Managing risk during a pandemic

When I ran the Financial Conduct Authority, we thought a lot about risk. It was a big part of how we supervised banks. They had to have risk committees, who would typically consist of 50-plus year…


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The Intro


In 2016 I became extremely invested in rock climbing. I had just quit my job as a teacher and was giving esports a chance. Working for a team meant that I was working sporadically throughout the day and thus there were times when I could just do whatever I wanted to do. While I’m sure I didn’t need to dedicate as much effort as I did into my work for what I was doing, I really wanted to succeed in that space and worked pretty much all day with a side of climbing.

Occasionally a friend or two would join me and we would alternate between climbing, working in their co-op space, and lifting in their gym all day. For those who don’t climb, the activity is incredibly social as you work with others to figure out a problem (bouldering-speak for a specific route). Honestly, it was one of the most liberating experiences to be able to balance work, exercise, and play all while socializing.

I never really found strength training appealing, so when I discovered climbing, like many things in my life, I became obsessed. The ability to problem solve (often in real time) and socialize while getting strong made me gravitate towards the activity. In my prime I was by no means jacked out of my mind but I was incredibly fit — something I struggled with most of my life. Rock climbing changed that for me and not only did I look good, but I felt good. Unfortunately being able to climb all day was short lived.

When I got the opportunity to work for Monster in May of that year, it meant moving to California and working 9–5. No more were the days of me hanging out in the gym. Moreover, I was traveling nearly every other week, which significantly decreased the amount of time I could dedicate to climbing. I had plenty of opportunities to work out in the hotel gym, but weight lifting just isn’t for me.

Maybe I became complacent, maybe I wasn’t as strong or flexible as I used to be, but I was still enjoying the activity. And I was still doing problems that were as difficult as I was doing before I started to climb less — not the smartest choice but I typically always climbed until my arms felt like spaghetti.

Unfortunately it would likely be the cause of an injury that has plagued me ever since. Sometime in May or June 2019, I started my climbing routine as I normally would — warm up with an easy v0/1 just to get my arms and legs warm, loosen up my muscles, and get ready for harder routes. Right next to where I was warming up, there was an intriguing problem.

The gym chain that I go to typically has problems that are primarily strength-based, so it was rare to see a technical flexibility problem. The group before me didn’t complete it so I didn’t get a beta (climbing speak for someone showing you the solution), but I began attempting it and was making decent progress. It required you to hug the wall, so falls were causing some scrapes on the way down but it wasn’t too serious. My flexibility was seriously being put to the test and I was already beginning to tire myself out, so I went and did some other problems while keeping an eye out for someone to give me that beta.

The beta never came and I really wanted to solve it. At this point several groups tried and couldn’t do it, so the spirit of competition was flowing through my veins. I was able to get roughly half way up which was average based on what I had seen but it was towards the end of my session and I wasn’t so fresh anymore. Maybe I should have listened to my body to stop, but unfortunately I slipped.

The hold I slipped off of was only a few feet off the ground, which under normal circumstances wouldn’t be too bad. What made it brutal was because it was a flexibility problem, I was stretched out as far as my body would allow and furthermore I had wedged my hands and feet into place. When I slipped, half of my body was still in place while the other half slid down the wall and my leg tangled behind me. Originally the pain wasn’t too bad — rubbing it out and walking it off made it feel better. I took a break and did a few more problems before deciding that this was actually relatively serious.

Over the next few months I would go to various doctors to try and figure out the source the sciatica that was a result of the fall. First the doctors thought it was my back and that I slipped a disc. The imaging on my lower back showed I had a bulging disc in my L4 vertebrae but upon further inspection it wasn’t big enough to be causing my problems which kept returning every few months. Physical therapy was my prescription along with some pain killers and nerve blockers. No one knew what the source of the problem was.

Then the pandemic hit.

If it wasn’t stressful enough dealing with staying indoors and the trials and tribulations of getting groceries and my family being thousands of miles away, my symptoms were getting worse. I remember at one point I was up until who knows when with the most outrageous pain, having a breakdown because I couldn’t go to the doctor in person to continue to try to find the source of the pain, which at this point was a complete enigma.

My boss had been begging me to go see a chiropractor and after consulting with a family friend I found one that was highly recommended. My insurance of course wouldn’t take him and I was paying out of pocket but honestly it didn’t matter because he immediately was able to fix me up. I was feeling much better, but now that my back wasn’t hurting, it became apparent that I had bigger issues than some misaligned joints because I was still experiencing symptoms. I went to him religiously over the next few months to ensure my back stayed healthy and eventually my underlying condition became clear.

After a session sometime in the summer of 2020, he made a suggestion that none of my doctors had considered — when I fell, not only did I mess up my back, but I had torn my hip labrum. Now I could go on a whole other rant about the American medical system being a revolving door of patients with very little care being placed into your visit, but that is for a different day. But my chiropractor was the one to find the source of my pain that not even a specialist could pin point.

But because this idea didn’t stem from my primary doctor I had to beg them for an MRI. Once I got it, the results confirmed what my chiropractor already knew — I had a torn labrum with a sizable cyst growing in there. The entire process took around 4–5 months to get the images done, read, and a specialist approved and scheduled which is an absolute travesty.

When I finally got an appointment in the winter of 2020 with my insurance recommended orthopedic, after looking at my chart and imaging he wanted to try cortisone injections first. This procedure, he said, was supposed to be therapeutic (it wasn’t) as well as diagnostic (it was, but he didn’t see it — more on that in a bit). I would later find out that these shots are rarely effective for this type of injury, but nevertheless I got one shot that day and another directly into the hip utilizing ultrasound guidance 6 weeks later.

