold? According to the rule of 72, if money grows at an after-inflation 7% a year, its real value would double after 10 years, quadruple after 20 years and be up eightfold after 30 years. To be honest, I’m not sure the stock market will fare that well. Still, using 7% made the math easy, and I’m hoping the potential growth impressed Hannah and Henry.
4. Estate planning has become my top priority. My financial focus today is on giving away money and getting my affairs in order. In recent years, I’ve been moving to simplify my finances. Yet my diagnosis has made me realize there’s still much to be done.
Indeed, if my life had come to an abrupt end, I now realize my family would have had a surprising amount of work to do to settle my affairs. Fortunately, I can now do a lot of that work for them. Make no mistake: Leaving behind a well-organized financial life is a wonderful gift to your family.
5. I can stop fretting over my retirement’s tax bill. In recent years, I’ve been focused on the hefty income-tax bills I’d face once I reached age 75 and had to start taking required minimum distributions (RMDs) from my retirement accounts. I’d also worried about the Medicare premium surcharges known as IRMAA, or income-related monthly adjustment amount, that would kick in at age 65. But thanks to my cancer diagnosis, living that long is highly unlikely.
With an eye to minimizing both RMDs and IRMAA later in retirement, I’d shrunk my traditional IRA by making large Roth conversions. A lot of number-crunching lay behind those conversions. But like my lifetime focus on retirement, all that thought devoted to future taxes now looks like a heap of wasted time. That said, there is a silver lining: Those conversions will mean a handsome inheritance for my two kids, who are my Roth’s beneficiaries.
6. Many worries of other 60-somethings are no longer my concern. I won’t need to choose between traditional Medicare and Medicare Advantage. I can forget about long-term-care costs. I don’t need to fret over how long I’ll be able to stay in my home or whether I ought to move into some form of senior housing.
These are all topics others in their 60s should be thinking about, and I’ve certainly given them a lot of thought in recent years. Indeed, I’ve paid careful attention to HumbleDollar articles on these subjects, including those by Nancy Fagan, Howard Rohleder, Lucretia Ryan and Kathy Wilhelm. Even now, my web browser’s bookmarks include those for local continuing care retirement communities (CCRCs) that Elaine and I thought we’d visit down the road. But while Elaine will need to ponder the possibility of a CCRC, senior housing disappeared from my list of concerns the moment I got my diagnosis.
7. Social Security has become a different sort of conundrum. I could claim Social Security in January, when I turn age 62. But I won’t.
Instead, my focus is on the best strategy not for me, but for Elaine. How can she get the most out of Social Security? She could claim either her own benefit or she could claim survivor benefits based on my earnings record, with the option of later swapping from one benefit to the other. It’s an intriguing situation—one I’m currently researching and which I plan to write about in the weeks ahead.
Jonathan Clements is the founder and editor of HumbleDollar. Follow him on X @ClementsMoney and on Facebook, and check out his earlier articles.
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I am 78 and have a cancer diagnosis which is being treated but I know the outcome will be a shorter life, hopefully without pain but who knows. I too have had a wonderful life, full of travel and no financial worries. My wife will not have any money concerns as I have accumulated a substantial eight figure portfolio of stocks and real estate. Our children will benefit from this as well. I am not afraid to die and know that the greatest mystery known to man will be revealed to me at death…is there a heaven? Too bad I can’t report back to earthlings about this but each must discover this on their own.
Good luck to you in your journey and I hope you continue to be a peace.
Jonathan, I’m so sorry to hear about your diagnosis. And as a fellow (former) WSJ advice columnist and reporter, I can relate to the difficulties in turning a journalist’s salary into a comfortable retirement, with something left over for your heirs.
I’m glad to see that you’re planning travel now. But I hope you won’t spend too much time worrying about the extra cost of business tickets or other splurges. Might you also consider handing over some of the tedious number-crunching and estate planning jobs to a tax and/or financial planner so you can enjoy more time with your family and friends?
You’ve been a wonderful inspiration to me and so many others over the years. No matter what the future holds, you’re leaving a legacy you can be proud of.
Please keep optimistic. You seem like a family friend after all these years. I seem to remember you had a column in The Wall Street Journal many years ago and wrote about a yellow epiphyllum plant, but I may be mistaken.
