IT WAS JUST HOURS BEFORE UNDERgoing a heart procedure that Fred Gabourie, successful entrepreneur, finally came to terms with how to run his company.

His doctor's words resounded in his ears. "You're a very fast-track guy," the cardiologist had said. "But the fact is that you are trading years of existence for this perceived need for more and more success." Gabourie had certainly been successful, starting his own insurance agency and building the annual sales volume to $1 billion in just seven years. But he had paid his own steep premium: an increasing level of stress that had destroyed his first marriage and caused a host of physical problems leading to heart disease.

As the doctors prepared him for the procedure, Gabourie was starting to understand how difficult it would be to change his ways. Only a few days before, he had tried to keep the agency running smoothly from his bed in the hospital's cardiac-care unit. He had broken hospital rules and dialed the phone. In a whisper, he had asked his assistant all the standard questions: How many applications for policies came in today? How many premium checks arrived in the mail? What problems are developing?

Now, Gabourie was making his own silent vow. If he lived through the next few hours, he would make some big changes. I loved the success, I loved the validation, and I loved the strokes I got from my business," he says.

"But I also loved living. I decided I would have to find a way to balance that out."

THERE IS NO SUCH THING AS TOO much stress. At least that's what Fred Gabourie thought. And judging from the way they work, so do most executives of fast-growing companies. They ignore such symptoms as clammy hands, an upset stomach, a tight chest, or sleepless nights. They keep pushing themselves because stress is not as real as, say, meeting this week's payroll. "American businessmen are taught to put everything on hold until they make a lot of money," says Elaine Willis, president of Foundation for Wellness, a research and television-production organization. "We're losing a lot of them because of that."

Stress, in itself, is neither good nor bad. It means that the body is in an alert state because it is responding to change. But stress turns to distress when that level of alertness is exaggerated or extended for too long. Headaches and upset stomachs may not sound serious, but chronic stress contributes to such illnesses as heart disease, arthritis, drug addition, and alcohol abuse. Distress shows up in many ways: dizziness, inability to concentrate or sleep, frequent fatigue, irritability, and depression, to name a few. And the executive isn't the only one affected; spouses, children, and employees suffer the shock waves. "At some point, which is different for each person, stress become counterproductive," notes Dr. Kenneth Pelletier, an associate professor at the University of California School of Medicine.

The only was to control these symptoms is to break the cycle of stress. Dr. Herbert Benson's 1975 bestseller The Relaxation Response focused on the physiological effects of stress and identified methods of relaxation. Since then, the stress-management industry has been on a tear, with leagues of reconstructed burnouts preaching various great escapes. Some companies offer week-long cruises and rafting trips. Spas and retreats lure executives with promises that they can attain, affirm, and explore until their stress melts away. One California retreat offers some unusual extras: natural hot baths and instructors who help you deal with the leftover stress from previous lives. There are consultants, newsletters, and books vying for a piece of the stress trade. Some work in the time-management niche, laboring to expand the number of hours in a day. This may be a helpful approach, but the expert I called was too busy to fit me into his schedule.

Not all stress-reduction programs are expensive or exotic. And some actually work (see boxes, following pages). Most hospitals and health-maintenance organizations offer courses that teach relaxation methods, such as biofeedback, in which you learn how to control your heart rate, blood pressure, and skin temperature. Of course, many entrepreneurs prefer to think of themselves as givers rather than takers of stress. "These are action-oriented, take-charge people," says Dr. Stuart Rosenthal, director of psychiatry at Newark (N.J.) Beth Israel Medical Center. As a result, they tend to opt for individualized treatment.

Entrepreneurs feel stress in their own ways. For executive at big corporations, stress often arises from a conflict between the company's goals and their own. But a founder is usually in sync with his company. His or her stress comes from a different source. It may be from the strain of trying to pay the bills on time. Or from having personal financial assets on the line. Or from managerial failings, such as the refusal to delegate responsibility when the company becomes too big for one person to manage. For the founder, managing often becomes all-consuming. "Entrepreneurs start forgetting about having any balance in their lives," says Kenneth Blanchard, a consultant and co-author of The One Minute Manager.