A few weeks after that, we had an appointment to discuss the results, and he point blank told me that he had no idea where my pain was coming from and I was devastated. I remember his exact words, “As a surgeon I look for bad anatomy and I don’t see any bad anatomy in you.” How could we possibly not have a diagnosis after a year and a half? Am I making this up? Is there really nothing wrong with me? Naturally, I asked for a second opinion and a few more weeks later I was at a new doctor again, hoping for better luck.

Finally, I found someone who knew exactly what they were looking for. He was a sports medicine specialist, which in hindsight makes a ton of sense because this is more frequently an athletic injury. Within minutes of me explaining my symptoms, he laid me on my back, brought my leg back into my chest, and prepared me, “OK pay attention to what I’m about to do.” He extended my leg and said, “Did you feel that click? That’s your femur pinching the piece of the labrum you tore and is the source of your pain.”

Finally, an answer to the question that had been bothering me for almost two years.

I don’t entirely understand everything but essentially the shape of my femur predisposed me for this to happen upon injury. However to repair the labrum and prevent this from happening again in the future (and potentially some arthritis down the line) the solution was one I was expecting yet one I didn’t want to hear — surgery.

The reality is that I am young and the pros outweigh the cons because of how much my daily life has been impacted. At this point, any amount of physical activity apart from walking to the mailbox completely was ruining the subsequent days with pain. Even driving my car is liable to put me my leg in peril. Unfortunately it was the only thing left for me to do.

Because I haven’t been able to enjoy many physical activities, naturally as a gamer it has given me an excuse to play more video games. I have played a ton of my favorites: Path of Exile and Escape from Tarkov. But I’ve also been playing a fair amount of Hearthstone Battlegrounds and before you judge me— I play it the game predominantly focuses on your ability to strategize with future planning and there is very minimal APM-related success. It’s the perfect game to play if you’re looking to sit in bed on your iPad and relax. Well..except for one part.

The mechanic that players typically give the Battlegrounds flak for is the attack phase where you cannot directly control which of your opponents’ minions you can attack. There are several ways to account for the coin flips as well as ways to screw over your opponent, but ultimately it is theoretically possible for someone who is has a 95%+ chance of winning the round to lose. And I been there. And I have been mad.

Probabilities are something that are not entirely uncommon in gaming, especially when you look at RPG games which can feature hit rating, critical strike chance, block/dodge, ability proc’s etc. In fact, I bet there are far more probabilities in the games you are playing than you realize, however they probably don’t affect the outcome nearly as much. The point I am trying to get across is that no matter how much you prepare for your opponent, in the digital or physical realm, there is a chance that your best laid plans can completely fall apart even if you are favored to succeed. And sometimes those probabilities can severely impact the outcome of your game while others are completely innocuous.

The reality of any surgery is that there is no such thing as a 100% chance for everything to go exactly right. Even in my situation, they could potentially cause me some trouble by nicking something they aren’t supposed to, staph infection while I’m healing, it could be made worse. And as with all surgeries, there is also a chance that I have a bad reaction to the anesthesia. Or even that I could have such severe complications that I don’t make it. Just like with battlegrounds, there’s always a small chance that an undesirable outcome could occur.

I think if there was any other way to get consistent relief, I would much prefer to go down that route because the whole concept of surgery is horrifying to me. Not only is someone cutting you open, but anesthesia is designed to ensure that you have no recollection of what happens. It’s purpose is to place you in a state of nothingness so that someone can slice a hole in you and mess around with your insides. I’m sure my doctor will do a little more than mess around in there, but you get the idea.

Logically, I should be confident that the surgery will go just fine because the odds that they do something that causes complications are very low considering the location and type of surgery that I am getting. But as I’ve mentioned those odds are not 100% and that is causing me severe anxiety. Aside from the obvious loss of control by placing my life in someone’s hands, the fact that positive results aren’t guaranteed has been in the back of my mind for some time now. I am completely aware of how dramatic this sounds, but my brain deeply dislikes anything short of 100% certainty even in my day to day life. My boss could attest to this as we have talked about it on numerous occasions!

The other portion of surgery that frightens me is the state of nothingness that you float into when you go under the effects of anesthesia. I went under for a smaller procedure and to get some teeth pulled, but I was younger and way less aware of my consciousness and what it means to exist — or to not exist. A state of nothingness raises all sorts of questions in my mind about the spark of life that my brain sends to my body.

However, to me, it is anything but liberating. For me the concept of achieving nothingness raises it’s own set of questions that no one has a clear answer to. What does it mean to be alive? Are we simply a spark of electricity that ignited in our mother’s womb? What happens when we die? Is it more nothingness? If I’m out during surgery would I even know if something happened?

Consequently, there is a piece of me that wishes I had a stronger belief in religion because I feel that faith gives us the answers that we don’t have scientific answers to. Science would have us believe that we are simply a spark or an electrical impulse and once that spark fades we are nothing. But religion has promises of life after death and I imagine during times like these, it would be rather comforting to have faith in an afterlife should the worst come to pass so that I can see the people whose presence is sorely missed in this world.

However, as I’m writing down my thoughts on all of this one thing is abundantly clear — I actually should have faith. Faith in my surgeon to get in and get out without any mistakes. Faith in myself for coming out the other side. Faith in myself to heal and make a full recovery so that I can enjoy all of the things that I want to enjoy once I am pain-free. These are things to believe in.

I don’t think that my anxiety will ever be squashed to the point where I can enter the outpatient center with a clear head and ready for someone to cut me open. But hopefully I will emerge from my anesthesia-induced coma with a greater sense of being, knowing what it means to experience nothing for a few hours.

Plus, if I don’t get to experience the new Tarkov wipe on my brand new PC because something went wrong, my spirit will be soooo pissed.

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