721. What MS Taught Me About Life, Gratitude & Slowing Down
7 Oct 2026 · 20 min
Derek Cole spent 25 years racing through an HVAC career until multiple sclerosis forced him to stop. His bi-annual Ocrevus infusion leaves him bedridden for days, but he's learned to use that stillness to practice gratitude and question the assumption that tomorrow will always come. He shares a checklist for slowing down: call your parents, spend extra time with your kids, stay five minutes longer for a photo.
Chapters
Home and Life Comfort with Derek Cole. So welcome to today's deep dive. I want you to start by just imagining something for a second.
Okay, I'm ready.
Imagine you've got this engine, right? And this engine has been running at like 100 miles an hour for 25 years straight.
That is a lot of wear and tear on a machine.
Exactly. It's relentless. But then Unexpectedly, someone just yanks the emergency brake.
Oh, wow. Yeah, that would be a violent stop.
It really would be. And, well, that is exactly what we are looking at today for you listeners out there.
We're talking about a guy who never stops, who was physically forced to stop.
Right. We're diving into the story of Derek Cole. And to really grasp this, you know, you have to understand the sheer velocity at which Derek operates.
He's not someone who takes it easy.
Not at all. I mean, he has over 25 years of experience in the HVAC industry.
That's heating, ventilation, and air conditioning.
Yeah, exactly. And he didn't just, you know, inherit a corner office or something. He worked his way up from the field.
Turning wrenches, doing the heavy lifting.
Doing the actual work, yeah. All the way up to general manager and co-owner of Simmons 1 Hour Heating and Air Conditioning.
Which is a massive achievement on its own.
It is. And under his leadership, The company was actually recognized as the 2024 Franchise of the Year.
Wow.
Yeah. For the entire 1-hour heating and air conditioning system across the US.
The entire country. That is a serious testament to like customer service and team culture.
Oh, massively. And his personal career has gotten so much national recognition too. Like he was named to the News Top 40 Under 40.
He was featured in Entrepreneur Magazine too, right?
Yeah.
In their Franchise Player Spotlight.
Right, exactly. And his success has been highlighted by HuffPost and Bloomberg Business.
He even does television appearances.
Yeah. CBS, FOX, NBC. He goes on national TV sharing home comfort advice. So, I mean, the man's baseline operating speed is just maximum output.
But today's deep dive isn't actually about his business playbook at all.
No, it's not. We aren't analyzing his profit margins today.
No, we are looking at this deeply personal note he recently wrote. It's about a much more vulnerable reality.
Yeah, we are diving into his 14-year journey with multiple sclerosis.
Also known as NRS.
Right. And we're exploring the profound and honestly often uncomfortable life lessons hiding in the stillness of his medical recovery.
The contrast here is just massive.
It really is.
On one hand, you have Derek, the high-flying executive solving complex problems.
Leading award-winning franchises.
Exactly. And on the other hand, since November of 2012, you have a man who has had to quietly manage A highly unpredictable chronic illness.
For almost 14 years.
Yeah, he's been living this dual reality for over a decade. And in business, you're rewarded for control.
Right.
Yeah.
You manage personnel, you optimize the systems.
But a chronic illness like MS fundamentally strips away that control.
Well, and to understand why it strips away control, maybe we should quickly define what MS actually does to the body. Because, you know, we hear the term a lot, but what is physically happening to him?
That's a great question. So, multiple sclerosis is an autoimmune disease.
Okay.
It's where the body's immune system mistakenly attacks the central nervous system.
Oh, wow.
Specifically, it targets something called the myelin sheath.
The myelin sheath? What exactly is that?
Well, think of it like the protective rubber insulation around an electrical wire.
Okay, I can picture that.
Your brain is the power source, sending electrical signals down your spinal cord to tell your legs to walk or your hands to grasp.
Right.
When MS damages that insulation, those signals get disrupted, delayed, or they completely short circuit.
Oh man, that actually makes perfect sense, especially given his background in HVAC.
Oh yeah, how so?
Well, it's literally a wiring issue. Like, the thermostat is sending the signal for the air conditioner to turn on, but because the wiring in the wall is chewed up, the whole system just misfires.
That is a brilliant way to conceptualize it. It really is a wiring misfire.
So because of those misfires, Derek details these unavoidable physical indicators that pop up.
Warning signs.
Yeah, they signal it's time for his biannual treatment. Like, every 6 months, he undergoes what he calls his infusion day.