As time passed, you will adjust and see life through different lenses. Even if you are feeling like an oddball, you can let us know about your experience in managing your way when traveling. We all have to face the end of life sooner or later. Wishing you the best in your journey.
Jonathan, my husband and I have been following your columns for years. One thing we decided to do was to assign our Roth IRAs to each other as beneficiaries, rather than to our 30-something children to give the funds more time to grow after the death of one of us. If they need the money we can always just take it out of the Roth and give it to them. Just a thought on another way to deal with the ten year rule.
Don’t count yourself out too early. My uncle was given six months, and lived to walk his daughter down the aisle six years later. It wasn’t always comfortable for him, but he accomplished what he wanted to before he passed. Thanks for everything you’ve done for us.
I am so sorry to hear of your diagnosis and wish you much enjoyment and love in your remaining days. I send you and your family prayers for strength as you navigate this new reality.
Thank you for all the excellent advice and information you have provided in your Humble Dollar column. As someone who struggles to “get” all the financial mumbo jumbo required to handle my finances, you provided some easy-to-understand and common-sense information. I was always excited when I saw a new column by you was added. Sending a huge thank you for your amazing contribution to my and the world’s understanding of finance…
I hope you and your wife enjoy your travel. Just for the record, I wouldn’t spend $15,000 on a plane ticket—I would rather see my family or a favorite charity use the extra $ instead (though premium economy would be a no-brainer).
Thank you again for all your sage advice- I know your generous spirit in sharing all you have learned on your financial path, will live on in the countless people who have learned from your writings.
Jonathan, remember there is the medically assisted help to end suffering option towardstheend. My dad took this efficient and compassionate route. Not sure where to go in America, but the Swiss have it. If you want to pursue it, don’t wait until the last minute to investigate the process. https://en.wikipedia.org/wiki/Dignitas_(non-profit_organisation)
“Make no mistake: Leaving behind a well-organized financial life is a wonderful gift to your family.”
Jonathan …WORD!!
My father did this for us. He passed in 1996 at what I now consider an early age (72) … he planned it well but not perfectly … still better than most. He sat us down 4 or 5 years before he was ever ill and talked about what he wanted to be done and how to care for our mom should he pass. She lived 18 yrs longer, comfortable and happy. He didn’t just have it in a written will but he gave very clear directions -verbally face-to-face with all of the family in 1 sitting.
Over the years, I knew this was special but not until I saw the complete opposite when both my inlaws passed away within 1 year of each other in 2022. There was a muddy will naming 3 children as “co-executors”, the worst possible asset & estate planning, and most importantly, NO FAMILY CONVERSATIONS to give a clear mission to those left behind. It created estrangement, deceit, and anger.
thank you for sharing and continuing to engage your readership….
Leave a legacy or leave a mess … finances are just 1 important factor.
Jonathan,
You are still engaging readers with great insights. Haven’t missed a beat under these trying times.
I am very interested in your upcoming article on estate planning #4. I went through the process recently. Particularly shocking to me was the extent of powers granted through the power of attorney document. I had to reconcile with the reality that when I am incapacitated, the one granted POA needs all the powers. Another question we wrestled with: selecting one to have POA, as we have two sons.
My father had enough to go and do whatever he wanted to do but he waited too long. He got to the point where he could not travel anymore. I was disappointed that he didn’t spend more. I guess he was concerned about my inheritance, which I was not concerned about at all. I wanted to see him go and do. One of my big regrets is he did not use more of his money to enjoy life more while he could.
P.S. Buy the first-class tickets and send me the bill! I still have Dad’s money and buying your ticket would make me feel good.
Jonathan, I have benefitted from your articles and books for many years. You have certainly made a difference in this world and I thank you for it. God bless you.
I join Jeffrey in voicing appreciation for your work these many years, your current equanimity and humor, and sharing your current journey and revision to your financial planning. At some point i hope you will be able to co-write with someone and redouble your focus on your own needs. Thank you Jonathan.
I am 75 and was diagnosed with prostate cancer in 2008, but they operated and removed it. My reaction to your post is that if your wife is the same age she may need more money in the future than you expect. Half the social security goes away and in our case most of the house maintenance becomes a paid for situation.
