A Likely Death...Or Not?

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In June 2013, Ray Dalio found out from his physician at John Hopkins Hospital that he has a disease called Barret’s esophagus with high-grade dysplasia. Basically, that means he has early-stage cancer in his esophagus (throat). If it develops into real cancer (about 15% chance), then they would have to remove his esophagus. Unfortunately, Dalio’s case had complications that prevented such a surgery, which means he would die within 3 to 5 years.

Dalio started planning for his death, but he also wanted to learn from other experts aside from his doctor. As a billionaire, Dalio is able to get access to the best doctors in the country, so he got his physician to set up visits with four other experts on this disease.

The first expert was the head of thoracic surgery at a major cancer hospital. She told Dalio that contrary to what his first physician said, there is a surgery that could cure him. However, that surgery would have a 10% chance of death and a 70% chance of a crippling outcome. But chances are, he would live, so she recommended the surgery.

Dalio, being the humble and careful person he was, decided to call his first physician from John Hopkins right there on the spot and have the two experts discuss. He noticed the two experts were very focused on being courteous to each other, and he was concerned that they weren’t prioritized about finding the best solution. Still, it was clear that they had different views, and listening to them helped Dalio understand the situation better.

The day after, Dalio met with a world-renowned specialist at another hospital. This doctor told him that his condition would basically be no problem as long as he went to the hospital for an endoscopic examination every 3 months. The doctor explained that if they can cut out new growth of cancer cells before it metastasized into the bloodstream, then he’d be okay. In other words, he wouldn’t die if he got the cancer; His life would be pretty normal except for the occasional hospital visits.

Dalio reflected that over the past 48 hours, he had gone from a likely death sentence to a likely possible cure that would likely cripple him, then to a simple and slightly inconvenient cure. Which doctor was right?

Dalio and his first physician met two mother world-class specialists, and they both agreed with the third doctor about the scoping procedure, so Dalio agreed to do it. They clipped some tissue from his esophagus and tested it in the laboratory. Later, they found out there wasn’t any high-grade dysplasia at all!

From this experience, Dalio reflected on the importance of checking information against multiple experts to raise your chances of finding out the truth.

Source: Principles by Ray Dalio