Right, for the medication Ocrevus.
Yeah, Ocrevus. And in the lead-up to that day, his body starts flashing these warnings. His balance gets noticeably wobbly.
His walking changes.
Exactly! The daily struggles of managing the disease just become super magnified.
It's almost like a smartphone battery dropping below 5%.
Yes. The little icon flashes red, the screen dims.
The apps start lagging.
Right. The whole operating system is essentially shutting down to warn you that, like, if you do not plug into a power source right now, you're gonna go completely dark.
That low battery warning is exactly what his central nervous system is doing.
But, you know, for you listeners, the charger in this scenario, the Ocrevus infusion, it isn't just a simple boost of energy.
No, not at all.
And this creates a huge psychological tension for Derek. I mean, we usually view highly successful business leaders as these invincible forces of nature.
Unstoppable momentum.
Right. So how does a guy with that kind of career drive reconcile his identity with a body that literally forces him to hit pause?
Well, he writes with remarkable honesty about being suspended between 2 conflicting states of mind.
Which are?
Readiness and dread.
Oh, wow. Okay, I want to dig into that dread.
On an intellectual level, he's ready for the infusion because he knows he needs it. He knows his body is failing him in these small, undeniable ways.
Right.
But emotionally, he dreads it because he knows this treatment will— and this is in his own words— knock him down for the count for several days.
But why does it knock him down so hard? I mean, if this medicine is supposed to be helping him manage the MS, why does the cure seem to incapacitate him just as much as the disease?
It really comes down to the biological mechanism of the drug. Ocrevus is a targeted therapy.
Okay.
And it actually depletes a very specific type of white blood cell in the immune system, known as B cells.
So it's actively lowering his immune system?
Yes. Since the B cells are the ones mistakenly attacking his nervous system, the drug goes in and essentially wipes them out to halt the damage.
Oh, wow!
But forcing your body to undergo a systemic immune reset like that, it takes a massive biological toll.
I can't even imagine!
The body expends enormous amounts of energy, Clearing out those cells and recalibrating. And the result is this crushing, heavy fatigue.
So he is consciously walking into a hospital knowing he's receiving a drug that will intentionally wipe out part of his immune system.
Yep.
And he knows the resulting energy crash will totally sideline him for days.
Precisely. For a man whose entire life is built on velocity and momentum, this treatment demands absolute surrender.
And absolute surrender is... Like, completely antithetical to the mindset of a successful entrepreneur.
Exactly. It goes against everything he's built his career on.
Which brings us to segment 2, right back to that medical chair.
Sitting in the chair.
Yeah, Derek is sitting there receiving what he jokingly refers to as his juice.
His juice.
Right. So the biological crash is imminent, and yet this is where his writing takes a really surprising turn.
It really does.
Instead of focusing on the unfairness of it all, like, losing days of his life to severe fatigue, he shifts to this profound sense of gratitude.
He feels incredibly blessed.
Which is wild to me.
He focuses on the generations of medical researchers who spent their lives developing treatments that literally did not exist a few decades ago. Wow!
Yeah.
He thinks about the doctors and nurses dedicating their careers to patient care, The privilege of having access to this medical system.
And his family.
Yeah, the support of his family and friends holding down the fort while he's incapacitated.
Okay, I have to push back on this a little bit, though.
Go for it.
If we look at this critically, it's very easy to practice gratitude when you win Franchise of the Year.
Oh, absolutely.
Right. Feeling blessed in that moment on a stage is natural. But feeling blessed for a medical chair that you actively dread sitting in?
It sounds a little contradictory.
Yeah, to be honest, it almost sounds like toxic positivity. Like he's just trying to put a shiny veneer over a genuinely awful situation. How does he manage that cognitive dissonance?
Well, if he were just saying, you know, everything is great, I love my infusion, then yes, that would be toxic positivity.
Right.
Because that requires the denial of negative emotions.
Which he doesn't do.
No, he openly admits he hates the recovery. He acknowledges the dread, but what he is doing with the gratitude is something entirely different. He's using it as a psychological anchor.
An anchor? How does gratitude function as an anchor in that scenario?
Well, when you're in physical discomfort, human biology naturally forces your worldview to shrink.
Okay, that makes sense.
Pain is inherently selfish, right? It demands all of your attention until your entire universe consists only of your own suffering.
It's an incredibly isolated, lonely space to exist in.
Exactly. And Derek intentionally fights that biological instinct by zooming his perspective way out.
