Thursday, June 21, 2007

Three Life and Trading Lessons From a Personal Crisis

I was in Vermont on a family reunion and had just picked up a couple of snacks for the hotel room. Oddly, I couldn't find them when we returned to our resort. Only later in the day did I realize that they had been left in a storage compartment in our Jeep. I quickly took them out. One item was a container of egg salad. I didn't want that to go bad.

I didn't know it at the time, but I was 48 hours away from a medical emergency that could have been fatal.

The trip home from the reunion was not pleasant. It started with a small stomach ache in the morning and then became a fever and then developed into nausea. I was sick through much of both legs of the trip. By the time I returned to my Naperville home, however, the fever had subsided and my nausea was gone. All that was left was some stomach cramps. It was food poisoning, I reasoned, and the egg salad was the likely culprit.

Monday morning, and I'm scheduled for a flight to NY to meet with hedge fund traders. Still some cramps, but no fever, no nausea. I debate whether to call off the trip, but decide I'd rather not alter my plans. It was a fateful decision that would land me in a hospital.

The Monday meetings went well, and I took a car from the trading firm to my airport hotel. By this time the stomach pain had moved to a more specific area: the lower right side of my abdomen. I was increasingly concerned that this was appendicitis, not food poisoning. I checked into the hotel, took a look around my room, and turned right around with my bags. I asked the hotel clerk for the nearest, good hospital. She called a cab for me and away I went.

I've never seen neighborhoods like the ones the cab went through. Most of the signs on the stores were in languages other than English. I truly felt as though I was in another country. One sign alerted me to my location: Jackson Heights, Queens. Shortly after, the car dropped me off at the emergency room. There were few places to sit in the triage area; people with everything from primary care problems to broken bones to heart ailments to gunshot wounds came through here. I was the only Caucasian American in sight.

The pain grew over the next hour of waiting, and I alerted the triage nurse. She became interested in me when I told her I taught at a medical school and worked with ER staff. She moved me to the head of the queue, and I was wheeled into a holding area. A medical resident asked me questions, and now I felt on familiar turf. I explained my own medical background and why I thought the symptoms might be appendicitis.

Two hours later, I was interviewed by the full medical team, and two hours after that I received a CT scan. A friendly surgical resident with great bedside manner delivered the news: acute appendicitis. I would not be making my flight home. An hour later, I was in surgery.

It turned out, the surgeons told me, that the appendix was not merely infected, but actually gangrenous. Two-thirds of the tissue was already dead. The organ was "tissue thin" when they operated, a situation that could have spread bacteria throughout my body cavities and led to peritonitis.

Recovery was slow. Once again, I found myself the only native English speaker on the floor. The staff didn't ask what insurance I had; they asked if I had insurance. Police guards were placed throughout the hallways; many patients were loud and disruptive. Just about every bed was filled; my room was one of the few with vacancies. The nursing staff was continually on the go; it was clear that, in this community hospital committed to serving everyone, there just weren't enough hands to go around.

Still, the staff was extremely supportive. There were a number of mistakes in the system: I was brought meals that weren't appropriate for post-surgery, and I was not given the IV antibiotic the surgeon had recommended. When I called these items to the staff's attention, they eventually were remedied. When my roommate arrived--an engaging man who described himself as having major psychiatric problems--similar oversights led him to become extremely agitated. I told the nurses that I was a psychologist, and I explained how they could calm the situation. They did so, and I wound up with an excellent and appreciative roommate.

As I got on my feet, I wandered the floors and met many patients and staff: a kind man from Colombia who also had his appendix removed; an Irish security guard who told me of his own recent hospitalization and confided his frustration with the overwhelmed health care system; a third year medical student who went out of her way to find out how I was doing; a graveyard shift nurse from Poland who found a friendly way to wake up patients in the middle of the night for their care; a clearly burned out nurse from India who withheld simple comforts from a disruptive patient. After a while, I stopped noticing people's nationalities. We were all in this together.

By Wednesday I was ready to leave, and I flew home on Thursday. The outpouring of support from blog readers, friends, and family members was incredible. Several times I found myself on the verge of tears. I hadn't really eaten much in several days, and I hadn't stepped outside from Monday evening through Wednesday afternoon. Food tasted unusually good; the sky seemed especially blue. I was grateful to be alive and to enjoy these simple pleasures.

Perhaps the strangest experience of all, however, followed my release from the hospital. I needed to get a prescription filled, and the local pharmacy wouldn't take my insurance. The nearest Walgreen's pharmacy was 14 blocks away. Without hesitation, I shuffle-walked the 14 blocks through a neighborhood that only days before would have struck me as incredibly menacing. Again, I was the only Caucasian within view. But I had no problem with the walk or communicating with the helpful Asian clerk who worked everything out for me so that I could have my pills. By this time, I was part of the neighborhood.

So what are the life (and trading) lessons to be taken from all this? A few stand out for me:

1) A Little Knowledge Can Be Dangerous - I minimized my problems initially, sure that I had food poisoning. Only when I revised my view could I get the help I needed. If you're losing money in the markets, maybe it's a chance unlucky streak and a temporary phenomenon. But if it continues, make sure you consider alternative explanations--including the possibility that your trading ideas or methods are fatally flawed. Above all, be open to signs you're in trouble. I walked away from my hotel room when it was clear my pain was localized. When losses exceed normal drawdowns, go into defensive mode. It's the low-odds/high-risk events--those fat tails of risk--that can get you when your reasoning is following a normal distribution curve.

2) Advocate For Yourself - I'm sure some people at the hospital received excellent health care; I'm sure others did not. In a situation in which limited resources had to be devoted to the most pressing problems, many routine--but important--issues were sidetracked. The patients who received the best care were also the best self advocates. If you're an investor or trader, never assume that others will provide you with the tools and techniques you need for success. You'll only get out of forums, blogs, coaches, and seminars what you actively pursue and seek.

3) Networking Is Your Best Survival Tool - In a world of limited information and resources, you're best off networking with everyone who you can help and who can help you. I continually saw patients and staff help each other: it was in everyone's interest to share information and help each other out. Once I got that, the differences of culture and socio-economic class faded into the background. For traders, it means that knowledge is a social process; expertise is distributed. I "give away" information through my blog, but receive far more from like-minded readers.

I was in a multibillion dollar hedge fund working with traders; hours later I was in the holding area of a community hospital ER. Instead of walking Greenwich Ave., I hiked 14 blocks on Roosevelt Ave. Life is fragile; there are many twists and turns, and sometimes those offer life's best lessons. If you find yourself in an uncomfortable life situation, consider the possibility that you're meant to be there; that you can only expand yourself when you travel outside your comfort zone.

My deepest thanks to the fine professionals at Elmhurst Hospital Center. Many, many people in the schools, clinics, airports, and fire/police forces all across this country are quietly giving their best with strained resources. Theirs is a heroic story that deserves to be told.

And thanks again for all the warm support--