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Nicola Mendelsohn: “After I was told I had incurable cancer, I went back to work”

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Susan Riley
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Nicola Mendelsohn was diagnosed with an incurable form of blood cancer in 2016, and has since returned to work. How is the Facebook executive navigating a demanding career when her personal life is so challenging?

A healthy work-life balance is the eternal quest. That usually means trying to achieve equilibrium in a hyper-connected world; not getting too frazzled; not replying to emails at 10pm; taking time to exercise; to indulge your passions; to reclaim downtime (or bath time); to read; to step away from your desk and breathe clean air; to be whole; to be you.

But how about when the balance is less about struggling to make more time for the personal, and instead about trying not to let the personal consume you and your career? When strategy meetings, client pitches and sales targets churn on even as your life is imploding? It might be a divorce, a miscarriage, bereavement or crippling insomnia, but you still get up and show up – gluing your workplace veneer over a broken heart or a tortured mind.

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For this week’s Stylist cover interviewee, the implosion was an incurable illness. But the difference was, there was no veneer. She told everybody.

Nicola Mendelsohn, 48, is Facebook’s vice president EMEA. Born in Manchester, North London resident, CBE, a regular on industry power lists, mother of four, and – until 16 November 2016 – totally healthy. Then the diagnosis…

The bad news didn’t arrive in one go. Mendelsohn’s first symptom was a small lump in her groin that her doctor told her to “watch for a while”. Then came a precautionary CT scan – which Mendelsohn didn’t worry about until checking her phone hours later and seeing 25 missed calls from doctors. The scan, done on a Friday, showed she had tumours all the way up the inside of her body. On the Monday a biopsy confirmed she had follicular lymphoma: an incurable blood cancer.

Nicola became Facebook's Vice President for Europe, the Middle East and Africa in 2013.

“That was the worst weekend of my life,” she recalls. “Because you want facts and to be in control and you’re totally not in control… I did a lot of crying. I couldn’t eat. I lost half a stone of weight that weekend from sheer worry. [All while] trying to keep a semblance of normality among the family.”

Faced with the same diagnosis, what would you do? Quit your job? Travel the world? Who can say until it happens, but Mendelsohn went back to work, opting to ‘watch and wait’, having her cancer monitored as opposed to treated. In between check-ups, it was, she says, business as usual. “For follicular lymphoma (FL), there’s no benefit in treating early as we can’t cure it. Only when my cancer started to grow near my kidneys, and they were worried it would give me kidney failure, did I start chemo.” 

Fourteen treatments followed over six months, and today she sits opposite me in remission. “It’s complicated to say to someone: I’ve got an incurable cancer but I’m in remission and in time it’ll come back, but I don’t know when and I look OK. You don’t look sick so people think you’re not. “Twenty per cent of people will not fare well with FL and don’t know why; they can have the same treatments and it’ll come back. The other 80% can have a period of extended remission. Today, there is no way of telling whether I’m in the 20% or the 80% and if I’m in the latter whether I’m going to get two or 10 years in remission.”

That is quite a thing to live with, and to work with – especially at her industry level. So while I usually balk when women are asked how they do it, this time I’m genuinely – and respectfully – intrigued.

You said you spent the weekend after the CT scan “grieving for the life you had before”. What did you mean?

Until mortality hits you in the face, you think you’re invincible. In my head I still feel 25 and then suddenly it’s, “Oh, I never imagined I wouldn’t be a grandmother”. You realise that things you took for granted maybe aren’t your destiny. But I’ve learnt that the more you focus on that, the more it spirals you down. The only thing you’re in control of is what’s happening right here, right now, and how you respond. I didn’t want that weekend to be my life. I remember thinking: that’s not how I deal with things so I’m going back to thinking how I think. I’m a positive and optimistic person, that’s the only way I know how to be.

That shows great mental strength. Did you decide that as you were given the diagnosis?

Yes. I went in on that Monday knowing it wasn’t good news. But I looked around me and thought how lucky I am. I have family, friends, a good job. Many are not in the same position. I’m lucky I had the support. 

Have you continued to work since your diagnosis?

Yes. When I was diagnosed, work said take the time, whatever you need to do to get better. But I think that’s the worst thing so I said I’d like to carry on. Then [during] treatment I didn’t know how I was going to be… but I was able to work and my best working days were usually around my chemo days. Not all chemo treatments are the same. [Everyone] assumes you’re going to lose your hair and look really sick – some people do but some do not. My hair thinned. It was a rough treatment [most people with FL have around eight treatments] but it wasn’t as debilitating for me as it is for some. 

How are you day to day? Do you take medication?

Every eight weeks I have immunotherapy, which I need to have for two years. It makes me tired, so I’m a bit more tired today as I had it two days ago, but on the whole I feel the healthiest I’ve ever felt, which is ironic. 

How did you deal with telling people?

I’ve always been a very open person; I think if you hold things in it gives you more stress so all my immediate colleagues and friends knew straight away. But broadcasting to the whole company took me a few months to get my head around. We still find things like incurable illnesses and cancer great taboos, so I did experience instances of people not knowing how to react – the head tilt, the “I’m so sorry”. I understand that people want to show compassion but it actually made me feel worse. What I hadn’t expected when I went public was the overwhelming response of kindness and support. Strangers I hadn’t met and probably never will who shared their experiences.