Any successful plan to combat stress is tough going. It requires a basic shift in life-style and in management techniques. A week-long vacation may make you feel hearty, but it's not going to change the way you face the daily grind. "A lot of entrepreneurs say, 'I'll take a trip down the rapids if you promise that will take away my stress," says Blanchard. Many executives believe that they can drain their stress simply through a daily walk, run, or bicycle ride. "The reality, though, is that they have to deal with changing their day-to-day life," says Blanchard.

FRED GABOURIE THOUGHT THAT A jog at six every morning would alleviate his stress. He found out too late that it wasn't enough.

He first went on his own selling insurance to brokers and agents when he founded Employee Marketing Systems Inc. in 1969. A few year later, Gabourie met executives from Sovereign Life Insurance Company of California. The agency that represented Sovereign to agents and brokers in southern California posted a disappointing $11 million in new sales volume that year. Gabourie, the executives thought, was just the man to energize sales. The agency handed him around $35,000 to cover his start-up costs and guaranteed him exclusivity in the region.

Gabourie's splashy direct-mail campaign stood out among his many competitors. Brokers wanted to know: who was this marketer who used color, while most insurance mailings were dull and gray; who employed dramatic graphics, such as a fistful of dollars ripping through a page; and who teased them by sending playful "Gabourie-Grams"? Curiosity lured them in. In 1979, Fred Gabourie Insurance Agency Inc. wrote about $77 million in new policies, then more than $330 million in 1980, and double that a year later. But Gabourie was ridden with anxiety. "The more we did, the more pressure I felt," he says.

Gabourie knew that taking his problems home wouldn't help. A few years earlier, in fact, it had cost him his home. Immersed in his work, he made very little time for his family. "Anybody who had any degree of consciousness would have seen the signs," says Gabourie. "My wife did everything in her power to have me understand what was happening in our marriage." One morning, Penny, his wife of 15 years, grabbed their two children and slammed the door behind her. The divorce, Gabourie says, "was a cumulative effect of paying 95% of my energy and attention to business and 5% to my family life." Not that he understood it at the time. He didn't recognize the symptoms of his failing marriage, just as later he overlooked his waning health. "I didn't understand that being less intense about business would have solved some of our problems," says Gabourie.

He could hardly have been any more intense. Gabourie would march into work every morning at eight, fresh from an hour's commute spent weaving through California's tangle of freeways. If there had been a traffic snarl, he would be snarling himself, with cold perspiration slithering down his forehead. By the time he arrived at his office, his mind was on one thing only. "He took time out for niceties like 'How was your weekend?" recalls Vicki Falconer, his executive assistant. "But then it was business, business, business. He was always on the go, and he didn't talk much about personal things." He spread that attitude among his employees. "We felt absolutely pushed by him," says Joyce Waggoner, who was then a brokerage rep. "We felt guilty when it came time to schedule vacations." One employee even hesitated over taking time out to see a dentist. By the time he finally went -- carefully choosing a day that Gabourie was out of the office -- the dentist unearthed 17 cavities.

Gabourie had a couch in his office, but no one recalls that he ever used it. He was usually on the phone, with several calls blinking on hold and a few brokers waiting to see him. With the telephone at his ear, he'd glance at his watch, pace the floor, and nervously jingle the change in his pocket. His short temper flared easily. An underwriter at Sovereign's home office, for instance, might disagree on the pricing of a policy. Gabourie would argue until his face turned red. His tone would get very firm. "I have just told you three times about extenuating circumstances in this case, yet you continue to underwrite it by the book," he might say, dryly adding, "I didn't know that underwriting was such a precise science." Before he slammed down the phone, the veins in his forehead would pop out. Employees saw the look so often that they dubbed it the "Freedy Forehead."

At times like these, Gabourie would also feel a constriction in his upper back. "When challenges were coming at me from all sides, I would feel it tightening up back there," he says. Before returning to the phone, he would begin to feel emotional pangs. How am I going to get all this done? How can I deliver what's expected of me?