Thanks for continuing to write and for taking us along on your journey. You are so appreciated for the wisdom you share and the example you set. Wishing you peace as you move through these times.
My wife and I do a fair bit of international travel. In reference to your “I looked at the price of business class flights, and I just couldn’t bring myself to do it”, here’s what we’ve found:
1) We fly Delta. It is more expensive, but almost everything is better about them than the other carriers.
2) We paid for the rather expensive Delta AmEx card, mainly for Delta Sky Club and Amex Centurion Club access. It is definitely worth it. Travel has become much more pleasant.
3) Delta Comfort, their “premium economy” class is worth it, whereas business class is not. Indeed, I just flew back from England and got a free upgrade to business class (they call it Premium Select). I had turned down their early offer to pay $1220 for this, only even bothering to consider it because I thought they were asking $122 for it. What did I get for the upgrade: wider seats (not needed), same extra legroom as Delta Comfort, and a little white table cloth for my tray table for dinner and breakfast, though the food was no different. I accepted the upgrade only because it was to an aisle seat. For me, sitting in an aisle seat in Delta Comfort is better than a non-aisle seat in Delta Premium Select. On a recent international flight my wife and I paid $150 each for the upgrade from our 2 seats on the side (2-4-2 seat configuration) to be in the aisle and middle seat in Delta Premium Select (2-3-2 seat configuration). We wish we hadn’t. Just being on our own in the 2-seats of a 2-4-2 configuration in Delta Comfort is better.
4) We will pay a higher ticket price for shorter total travel time. Indeed, I now sort my flight results by “shortest travel time”. It’s worth it.
5) Delta has a price-calendar option. We use this to fly when it’s cheaper as we have the flexibility to be flexible around exact dates.
Jonathan,
Thanks so much for this and other articles you continue to write. It seems you have done your research and have chosen the best path forward.
Wishing you much more time and the opportunity to do the things you and your family will find the most pleasure in.
Blessings to you and your family.
John
Thank you.
that is all I have as I’m still processing all that you are going through and you still want to help us.
Jonathan, Thank you for reminder about the lasting investments in life. You and your family are in my prayers! https://youtu.be/aTS0K5cePww
Thank you for your courage to continue to write and to focus on issues that few of us ever hope to know much about, except in a theoretical sense. That said, I am hopeful that many of the people who visit and read this blog will be motivated to focus more attention on getting their plans in order and not wasting whatever time remains availabe to them.
At age 75, I am very conscious of the incresingly obvious fact that my remaining time on this earth – especially the “good” years, when my wife and I can still travel – is limited. However, as your experience should remind all of us, the future is never certain and no amount of planning or saving will overcome every challenge.
Your 7 key points are excellent, in particular investment time horizon and estate planning. Many people whom I have talked to don’t really understand investment time horizon and/or don’t think beyond their own deaths. In your case, it is highly likely that your wife will live for several more decades, with some additional years of investment for your children. Being too conservative at this point could have a major impact of what the final distribution of your wealth will amount to. As for your estate plan, I assume that you (as we all do who read this blog, right?) have a plan in place and that only minor tweaks should be necessary at this point.
The only other suggstion I can offer is don’t cut yourself off from friends and family as you go through this miserable journey. Too many of my friends who have gone before me retreated into themselves in their final months, not wishing to bother others with their illness. I try to understand this point of view, but what I am left with is the thought that, not only did they rob themselves of the gift of family and friends, they also robbed their family and friends of the memories of being with them in their remaining days.
Your courage in sharing your thoughts and fears at this moment is an example to all of us.
As always you are pragmatic. But please consider what might happen if the diagnosis improves. As I recall Art Buchwald would quip about being “thrown out of hospice” because he lived too long.
Jonathan, telling your past-diagnosis story is a remarkable gift to the rest of us. I love your courage in the face of reality; you are demonstrating how to do what we all must face one day. That is, this earthbound life is not forever, even though we often forget that. The value is in how we live, not only in how long we live. Last year, my 106-years-old father passed away, beloved not because of his age, rather because of his attitude. During his later years, he demonstrated an unembittered, open heart. I learned much of grace, gratitude and kindness from him and the others at his assisted living facility. They passed so many life lessons on to me. By gentle nudges, we all influence one another. We not hear of it from others—but, no matter, we all do bump and nudge and influence. To honor what I learned from them, I wrote this piece: https://snailtrekblog.com/2023/01/10/love-poetry/
Thank you, Jonathan, for challenging us concerning not only financial wealth, but also concerning a well-lived life.
