I despise the very concept of mortality. That everything we were, are, and can be comes to a crashing close at some arbitrary deadline. I’ve never been one to accept someone telling me to do something just because “that’s the way it is”, and I feel pretty much the same way about death. Having seen far more than my fair share of it, I consider it nothing but random and capricious.
For those that follow Twitter, yesterday afternoon mortality bitch slapped me upside the head. I found out that my cholesterol is two points shy of the thin black line that defines “high”. Being thirty seven, a lifetime athlete, and relatively healthy eater since my early twenties, my number shouldn’t even be on the same continent as “high”, never mind the same zip code. I clearly have my parent’s genes to blame, and since my father passed away many years ago of something other than heart disease, I get to have a long conversation with mother this weekend on her poor gene selection. I might bring up the whole short thing while I’m at it (seriously, all I asked for was 5’9”).
I tend to look at situations like this as risk management problems. With potential mitigating actions, all of which come at a cost, and a potential negative consequence (well, negative for me), it slots nicely into a risk-based approach. It also highlights what is the single most important factor in any risk analysis- integrity. If you deceive yourself (or others) you can never make an effective risk decision. Let’s map it out:
Asset Valuation – Really fracking high for me personally, $2M to the insurance company (time limited to 20 years), and somewhere between zero and whatever for the rest of the world (and, I suspect, a few negative values circulating out there).
Risk Tolerance – Low. Oh sure, I’d like to say “none”, but the reality is if my risk tolerance was really 0, I’d mentally implode in a clash of irreconcilable risk factors as fear of my house burning around me conflicts with the danger of a meteor smashing open my skull like a ripe pumpkin when I walk outside. Since anything over 100 years old isn’t realistically quantifiable (and 80 is more reasonable), I’ll call 85 the low end of my tolerance, with no complaints if I can double that.
Risk/Threat Factors – Genetics, lifestyle, and medication. This one is pretty easy, since there are really only 3 factors that effect the outcome (in this dimension, I’m skipping cancer, accidents, and those freaky brain eating bacteria found in certain lakes). I can only change two of the factors, each of which comes with both a financial cost, and, for lack of a better word, a “pleasure” cost.
Risk Analysis – I’m going to build three scenarios:
- Since some of my cholesterol is good to normal (HDL and triglycerides), and only part of it bad (LDL and total serum), I can deceive myself into thinking I don’t need to do anything today and ignore the possibility of slowly clogging my arteries until a piece of random plaque breaks off and kills me in excruciating pain at an inconvenient moment. Since that’s what everyone else tends to do, we’ll call this option “best practices”.
- I can meet with my doctor, review the results, and determine which lifestyle changes and/or medication I can start today to reduce my long term risks. I can reduce the intake of certain foods, switch to things like Egg Beaters, and increase my intake of high fiber food and veggies. I’ll pay an additional financial cost for higher quality food, a time cost for the extra workouts, and a “pleasure” cost for fewer chocolate chip cookies. In exchange for those french fries and gooey burritos I’ll be healthier overall and live a higher quality of life until I’m disemboweled by an irate ostrich while on safari in Africa.
- I can immediately switch to a completely heart-healthy diet and disengage from any activity that increases my risk of premature death (and isn’t all death premature?). I’ll never eat another cookie or french fry, and I’ll move to a monastery in a meteor-free zone to eliminate all stress from my life as I engage in whatever the latest medical journals define as the optimum diet and exercise plan. I will lead a longer, lower quality life until I’m disemboweled by an irate monk who is sick of my self righteous preaching and mid-chant calisthenics. We’ll call this option the “consultant/analyst” recommendations.
Risk Decision and Mitigation Plan – Those three scenarios represent the low, middle, and high option. In every case there is a cost- but the cost is either in the short term or the long term. None of the scenarios guarantees success. This is where the integrity comes in- I’ve tried to qualify all the appropriate costs in each scenario, and don’t try and fool myself into thinking I can avoid those costs to steer myself towards the easy decision.
It would be easy to look at my various cholesterol levels and current lifestyle, then decide that maybe if I read the numbers from a certain angle nothing bad will happen. Or maybe I can just hang out without making changes until the numbers get worse, and fix things then. On the other end, I could completely deceive myself and decide that a bunch of extreme efforts will fix everything and I can completely control the end result, ignoring the cost and all the other factors out there.
But if I’m really honest to myself, I know that despite my low tolerance for an early death, I’m unwilling to pay the costs of extreme actions.
Thus I’m going to make immediate changes to my diet that I know I can tolerate in the long term, I’ll meet with my doctor and start getting annual tests, and I’ll slip less on my fitness plan when work gets out of control. I’m putting metrics in place I can track over time, taking a programatic approach, and not pretending I can control everything or completely eliminate the risk. If those changes aren’t enough, I’ll re-evaluate them to build a more effective program and consider investment in medication.
Here’s the secret of risk management- integrity. No risk framework, quantification scheme, or qualitative approach can ever compensate for self deception. Nearly every major risk analysis failure comes down to someone, somewhere, (if not everyone) closing their eyes and skewing the system to give a desired result. And the higher the stakes, the more likely we are to fool ourselves.