Leadership Signal #2: Most progress is invisible while it is happening
The hidden work of rebuilding after everything changes
I was first diagnosed with stage 3 diffuse large B-cell non-Hodgkin’s lymphoma in 2014. I went through six rounds of R-CHOP chemotherapy. One of those drugs was doxorubicin, a red gelatinous medication often referred to as the “red devil” because of its potency and the potential damage it can cause to the heart and tissues if it leaks outside the vein.
A decade later, in 2024, what I thought would be a routine visit to my ENT for nasal medication turned out to be something much different. My cancer had returned.
This time was different. The process was more extensive, involving numerous PET scans, CT scans, and bone marrow biopsies and aspirations. I had two three-day hospital stays to administer a conditioning regimen, daily injections for over a week, and a catheter placed in my neck for stem cell harvesting. What was supposed to be a three-week hospital stay turned into 29 days, with tachycardia, lethargy, neuropathy, bone pain, constant loose stools, extreme dry mouth, no appetite, and a 26-pound weight loss.
A few weeks later, through blood tests and scans, I received a CR, a complete response, or complete remission. But I chose to continue with an optional four-and-a-half-month clinical immunotherapy trial as an additional layer of protection, followed by five months of physical therapy.
What did recovery look like after the transplant? It was nothing like the first time.
Once you have a stem cell transplant, doctors begin counting time differently. The day of the transplant becomes Day 0. Everything after that becomes Day +1, Day +2, Day +3, and so on. They actually consider it a “medical rebirth” and mark the transplant date as a second birthday. And no, it is not a woo-woo term. Once your bone marrow is completely depleted and your harvested stem cells are returned, you are biologically a different person. Your body is rebuilding itself, and that process can take close to two years, depending on side effects, infections, and complications. What surprised me most wasn’t the transplant. It was recovery. I expected it to feel obvious. I thought each week I would notice a little more energy, a little more strength, and eventually reach a point where I could confidently say, “I’m getting better.”
Instead, most days felt the same, and other days felt worse. That’s when I learned that healing is not linear. I’ll die on that hill. You learn to look for small pockets of progress wherever you can find them because they rarely arrive all at once. I would go for a walk, go to physical therapy, have blood drawn, come home tired, and then do it all again the next day. There wasn’t a defining moment when everything suddenly changed.
Having a board certification in health and wellness, I knew the importance of integrative medicine. Once your mainstream medical team deems you stable, there is no one around. And no one but you truly understands what you’re sensing and feeling. Health and wellness often live in silos. Both have their critics, and at times rightly so, but healing is rarely that black and white. It requires both science and curiosity. It is shaped by both pressure and time.
I explored non-traditional modalities that stretched well beyond conventional medicine: ecstatic dance, Internal Family Systems, osteopathic manipulation, IV therapy, nervous system regulation, vagus nerve stimulation, and ancient traditions that viewed nature, sunlight, darkness, and ritual as catalysts for change. It was a deep dive into the unknown that I was willing to take. But the deepest of all those discoveries was my daily practice of silence and stillness, something I accidentally stumbled upon while lying in my hospital bed during quarantine. It was, and still is, my saving grace.
Then one morning, several months later, I walked upstairs without thinking about it. That may not sound like much, but after the transplant, I had gotten into the habit of planning everything my body did. I tracked my blood work, my cardiovascular health, and my strength. Besides taking low-dose heart medication, there was even a conversation with my cardiologist about whether I might eventually need an implanted cardiac device because my ejection fraction had dropped.
Sometimes you simply don’t know what your body is capable of rebuilding. And that realization changed something else for me.
What you wish to control sometimes ends up controlling you.
Every flight of stairs. Every walk. Every outing. Eventually, I reached the top before I noticed I wasn’t thinking about any of it. Looking back, I realized progress had been happening the whole time. I just couldn’t recognize it while I was living through it. The absence of visible progress didn’t mean nothing was happening. It meant the work was happening in places I couldn’t measure yet. That experience changed the way I think about patience.
I used to believe patience meant waiting for results. Now I think it means trusting a process before there is any evidence proving that it is working. My body was doing work I couldn’t see. My immune system was rebuilding. My bone marrow was recovering. None of that announced itself from one day to the next. It revealed itself only over time.
I think leaders experience something similar after disruption. The crisis eventually ends. Meetings return, and calendars fill back up. From the outside, it can appear as though everything has settled down. But underneath the surface, something else is taking root. People are rebuilding trust, confidence is returning, and judgment is recalibrating after months of sustained pressure. None of those things happen overnight, and very few of them show up immediately on a dashboard.
That is why I think we sometimes misunderstand progress.
We naturally measure what is visible: revenue, productivity, and performance. Those things matter, but they usually tell us what has already happened. The conditions that create future performance develop long before they can be measured.
Cancer taught me that. Leadership keeps reminding me of it. Some of the most important transformations in life and leadership happen in the quiet seasons, before there is any evidence that they are working.
I’m a journalist, keynote & TEDx speaker, best-selling author, and creator of Adaptive Resilience Leadership, a framework for leaders navigating what I call the Post-Crisis Leadership Gap: the period after disruption when performance is expected to return, but clarity has not fully recovered. I write about how judgment shifts under pressure, why decision quality can quietly degrade, and what it takes to restore clear thinking in high-stakes environments. I’ve interviewed more than 2,000 leaders, experts, and cultural figures across healthcare, business, and leadership. Across those conversations, one pattern continues to emerge: performance does not fail first. Clarity does. I’m also a board-certified health & wellness coach (NBC-HWC, ACC) and a two-time cancer survivor. After a life-saving stem cell transplant, I rebuilt my relationship with recovery, perspective, and decision-making under sustained pressure. 🔗 saviopclemente.com ↗