Traditionally, when an executive has announced his or her resignation "for health reasons," the office betting pool has offered a straight 50-50 proposition: Either the boss has been stricken by a life-threatening disease, or the boss has gotten sacked.
In early February, however, former L.A. Lakers coach Rudy Tomjanovich upset the bookmakers and gave the "health reasons" euphemism new meaning. Just 43 games into a five-year, $30-million contract, Tomjanovich said he was quitting because the "wear and tear of doing this business" was making him anxious, wrecking his diet and wearing down his immune system.
His job, he said in short, was killing him slowly. And with that, he walked away.
Tomjanovich's decision flummoxed basketball fans and left type-A personalities everywhere scratching their heads. How, many asked, does a guy who has made it to the pinnacle of the sports world admit he's been licked by the stress?
But to those who tend to the physical and psychological health of the highly motivated, Tomjanovich may be a hero for an age in which 40% of American workers describe their jobs as "very" or "extremely" stressful.
He is a public figure who recognized the toll that his job was taking on his health, made the necessary adjustments, and called a news conference to acknowledge that, at the age of 56, "maybe I'm an old general who needs to get ... off the front line and do something else."
"Our culture is so driven by achievement, money and status. I'm delighted that someone had the courage to admit ... that there's a price" to be paid for getting to the top and staying there, said James W. Gottfurcht, a Los Angeles-based psychologist who coaches individuals and companies about the role of money in their lives.
More typically, added Gottfurcht, the acknowledgment of that toll comes from "people on the other side" -- public figures who have been driven to addiction, exhaustion or illness by the stresses of success.
Although few have been willing to acknowledge it, success (and the stress it brings) does not come cheap. Employees who report that they are stressed incur healthcare costs that are 46% higher -- an average of more than $600 more per person per year -- than employees who are not, according to the National Institute for Occupational Safety and Health, the federal government's workplace research center.
The New York-based American Institute of Stress estimates that workplace stress costs the nation more than $300 billion in additional healthcare costs, missed days of work and stress-management programs for workers. Although workplace stress is rampant, publicized examples of those opting out "for health reasons" remain scarce.
In announcing his decision to quit on Feb. 2, Tomjanovich said he had probably tried to return to coaching too soon after treatment for bladder cancer that was diagnosed in March 2003. He said that his moods were swinging higher and lower with each Laker victory or defeat, adding that he was frequently sapped of energy and getting sick. He began taking an antidepressant, and when that didn't seem to help, Tomjanovich said, he was set to switch to "something stronger."
A recovering alcoholic, the coach said he was concerned about the new medication's potential for addiction and questioned whether another prescription was the answer to his problems. "I didn't like the fact that I was going to start taking medication so I could do my job," Tomjanovich said in announcing his departure. "I never had to do that before."
Physicians say that Tomjanovich's symptoms are a classic recitation of the health effects of job-related stress and strain. General internist Benjamin Ansell, who directs UCLA's Executive Health Program, says that people under constant or acute stress at work often complain of diffuse muscle aches, depression, anxiety, sleep disruptions and a greater vulnerability to minor infections. A closer look at their blood chemistry often reveals other, more subtle tolls of stress, including elevated levels of blood glucose after fasting -- a sign of incipient problems of metabolism.
Warning signs of heart disease, such as high blood pressure or elevated cholesterol levels, are usually more pronounced in executive patient populations than in the broad population of adults first diagnosed with the same conditions, Ansell says.
"Stress is the X factor," he says. "If you see an individual under a great deal of stress, they're both more likely to have risk factors for heart disease and more likely to have significant presentation of those than other populations. It's multiplicative."
What is unusual, say experts, is Tomjanovich's response to signs of his stress. To leave a pressure-cooker job is a solution that few high-profile people take. Most workers simply cannot afford to do so. And for those who could afford the financial sacrifice of punching out of a job, there is often little willingness to admit defeat, especially to the forces of stress.