Oh, I see. So he's actively resisting the urge to turn inward.
Yes. By focusing on this massive, sprawling web of human effort required just to put that medicine into his arm—
The researchers in the labs.
The complex logistics of the supply chain, the nursing staff.
Yeah.
By seeing all of that, he is contextualizing his own suffering.
So he shifts the focus from, like, look what is happening to me, to look what has been done for me.
That is a perfect way to put it. It's a cognitive pivot.
That is fascinating. So the gratitude isn't there to just erase the dread?
No.
It's there to balance the scale so he doesn't get entirely consumed by it. It connects him to a broader community precisely when his illness wants to isolate him.
It's literally a survival mechanism. And it's the only way he can endure what comes next.
The aftermath.
Yeah. The infusion finishes, and he enters the phase he dreads the most.
The forced stillness? Because, um, Derek admits he is terrible at sitting still.
Oh, his default state is constant motion.
If he isn't managing the HVAC business, he's busy with church activities.
If it isn't church, he's finding a new project to build, a new problem to solve.
He seems practically addicted to doing. But then he writes this incredibly stark sentence. He says, recovery doesn't really care about my schedule.
That sentence is just— it's the absolute core of his reflection.
Biology does not negotiate with an executive's calendar.
No, it doesn't. The post-infusion fatigue knocks him down so thoroughly that all of his usual distractions, his productive distractions, are stripped away entirely.
It kind of makes me think of being stuck in a waiting room when your phone dies.
Oh, that's the worst.
Right. For the first few minutes, you fidget, you look around for a magazine, you try to find literally anything to occupy your attention.
Just to avoid doing nothing.
Exactly. But eventually, the distractions run out, the quiet sets in, and you're forced to just sit there unprotected with your own unfiltered thoughts.
And for a high achiever, that unfiltered quiet is often deafening.
I can imagine.
When you're moving at 100 miles an hour, it's very easy to just skim over the surface of your life. You substitute velocity for depth.
So, if an uncomfortable thought bubbles up, you just focus on today's calls.
Or tomorrow's schedule, or the next quarterly goal. You just outrun it.
But once the capacity for velocity is physically removed by his MS, his mind has nowhere left to hide.
Exactly.
So, when the CEO can no longer outrun his own mind, where does his focus actually go?
It goes straight to the foundation. The forced stillness acts as an emotional centrifuge.
A centrifuge?
Yeah. You know how a centrifuge spins rapidly to separate the heavy, dense materials from the lighter liquids?
Oh, right. Okay.
The stillness separates the superficial busyness of his life from the core weight of it. And what remains at the center are his family, his friends, his legacy, and the people he deeply loves.
And from that foundational place, he arrives at a realization that he writes down plain and simple. He says, life is short.
Which is true.
But— and look, I'll play devil's advocate again here.
Let's hear it.
Life is short is— Like the ultimate cliché. It's on a million bumper stickers. It's cross-stitched onto throw pillows.
It really is everywhere.
So why should you, as a listener, care about a highly successful executive repeating a tired old trope? What makes his realization any different than a cheesy greeting card?
Well, we dismiss clichés because they're ubiquitous, right? But they only exist because they represent profound universal truths.
We've just repeated them so often they lose their edge.
Exactly. We use the phrase life is short as a shield to acknowledge mortality without actually feeling it. But Derek makes a vital distinction here.
What's the distinction?
He points out the massive gulf between knowing a cliché intellectually and actually living like you know it's true.
So, knowing the cliché is buying the bumper sticker, but living it means actually shifting the way you structure your calendar.
That is a great way to frame it. We all know life is finite. But human beings operate under a psychological phenomenon that Derek calls the assumption of another.
The assumption of another? What does that mean?
Well, our brains are prediction machines, and they base tomorrow's predictions on today's realities. Because we woke up today, we subconsciously assume we will wake up tomorrow. We navigate our entire lives assuming there will always be another dinner.
Another conversation.
Another Sunday afternoon.
Another birthday, a hug, a kiss. Or a chance to say I love you.
It's almost a form of temporal arrogance, you know?
Oh.
We just assume time owes us an endless supply of do-overs.
It is. But it's also a necessary cognitive bias. If we walked around acutely aware of our own mortality every single second—
We'd be completely paralyzed by anxiety.
Exactly. The illusion of infinite tomorrows helps us function. But chronic illness shatters that illusion.