Thanks for sharing your journey. I like many of your readers appreciate your personal and financial insights.
Reading both your article and comments got me thinking about how best to title assets for someone approaching end of life. Here’s my question…if all your jointly owned taxable assets were placed in your name only would your wife get a 100% step up valuation on all those assets?
Take care.
As I understand the law, the answer is yes.
In a separate property state, the step-up may be limited to 50%
Even if one spouse legally owns 100% of the asset?
I wouldn’t be too sure of anything. The new drugs coming out are fantastic, and many people who would have been goners for sure in 2020 are now recovering.
As a pharma investor, I follow the stage 2 and stage 3 trials, and they are testing drugs for nearly every cancer right now.
Jonathan, you don’t go into detail about your emotional response to the discovery that all these financial issues are suddenly off your plate, but after a lifetime of devotion to these tasks, it must be a jolt.
I found it oddly freeing. With a year or two to live, not worrying about my IRA contribution and not opening my brokerage account multiple times a day to track my stocks was downright relaxing. In a moment of irony I ceremonially tossed my copy of Medicare For Dummies into the wastebasket, representing the end of my planning for our financial future.
And when the arrival of immunotherapy unexpectedly saved my life, the joyous remission news was followed by a rush of panic that I suddenly needed to resume my financial planning responsibilities. I spent $16 to replace the discarded book. Argh.
With regards to travel, my decision was to book our trips without considering what my condition might be, simply because that aspect was so unpredictable. Like you, I got great pleasure out of seeing the trips on my calendar. They gave me something to look forward to. And in case it turned out I was too sick to go, I purchased travel insurance.
As always, thank you for choosing to share your difficult journey.
When I retired, I was also a bit frugal when it came to traveling. When my wife got cancer (rare, aggressive form), we were given a poor prognosis. After surgery and two rounds of chemo, she was “declared” cancer free. Before this “declaration” though, she was in the ICU and the doctor told us on one occasion that she would not make it through the night. So we had a lot of ups and downs. After the “good” news, we discovered that the cancer came back within nine months. Her oncologist told her that she had the “best” two treatments (Dana Farber Cancer Center) and didn’t feel that any further treatment would be fruitful (although they had some phase two trials that didn’t look particularly interesting). I couldn’t accept that and started interviewing other medical centers across the country that had clinical trials for this type of cancer and found two that looked promising. This was one time we were glad that we opted for regular Medicare with supplement (Plan F). After a few interviews, I managed to get her enrolled in a trial. One year later, she was cancer free and has been for the past nine years.
It was soon after, that my “frugal” travel trends disappeared. Where previously, I would balk at spending three or four times more for business or first class (compared to economy), these days I don’t even look at what economy class cost (unless it is short flight). While we liked traveling, we hated the waiting in line, struggling for overhead space, sitting in cramped seats, dealing with center seat arm “wrestling,” and dealing with that five-year old behind you that likes to kick the seat back. Now traveling is much more comfortable and I don’t think about the cost. My criteria is that we spend a certain amount each year for travel (now that amount is our RMD). As long as we don’t exceed that amount too much, I don’t bother thinking about it. I typically use a travel agent and tell her to book business or first class and only look at the total cost. These days, we consider every trip we take might be our “last” trip. I know you have to worry about having sufficient funds for your heirs (so do I) but once you have that “under control,” why not splurge more.
Everyone’s different but once I received a cancer diagnosis I opened the spending taps quite a bit to enjoy more things while I can. Living on the West coast a 12-hour or so flight to Europe is much more comfortable in a lie-flat business seat than in coach.
I’m excited to read your upcoming articles as our retirement mileage varies.
Your unfortunate turn has opened a world of material to reconsider, as you begin above. And you’ve created new treasure, like in #5. You made those IRA conversions to limit your tax bills for the years of expected RMDs. These conversions are not in vain. Instead, you’ve created the excellent collateral effect of allowing your children to keep that money growing for decades under current Roth rules, while ordinary IRAs have to be emptied out in ten years. And you can have these conversations with them now, so they can understand what’s possible for them.