He couldn't, and for a good reason: it was too much work for one person. Gabourie's anxiety wasn't just an outgrowth of his personal style. His managerial shortcomings were putting added pressure on him. Like many company founders, he failed to delegate authority as his company grew. It was his name on the door, and he didn't want to take any risks with it. "He felt that if he didn't do it, it wouldn't get done," says Falconer. "He got involved in every agent's problems. If one of them had a complaint, Fred would take it as a personal quest."

Any case that needed slightly special handling -- and agents tend to think most of their cases do -- went straight to Gabourie, instead of through his managers. "I allowed that to be perpetuated," admits Gabourie, "maybe because of the ego gratification of being the guy who gets the problem solved." As the agency grew, Gabourie buried himself in more and more problems. He scheduled so many appointments that he often lunched on handfuls of M&Ms and Junior Mints. His agency was Sovereign's top producer in 1980. In 1982 and 1983, it set a record for new policies that still stands: $1 billion. Gabourie began to feel, he says, "like I was somewhat invincible."

His employees clearly saw Gabourie's flaws, even if he didn't. "Fred didn't do well at the one, two, threes of managing people," says Waggoner. He was so impatient that he nearly boiled over when others didn't see his point at meetings. If he saw an employee goofing off, Gabourie could be "Mr. Understanding," taking an employee out for a drink and calmly explaining that "there are opportunities to play and there are opportunities to work." But all the while he would be storing up frustration. The next time it happened, he might flash the famous forehead and start yelling, "Why are you doing that? Why are you be-having that way?" He often failed to act decisively when employees weren't producing, which ate him up inside. It took six years of indecision before he fired one employee. "I really chewed on it and suffered," he says.

So did his second wife, Michelle, whom he met on a blind date and married in 1978. On dates, he would arrive at her apartment and reach for the phone. When they went out, she recalls, "he was always talking a lot about business." He didn't even let up on their honeymoon, a cruise to Alaska. The minute the boat docked at Ketchikan, Gabourie was "hurrying down the gangplank to grab the one phone booth to find out about a case back at the office," says Michelle. "He was simply addicted to telephones." During trips, he would often encourage her to go shopping. "I'll stay in the hotel and read," he'd say. As soon as she was gone, he would be on the phone to the office, sometimes for as long as two hours. "He always had to know everything," says "Falconer. "I knew that if he didn't slow down, something was going to happen." Already, Gabourie had given up on having a good night's sleep. Problems kept him awake. "It went on for years," says Michelle. "He'd wake up at two a.m. and spend the night working out a problem."

One night in March 1983, Gabourie couldn't sleep. He wasn't thinking about business, though. He was thinking about death.That day, a doctor had put Gabourie on a treadmill after hearing his complaints of back spasms. "Whatever you find," Gabourie assured the doctor as electrodes were attached to his chest, "it won't be heart related. I've been running for 16 years." Running, Gabourie liked to say, was his own insurance policy against ill health. But apparently, it wasn't enough coverage. "I'm getting some abnormal readings," the doctor said, pulling him off the treadmill early. "There is a heart irregularity." After considering open-heart surgery, another doctor later decided to try a new procedure called angioplasty. It was scheduled for the morning of May 3.

As Gabourie lay awake the night before, he tried to picture the next day's events. Angioplasty works like this: while Gabourie lay flat on an X-ray table, doctors would insert a catheter into his leg and snake it through an artery to his heart. When it reached the portion of the coronary artery narrowed by fatty deposits, a balloon at the tip of the catheter would inflate, flattening out the deposits and opening up a bigger channel for the blood to flow through. It was a dangerous surgical procedure. Gabourie had seen the postoperative room, and the vision of all those "white and pale people with things hanging out of their bodies" stayed in his head through the night.

Gabourie thought about the people he would leave behind. And he thought about the agency. How could it go on without him? Who could handle all the cases that needed special attention? It was just this sort of intensity and focus that had landed him in the hospital. If he lived through the surgery, he decided, he would find someone else to worry about those things. Or, better yet, he would sell the company.