It introduces a permanent error code into the brain's prediction machine. Yes.
And Derek writes about this shattering in a way that is genuinely haunting. He observes that we rarely, if ever, know when a normal goodbye is actually the last goodbye.
Oh, wow.
We only recognize the monumental weight of those moments in hindsight.
Because when you're rushing out the door, briefcase in hand, yelling a casual goodbye over your shoulder, you are completely relying on the assumption of another. You just assume you'll see them at dinner.
Right. But MS acts as a magnifying glass for mortality. When your own immune system routinely reminds you of your physical fragility, you stop taking another for granted.
It takes the cliché of life is short and injects it with a visceral biological reality.
And because of that reality, while he's lying there recovering, Derek asks himself this incredibly difficult question.
That's a tough one.
He asks, am I actually cherishing the people God has put in my life, or am I moving so fast that I'm missing some of it?
That is the pivotal question for any high achiever listening to this. And notice how he frames it. He doesn't demonize his ambition.
No, he doesn't.
He isn't suggesting that corporate success is inherently bad. He explicitly states that his work, his team at Simmons One Hour Heating and Air, and his church service truly matter to him.
Right. He isn't having an existential crisis where he wants to quit his job and move to a cabin in the woods.
No, because his work provides value. What he's doing is recalibrating his hierarchy of values.
The business matters, the franchise awards matter.
But the people he loves must matter more.
It's an issue of alignment. Like, is your daily velocity aligned with your ultimate values? Or is the sheer speed of your life causing you to blur past the very people you claim you're working so hard for?
And to fix that alignment, Derek doesn't just ask philosophical questions. He provides a very specific, actionable checklist.
Yes. And there is a real sense of urgency behind it. He is practically begging the reader not to wait for a medical diagnosis to wake up.
What kind of list?
He says, call your parents, spend extra time with your kids, sit by your spouse instead of staring at your phone.
That's a big one.
Tell somebody you appreciate them. Say thank you. Say you're sorry. Take the picture and stay another 5 minutes.
What is remarkable about that list is how he's essentially taking his executive operational mindset and applying it to his relationships.
Oh, that's so true.
An executive doesn't just hope a quarterly goal is met; they schedule it, they track it, they prioritize it.
Derek is realizing that you have to operationalize love.
Exactly. You have to treat staying another 5 minutes with the same non-negotiable urgency as a board meeting.
The irony here is just astounding, though. Look at Derek Cole's resume— 25 years of corporate climbing, top 40 under 40, National television appearances on CBS and FOX.
Accolade after accolade.
But when the engine is forcefully shut down, his ultimate checklist for a successful life has absolutely zero to do with profit margins, television ratings, or market share.
Because the resume is what you build to interface with the world. But this checklist is what you build to anchor your soul.
Wow.
Multiple sclerosis has undeniably taken a great deal from Derek over the last 14 years.
His mobility, his energy.
Yeah. Physical comfort. But in the crucible of that illness, he discovered a strange gift.
The disease gifted him the forced stillness required to clearly see what he still has.
Yes, it forces him to stop long enough to realize that while the assumption of another is a dangerous illusion and tomorrow is never promised, we undeniably possess today.
And his ultimate message is that you do not need an autoimmune disease to learn this.
No, you don't.
You do not have to wait for an Ocrevus infusion or a major life crisis to gain this perspective.
Which is exactly what we want you, listening to this right now to walk away with?
You don't need a medical emergency or a flashing red battery icon in your own nervous system to hit the brakes. You have the agency to choose to step off the treadmill.
You can simulate this stillness without the trauma.
It just requires intentionality.
Absolutely.
So, think back to that relentlessly tuned engine we talked about at the beginning, the one running at 100 miles an hour for 25 years.
Right.
If a forced medical recovery is what it took for an executive like Derek to finally sit with his own unfiltered thoughts, what would happen if you intentionally scheduled a forced pause in your calendar this week?
Just 1 hour. Treat it like the most important meeting of your week.
Exactly. Block out 1 hour of absolute stillness. No phone, no work email.
No background television.
No podcasts, not even this one. Just You sitting in the quiet.
What truths about your own life, the health of your relationships, and the velocity at which you're traveling might bubble to the surface if you finally stopped outrunning them?
It is a challenging, slightly terrifying, but ultimately beautiful thought.
It really is.
We will leave you to mull that over. Until next time, echoing Derek Cole's own words, let's go. Home and Life Comfort with Derek Cole.
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