I have the vast majority of IRA money in my portfolio (which includes what was once my spouse’s IRA, before his untimely end) in ordinary IRAs, not Roths. It seems like the only “good” years (in terms of where it would put me in taxes and IRMAA) for Roth conversion would have been the year he died, and the one after, but I was consumed with grief and injury and dealing with three grieving teenagers. I’m worried about how my relatively young adults will manage getting too much money too soon, if I too pass unexpectedly, and whether I should take a massive tax hit now, or how else to set them up for a stream of income that’s less taxed and more stable over a longer period of time. While still leaving money in my portfolio, in case I need it for health or other likely expenses.
There’s much about managing a portfolio while not planning for another 30 years that hasn’t been written by someone trying to sell me something.
Alternatively, you could write less and just spend your days travel planning. To add to others, my not-so-secret method for landing business class seats at a discount is checking daily the price at which an upgrade is offered on an airline’s own website. This fluctuates daily or maybe even hourly, and you might see thousands of dollars drop off the price only to see it go up again the next day. Finding opportunities in the computer algorithms on travel prices are as intoxicating as trying to time the market.
As for the rest of life, many days offer sparkles, even in terrible times, at least that has been my experience. Here’s to a “good enough” day for you and your family today, with extra sprinkles of love and possibly moments of joy. Maybe you’ll land that upgrade for 80% off yesterday’s rack rate.
Thanks for the comment, Catherine. Unfortunately, under current rules, Roths must typically be emptied by the beneficiaries within 10 years, just like traditional IRAs. My kids will be lucky to be getting tax-free Roth money — but not so lucky that they’ll get more than 10 additional years of tax-free growth!
I guess they can take your Roth distributions annually and turnaround and fund their Roth IRAs (up to the annual limit)?
…assuming they fall below the income limits.
https://humbledollar.com/money-guide/qualifying-for-a-roth-ira/
But it could help with a Roth 401(k).
Darn!
Before version 2 of the Secure Act I’d set up a plan to dole out the money in five year increments till middle age so they’d have time to learn how to manage it. That plan mostly inert now. I guess it will still work for money in ordinary non-tax-advantaged investment accounts.
Jonathan I am so sorry for your diagnosis. You are truly a wonderful person and even in these tough times you are thinking of others. My thoughts are with you.
Jonathan, i am so sorry you have to make these unexpected plans due to this horrible diagnosis . I have followed your column and read your books. I value your opinion more than anyone else who writes about financial planning. I am so glad you have the support of a loving family and that they have the reassurance from your planning that they will not suffer financially in the future. I see Greg in church and I’m sure that he is a great source of support for you too. I will keep you in my prayers.
Jonathan, thanks for a great article. If you’re willing, I’d be interested to know a little more about #4. What are the things that surprised you about estate planning? It’s a topic far too many of us ignore, or are ignorant of. Thanks again for your courage as you continue to help all of us.
I’ve got an article on that topic that’ll probably run three weeks from now. You’ll have to wait, Rick!
Jonathan,
You are in my prayers. I hope the Doctors are wrong and you beat this thing.
May God Bless You!
I, too, wrote personal finance columns in the Everyman mode for years, and then became a widow suddenly at 48. I was then an outlier, but in different ways. I had a big cash infusion from the life insurance, but not so much that I didn’t have to think about what to do. I had to figure out Social Security strategy as a young widow who works. There’s much more, but I’m probably reaching a word limit. Eleven years later, I’ve managed to build a portfolio that is modestly larger than when I started and it put 2 kids through college and should get me through my own retirement, with help from my own career earnings. All this is to say, thank you for your work, because it not only influenced my work, but also my life. Wishing you fun and laughter and joy in abundance for all the days ahead.
Longtime reader, first post. Jonathan, I first heard you on Consuelo Mack’s Wealthtrack a few years ago, and I’ve read with appreciation, gratitude, and joy your sage life and investing advice. I love the community you’ve created here. People largely follow your leadership here, of being frugal, candid, and following the simple but not-often-enough-followed process of long haul investing. Your grace under the weight — and liberation — of your diagnosis is moving and your devotion to your family, glorious. You’ve made your time on earth truly meaningful. You nailed it.