The Daily Telegraph called Nicola "the most powerful woman in the British tech industry."

You’ve said the best advice you’ve had is to speak up and bring your whole self to work. How do you do that when going through personal trauma?

I’ve thought about this a lot – in part because it’s incredible how many people have come up to me since I shared [my story] and told me that they are living with X, Y and Z and nobody knows. 

I go back to the question: what does that do to you? I have a girlfriend who’d been diagnosed with breast cancer and hadn’t told her boss and chemo was looming. I asked her: “What’s the fear here?” She’s self-employed and she said the fear is, “Maybe I won’t get the work”. But I said, “How much stress is that putting on you?” When she told her boss, they were, of course, unbelievably supportive, and that weight was lifted.

And I think there have been very artificial divides about work and life, to do with the way institutions were created – it’s almost military; don’t show weakness or vulnerability. But it’s not real. Most people will have to deal with illness or grief and they’re going to need help and compassion. We need to help people live their best lives. We only get one shot at this. 

Is the work-life divide an issue for everyone, or do women feel it more?

It starts with everybody. There are still taboos in the workplace. Very few people talk about having an incurable illness because it could be perceived as a sign of weakness. A man in my Facebook group for FL [Nicola is currently coadmin of the Facebook group, Living with Follicular Lymphoma] is in his 30s, and the only person who knows is his wife because he fears he’ll be passed over for promotion. There’s an onus on leadership [teams] to normalise this stuff, and create a workplace where people feel that they can be their authentic self. 

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How is that achieved?

You have to show vulnerability. Which is changing, but it’s glacial. [To your other point], as women we are much tougher on ourselves. We have so many conversations in our heads about the things that may or may not happen that we don’t have the actual conversation in the first place for fear of the 65 things that might happen but probably won’t. 

How have you allowed yourself to heal without losing your sense of ambition and purpose? 

Everyone has good days and bad days, right? For me, work has always been about learning, doing things I enjoy and playing to my strengths. If I’m doing all of that then I feel like I’m in the right place. That’s not to say I don’t worry, of course I do. There’s this thing with cancer called scanxiety – that fear of a big appointment and discovering it has come back. But what I hear from people who are more advanced than me is that it gets more normal; that you can live with cancer and have whole days where you don’t think about it. I’m not at that stage yet – but I take inspiration from the people who tell me I can get there. 

How do you cope when fear does set in?

Sheryl Sandberg gave me great advice when I was diagnosed. She said, “Whatever you do, don’t do the secondary worrying.” Secondary worrying is basically going straight to: now I’m dead, and my children are without me. A huge amount of energy goes into that and we do ourselves a lot of damage. As soon as I see that happening, I shut it down and try to preoccupy myself. It’s easier said than done. 

How has your illness changed what you want to achieve?

I have never been one of those people who’s mapped out how their career is going to be. [But] I practise vision writing where I’ll purposefully sit and work out what I want to do next year against my personal life, my family, my business goals and the community. My parents brought me up with the Jewish saying “Tikkun olam”, which means: “You’ll live the life you give back to others”. So that’s always been a part of my DNA. In my experience, a lot of people think about their work the most, and not about the effort they put into their relationships or the moments that matter, and so the life you get just happens along.

How long have you done vision writing?

Six years. I do it at the end of one year going into the next. I’m writing one at the moment which [is set in] December 2020, and I’m looking back on that year… I sit with my family and we discuss the things we want to do and achieve together. It includes where we want to go on holiday, day trips; all different things. There’s evidence that if you write something down and share it with someone you’re 42% more likely to do it. 

You’ve said: “I often talk about seizing your own destiny so it’s hard to be reminded there are things we can’t control.” What is your advice on regaining control?

I do think about this a lot. I heard a great speaker talk about climbing Everest, which seems like an overwhelming, impossible task but of course the planning takes place months before. Break down the job into small, achievable parts: read about it; get fit; buy the tickets; get to base camp; then to first camp. Every day, you make singular decisions. With cancer, it’s like: “OK, what can I do?” I can research; I can book an appointment; I can go and see friends to calm me down. Put yourself in control of the things you can control. 

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Your husband [the Labour peer Jonathan Mendelsohn] is working in politics at a very turbulent time. You work for Facebook at an incredibly testing time. And you’re experiencing the biggest personal challenge… Aren’t you tempted to just move abroad and buy a farmhouse?

You probably think I’m mad but it’s what makes me tick. I passionately believe in Facebook’s vision and its mission: to give people voices and to build communities. That doesn’t mean I don’t acknowledge the challenges we’ve had, big time. But I also see how the company is working to restore trust, which I know will take time. We’ll get there.

Are you still an optimist?

Yes. Definitely. I have always looked up every day and tried to see something different, even if it’s on the same route to work. Think how lucky we are to have the things we do and see. Whatever is going on in the world – and my goodness, there is a lot – I’m very hopeful. 

The Follicular Lymphoma Foundation, founded by Nicola Mendelsohn, is the first charity to focus solely on helping people with follicular lymphoma (FL) to live well and get well. Find out more here, or follow the foundation on Facebook, Instagram, or Twitter.

You can join the conversation across all channels using the hashtag #CureFL.

Photography: Chris Floyd 

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