About a week later, a chastened Gabourie was running again -- but he wasn't running the agency. "I had faced a lifethreatening experience," he says. "I knew that it was either do the right things for myself or risk not being on the planet anymore. I came to see there are things more important in life than being the number-one agency." He was so frightened by this picture of his own mortality that he decided to put someone else in charge. His employees were instructed to tell outsiders that he was "taking some R&R" or "working on a special project." He later installed Waggoner as manager, telling her that he wouldn't be coming in very much. She doubted that Gabourie could stay away. "Old habits do die hard. And the company seemed as much a part of Fred as his heartbeat," she says. But Gabourie was serious. He even insisted that Waggoner use his old office, so his visits couldn't last long.

Gabourie struggled with his decision. He couldn't help calling in to the office about four times a day. After all, his name was still on the door. The agency was the only place where he had met challenges, found excitement, and earned recognition. Now he sat in his new office close to home, bored and worried. He just couldn't stand it. "I knew that because of my unwillingness to let go, the thing to do was to sell the business," he says. "I had to find the courage to do it."

And he had to find a buyer. When he first approached Sovereign's owners, they turned him down. His employees, they said, weren't seasoned enough. But they eventually proposed an experiment: Gabourie would take the new position of Sovereign's national marketing director. While he was hiring new general agents and teaching others how to be more productive for Sovereign, his agency would continue operating without him. Then Sovereign could see how the staff functioned by itself.

Eighteen months later, he asked for another meeting with Sovereign. The agency had been doing well without him, he began, so maybe Sovereign would be willing to reconsider? To his surprise, the owners said they would. What number did he have in mind? Something, he replied, "in the low seven figures." That sounds fine, they said. "All cash," he demanded. They nodded. We'll get back to you with the details, they said. All of them stood up and shook hands. Gabourie left, and started the hour-long drive home.

By the time he got there, he was beginning to feel awful.

This is my company, Gabourie thought. He had built it from ground zero, built all those big numbers. He was the agency. Losing it meant losing his identity. "I felt bad for him," says Michelle, who talked to him about traveling and spending time with his three-year-old son. Recalls a friend: "He looked a bit lost. For him, it was like moving to a new home in a new neighborhood with new people." Later, Gabourie even stalled the negotiations a bit. At one lunch meeting, he blurted out: "I'm afraid that you won't let me run the agency the way I want when you own it." His fellow diners gave him a perplexed look. "It was a silly thing to say, of course, since it was not going to be my company anymore," says Gabourie. "But I still felt it was so much a part of me."

After they signed the final papers in January 1986, Michelle took him to one of his favorite places, Laguna Beach. "My God, what will I do?" Gabourie implored as they walked. "I can't believe I don't own the agency anymore." He couldn't get over it. "All of a sudden," he mused, "there is a Fred Gabourie Insurance Agency out there, and I have very little to do with it."

Gabourie moped for a time -- "He was a guy walking around with a briefcase and no place to go," recalls Michelle -- then finally began turning it into a challenge. "Is my company all that validates me?" he asked himself. "I needed to prove that that was not the case." He was soon working out at a swanky health club every morning. Aside from a three-year consulting agreement with Sovereign, there was a group medical plan project and a bank that wanted his help. He took on the jobs enthusiastically, but his approach was different.

Now Gabourie dressed casually. And he began asking associates to meet him at the gym, where he'd discuss business while doing 60 sit-ups or leg-pressing 190 pounds. When he visits the agency, now called Sovereign L. A. Brokerage, he greets former employees with a big hug. "He seems to be approaching things from a different part of himself," says Waggoner. "He doesn't get his whole being involved." When Gabourie finds he's "getting cranked up," he'll spend an afternoon tackling a jungle gym with his son. "I used to wonder, 'When does he come down?' He never took a restful day," says Falconer, who is still his assistant. "I thought, 'Well, that's Fred.' But I've since learned that that's not Fred at all."

Of course, most executives would feel less stress if they could sell their company for lots of money, too. Gabourie argues, though, there are other paths that could work just as well. After all, he did run the company by remote control for nearly two years. "You can delegate or be a better manager than I was," he says. "Share a piece of the action if you have to. Bring in an assistant. It's not as live or die as I made it."

The key, he says, is for executives to realize that distress is not part of the price they have to pay for running a growing company. "People like me, who take business so seriously, usually just drop dead," says Gabourie, who is 46. "But this is chapter two of my life. I feel like I've been reincarnated without having to die."