Jonathan, Please continue to share your thoughts, as we continue to keep you in ours. I admire that you stay true to your nature, while being acutely aware that your financial paradigms have changed. You have always been an excellent teacher through your writings. We now get to see a new perspective on finance, which I am glad you are comfortable in sharing. Thanks for allowing us to take part in your unexpected journey.
I’m sorry.
Handover is something the parent had done when he knew he was going. Just premonition, nothing obviously wrong with him.
And…thank you. Humble Dollar calmed me and centered me a lot of times..even if I’m halfway across the world and 1 humble $ is 85 INR.
You did good sir.
Stage 4 lung cancer is no longer the death sentence it once was. Combinations of immunotherapy plus radiation and a little chemotoxic therapy are producing more and more 10 year survivors with no evidence of disease (NED), even if they either presented with brain mets or developed them early on. Of course, not every patient is a robust responder to combo immunotherapy, but enough are that all of them still need to plan for needing 30 or so years of retirement income. Besides, Stage 4 NSCLC in a 61 year old is strongly suggestive of a genetic mutation, many of which can be addressed with targeted (“precision”) treatments, either marketed or in clinical trials. The travel you need to plan for is to the U of Penn, MD Anderson, MSKCC, Mayo, LA, etc. Good luck.
Lung cancer is not a uniform entity, and I’d encourage you to find out more about the patient in question before offering advice. I have a relatively rare genetic mutation known as EGFR Exon 20. Google “EGFR Exon 20 life expectancy” and these words leap off the screen: “Patients with EGFRm ex20ins NSCLC have a median real-world overall survival (rwOS) of only 16.2 months (fig. 1).”
Talk to your doctor about clinicaltrials.gov
I have. There are no clinical trials that are at a stage where they’re worth joining. EGFR Exon 20 has a single recommended treatment plan — one that is not promising. I could waste my time running around the country to different cancer centers, and I’d end up with the same treatment plan I currently have.
I apologize, I wasn’t trying to be intrusive. I’m sure you are getting excellent care. When my mother had lung cancer, no one mentioned clinical trials, so it’s something I bring up.
Jonathan, I’m afraid this is an area in which your patience will be tested on a recurrent basis — intrusive advice from strangers who are certain they know how you can be treated. The most irritating for me were the people who knew someone who had the “same thing” (a co-worker or a friend’s mother or something) and is now cured.
Please remember that you owe no one an explanation of your situation. And on a day when you’re not feeling up to it, you don’t even owe them courtesy. Hit the ignore button as often as you consider it necessary, and don’t worry about hurting anyone’s feelings.
Having been on both sides of the doctor-patient equation I know how helpless and hopeless it can feel on the patient side. It helps empower patients to give them information and options. Including them in decision-making instead of dictating the plan to them is different from what you are implying.
A quick search of Exon 20 therapy shows a good review
as of March 2024
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11010879/
including the Papillon trial, recently completed and published. You dont need to go to the Mayo clinic for state of the art treatments!
https://www.nejm.org/doi/suppl/10.1056/NEJMoa2306441/suppl_file/nejmoa2306441_research-summary.pdf
That’s interesting. The study reports that this mutation occurs accounts for about10–15% of diagnosed cases in Caucasians and about 45–50% of Asian populations and in nonsmoking women. I wonder if it is inheritable?
That’s the treatment plan I’m on, which was approved by the FDA earlier this year. But it doesn’t buy the typical patient that much time. My oncologist, who is excellent, says I can reasonably expect 12 good months. I’m hoping good diet and regular exercise, combined with the fact that I have no other significant health issues, will give me more time than that. But that may be false optimism on my part.
In my 40 years of medical practice, I always found optimism was a powerful drug! I had many patients with horrible prognoses do very well, an unexpected outcome if you just looked at “medians”.
No one knows what the future holds for any of us. I have had friends drop dead.
One day at a time, stay close to family and friends, enjoy Paris and we will keep praying for you and your loved ones.
That’s a great point. I truly believe that positivity and humor contributed to my survival. And it made the darkest hours a bit brighter for the people around me.
I would say Dick’s advice is good for you too, Jonathan. Don’t suffer from breaking life-long habits that still feel are the “right” way to live. But also don’t fail to squeeze every drop of joy from each ordinary moment. Take the extra dessert, have a nap when you feel like it, or just keep working like a madman when others tell you to take it easy.
