Building Trust And Ceding Control: The Lessons Preparing Me For My Third Brain Tumor Operation In 14 Years

Marian Salzman
6 min readMar 23, 2021
Photo by National Cancer Institute on Unsplash

This week I’ll be undergoing round three of brain surgery. I probably shouldn’t feel as casual as I do about the impending removal of another tumor (should the organ most under threat not be quaking with dread and fear?). But when it comes to putting my life in the hands of others, I’ve been there, done that, and as they say, bought two T-shirts as souvenirs.

Often, we have no choice but to cede control to the people we trust — in this instance, my surgical team. It’s no different from taking a seat on a passenger jet. We’re entirely dependent on the pilot, copilot, and air traffic controllers to get us safely from A to B. We willfully surrender our control and trust these strangers with our lives. And the more times we do it, the more confident we become in our odds of survival at 38,000 feet.

You could say I’ve unlocked my ability to relinquish control the hard way. Since I’ve never feared flying, perhaps I was always destined for a sterner test of my mental constitution. But when I go under the knife this week, I’ll have greater trust in the person wielding said surgical tool than I did in 2007 and 2013. Not because of any difference in the surgeon’s aptitude, but because the trust gained from past experience makes it easier to cede control.

That isn’t to say I don’t grasp at every small measure of control available to me. I have become obsessive about preparation, applying the same skillsets I’ve honed at work to identify the best surgeon to extract these menacing (albeit mostly benign) cerebrum squatters of mine and making my final choices based on a peculiar mix of intellect, information, and intuition.

A brain tumor, after all, is an entirely different proposition from a bone fracture. When I broke things playing sports or horsing around in the past, I’d go to the local emergency room and wouldn’t care who was randomly selected to put me back together. But when it comes to something as complex as brain surgery, I am convinced that the more knowledgeable patients become, the better they are to talk their way into the hospital best equipped for the job.

And that’s where the control available to you ends. The moment the anesthesia kicks in as you’re being wheeled into the operating room, you’re under the control of others. (I remember well the very last moments I was awake the last time, muttering could they turn up the heat; I’m always cold, which is an amazing claim for someone who thinks of Tucson, Arizona as home.)

Then, with the click of a finger, you’re awake again. Groggy, confused, exhausted, stiff, and sore. What seems like a moment has actually been several hours. Here marks the beginning of that long road to recovery — one on which I have repeatedly stumbled in the past. Why? Because sitting still and patiently biding my time is not something I’m good at.

After my first surgery, I pushed the limits way too far. Within a few weeks, I had traveled to Bangkok. Although I was under strict instructions not to swim, the doctors hadn’t mentioned boating. I decided to interpret that as a thumbs-up to rowing on the Chao Phraya River. In doing so, I caught MRSA. Did I really expect to escape unscathed after a few hours on one of the world’s most polluted rivers with a healing head wound?

Following my second craniotomy, before my stitches and staples had been removed, I taped a CBS special with the family of one of the children murdered in the Sandy Hook massacre in Newtown, Connecticut. Afterward, I visited the home of one young victim’s family with whom I had become particularly close. Their five-year-old daughter jumped into my arms, overjoyed to say hello — at a time when I wasn’t allowed to pick up anything heavier than a quart of milk. As quickly as I caught the child, I was able to put her down. Crisis averted.

I have learned my lesson. This time around, there will be no such errors in judgment. Instead, I’ll approach my convalescence as I did the surgery itself — and cede control to the tried and tested rules of my recovery program.

Initially, this will involve taking two weeks off. People who undergo brain surgery can be more emotional and reactive in the short term, so I won’t risk subjecting anyone to that. I’ll also be catnapping a lot, sleeping in 15-minute increments, sitting up since that’s part of the recovery process (both the naps and sleeping upright). This napping will continue when I’m back at work. You simply cannot stay awake when your brain is tired. (Good luck keeping me conscious in meetings — and thank goodness coffee isn’t contraindicated for healing brains.)

Reading will play a role throughout my recovery. The brain can’t be left to languish. In my experience, it must be fed information to exercise it back to full capacity. The fog lifts slowly, and you need to keep teasing it back.

And I’ll be steadfastly attentive to what I eat, at least in the beginning. Soy and white sugar are said to feed tumors, so I’ll be avoiding them for the next two years (an arbitrary self-imposed decree, but I like knowing when an end is in sight). As I am based in Switzerland — a renowned haven for chocoholics and a fantastic place for sweet creams — resisting sugar won’t be easy.

Yes, recovery from brain surgery is a long, hard slog. Yes, the procedure itself is a daunting prospect. Yes, I may grow an unsightly patch of mad scientist hair, hard for someone who obsesses over her blond locks. Yes, my head will behave like a weather vane that senses changes in air pressure and accurately forecasts rain.

However, these are the life-changing adversities I credit with teaching me the critical importance of trusting others to steer and safeguard those stretches on life’s journey over which one has no control.

This, in turn, has made me a far more trusting manager. Where I was once across the minutiae of everything, I now have unwavering confidence in my highly talented and qualified team. I can’t stand over the shoulder of my surgeon in the operating room; nor can I always stand over the shoulders of my leaders. I trust them to do what they do best. Having established this high level of trust, I’m able to cede control. And, as my hospital stay rapidly approaches, that’s as close to full “control” as I’m going to get for a while.


Yet again, I find myself marveling at the miracle of science and the dexterity of my surgical team.

Just one week ago, I was lying powerless on a surgical table in Boston’s Brigham and Women’s Hospital — my fate in the steady hands of those I had entrusted with my life.

No operation is a pleasant experience, but mine passed in a flash (thank you, anesthesia) and without complication. Far worse was the pounding headache that followed.

Being parted from my two laptops, two cellphones, and iPad wasn’t easy either — I’d packed excessively in fear of technological breakdown — but I was soon back online, eager to give my post-op brain a gentle test of its faculties.

Less than 48 hours after surgery, I was given the all-clear to leave the hospital. Since then — with authorization from my medical team — I’ve been working six-hour days, which I will step up to eight hours beginning on Monday. It may sound crazy, but work is a welcome reward and acknowledgment that the brain surgery was a success. It’s remarkable what can be achieved when we cede control and entrust others to work wonders.

The same can be said of a 15-minute power nap.

Much gratitude to all who sent words of encouragement and support.



Marian Salzman

SVP Global Communications at Philip Morris International — award-winning PR and marketing professional, author and trendspotter — popularized “metrosexual.”