I don’t expect you’ll be selfish, but I’m sure it would please those close to you to see you consider yourself a fair amount of the time. You’re spending an awful lot of time thinking of them.
Acting only with concern for others and immense courage. What else is there to say Jonathan?
Your experience shows the need for balance in our lives. Save for tomorrow, but not at the expense of joy today.
Empathy. Irony. And a small, sad smile. And annoyance. That’s what I experienced reading this. Empathy— I shared earlier that my husband was diagnosed with terminal cancer in 2013. Survival stats at 5 years was 20%. We started spending $40K a year on travel—pulling it from my 401K. After 5 years I told him he’d better die or we’d go broke:). And here we are 11 years later on a world cruise. Irony—all the money we spent from 2013-2018 got replaced when my brother died an early death with two ex-wives, no children and 14 acres of land in a hot real estate market.
I hope you find this phase of your financial planning satisfying, if not necessarily happy. I hope you beat the odds—at least a bit and enjoy the time you have left with family and friends. (IMO, We’d all be better off if we treated our loved ones as if they were going to die tomorrow every time we’re with them).
And for everything you deem holy, buy the business class tickets! Live your life. Live your life.
I’m stunned by the similarities of concerns you have expressed so well that I have been struggling with myself. You hit the nail on the head about the irony of having spent so much time and effort in preparing for a future that no longer exists after receiving a terminal diagnosis. Reading about your new journey is providing comfort and support to the rest of us dealing with the same kind of issues. Thank you.
Jonathan, God bless. Neither would I have regrets about all the planning and efforts to fund my retirement, knowing that it was going to help my kids if I were in your situation. And likewise, even if I had only a month to live, I don’t think I could spend the money for a first-class seat for an 8-hour flight. I’m just too much in the mindset of being reasonable with my spending. I’m not a tightwad, but I have my limits. I drive a Toyota Corolla when I know I could afford a very nice SUV. But I know it would gall me every time I filled up the gas tank.
Johnathan, I’ve only recently discovered this site after I did some financial soul searching from my idiotic gambling in the stock market. The articles here have greatly helped me to refocus towards a path forward. My condolences for the awful, awful hand you have been dealt. Praying for great vacations ahead 🙏
Jonathan, I’m honored to be the first to post to your latest column. Like many others, I feel I’ve known you for many years given your honesty and candor in your columns. I also wish you you the absolute best as you fight your cancer prognosis. Okay.. I’m writing tonight as I truly think you should reconsider your decision to fly premium economy on any international trips in the future. I was never a senior corporate executive, however thanks is large part to learnings from you over many years I have amassed a substantial portfolio. I’m a big believer in “fly business class or your kids will!” Okay… now there are great ways to get round trip business class fares anywhere in the world for $2500-4500 (not $5000-8000). I am not a travel agent but have used Business Class Consolidators and Cook Travel to successfully do this on multiple trips. When you fly Business Class you are able to sleep on the plane (avoiding jet lag) and feel pampered. Please reconsider, and God Bless You, Jonathan Clements for all you have done for others!
I did pay up for premium economy for an upcoming trip to Paris, which is my go-to choice for international flights. But for a one-way business class ticket, American Airlines wanted $15,000. Just. Couldn’t. Do. It. Especially as I’m still recovering from the $6.50 I had to pay for a recent ATM withdrawal.
Flying business class to Europe from the west coast is more compelling than flying from the east coast, but I still choked when I looked at BA’s fare to Florence in Sep. Shopping around and booking with Lufthansa (thru Munich) saved a lot. I think of the added cost as an investment in better experiences during our first few days.
If it’s a daytime flight, you’ll just eat, drink, and watch movies, anyway. No need to lie flat. The east coast to Paris isn’t THAT bad of a trip. Premium economy should be fine. I use points/miles for business class, but only for really long trips that are overnight. It’s a schlep from California to Europe but not so much from California to Hawaii.
I agree with DrLefty. Premium economy across the Atlantic, but business class on frequent flyer miles across the Pacific. I’ve had an affinity credit card with American Airlines for many years which has given me access to all the OneWorld carriers.