By NapoleanDynamite, Guest Writer
In 2010, I was finishing residency and about to take on my first job that would pay me a whopping $150,000 salary for my first year of work. That was more than triple the salary I made in the final year of my residency! I was excited to finally be “making it”—I’m sure many of you have had similar feelings—but I knew absolutely nothing about personal finance.
Luckily for me, one of my attendings at the time was about to retire at age 54. All of the residents and many of the other attendings questioned how he could afford to retire so early. He then introduced me to The Coffee House Investor. That became the first financial investing book I would read. From there, I learned about the Boglehead forum, which then introduced me to this guy named The White Coat Investor. I’ve been a loyal WCI follower ever since, and I am proud to say that I have read or skimmed every blog post since then.
Some of you may know me already as NapoleanDynamite. I have written one post in the past, and I also have a long-running thread about Bitcoin on the WCI Forum. I have learned a lot along the way, and I greatly appreciate the work Dr. Jim Dahle and his team do in educating those of us white coats who graduate medical school/residency with zero knowledge of personal finance. We don’t always agree (Bitcoin, oil investments, trading individual stocks, etc.), but I have always appreciated his perspective.
Establishing a Strong Financial Foundation
Some of what we've agreed upon are a high savings rate, low time preference behavior, and having good insurance. At one point, I almost bought whole life insurance . . . but Jim’s constant harping about it saved me from that mistake. It was strongly encouraged by WCI that I purchase long-term disability insurance, have an HSA medical insurance plan and use it as a Stealth IRA, and get good term life insurance policies for myself and my wife. We did all of these things very early on in our investing career. Making those uber-expensive long-term disability payments over the years has been painful. However, we have also saved and invested >50% of our earnings starting in 2010. The “live like a resident” mantra worked well for us.
It turns out that living like a resident and having a sound personal financial plan would be important a lot sooner than I expected, because 2023 would be the year that I learned I have a brain tumor. Since it isn’t the first time I've had a tumor (I had testicular cancer in medical school 18 years ago), it wasn’t as big a shock to me as it would probably be for most people. But more to come on that in a moment.
In 2012 and 2015, my wife and I welcomed our two children. Thankfully, they have both been healthy. But it added an extra wrinkle to our financial lives. After they were born, we had to form a living trust and start saving for possible college. We loaded up on those 529 accounts. In 2013, I also got the opportunity to buy in to my medical practice. After seeing my income grow from $150,000 to $350,000 over the first three years, everything was going just as I had hoped. After three more years of paying my way into the practice, my income quickly swelled from $350,000 to more than $1 million dollars. I would have never dreamed of that much money in medical school. I’m not going to lie. It felt awesome!
More information here:
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Growing into My Increased Income
Along the way, I slowly grew into my new income. However, my wife and I have always been big savers and fairly frugal people. Although I did buy that brand new Tesla back in 2013, I still drive it to this day with over 130,000 miles on it. We also increased our retirement savings significantly over that time by maxing out all 401(k)s, Roth IRAs, Stealth IRAs, taxable retirement accounts, private real estate funds, and a few extra investments. Despite reaching financial independence by 2020 at age 42, we still maintained all of our insurance. I still enjoy my work and do it full-time, and my wife still works about 25-30 hours a week as a physical therapist because she enjoys it. Long story short: we worked hard, we saved hard, and we learned a lot along the way.
Although my wife has always been a frugal person (more so than me), which has helped us immensely with our saving goals, she has always hated learning about personal finance. So, I have been the one who does all of our financial planning and investment work. Even though we found a method that worked for us, I was always worried about the downside risk. What if I got into a car accident and died? How much time and effort would she have to put in to find all of our money? Would she even be able to find it all? It would be a mess.
Despite my concerns, we just kept moving forward without this one key safeguard.
Our life was on track, but in the fall of 2022, I started experiencing some weird things. I intermittently had some strange dizziness/vertigo-like symptoms. I felt like I couldn’t run as far as I normally do (I run about 15 miles a week), and I couldn't work out on my Peloton like normal. A couple of times, when I got out of bed in the morning, I almost fell over. Once, while I was in the middle of my Peloton ride, I almost passed out and fell off the bike. Although I have always been very healthy (with the exception of the testicular cancer), I decided to get a workup.
I mostly ignored my symptoms until I saw my PCP in December 2022. My blood pressure was doing weird things while in the office. While lying flat, it was 130/85, but when I sat up, it shot up to 170/100. We went down a metabolic workup pathway to try and ensure I didn’t have anything weird. Cortisol levels were normal. Thyroid levels were normal. We even did a 24-hour urine test for catecholamines for possible pheo. Everything came back normal.
I cut out all caffeine for six months and monitored my blood pressure (it has remained at about 125/80 off the caffeine). But my symptoms never fully abated. I also realized that the yoga I do for my back and neck made my symptoms worse.
Finally, in April 2023, I decided we needed to get a more complete workup. It was time to get an MRA/MRI of the brain and neck and also start down the cardiac workup pathway. Because of timing, the MRA/MRI was done first. My schedule, like most docs, is pretty hectic, so I got the scans done at noon on a Saturday. Since I didn’t want to wait and get the read done on Monday, I walked down the street to my neighbor’s house who is a local neuro-radiologist. We sat down at his monitor in his house. The MRA was perfectly normal. When we were going through the MRI read, he said, “Hmm, I think I see something.” He was surprised since, as he stated, he had done many reads for friends and never found anything. Unfortunately, I had a very weird mass near my thalamus. It was approximately 1.8 centimeters in diameter, and it didn’t look like anything malignant—or look like a metastasis from my prior cancer. But he couldn’t identify what it was.
Since I have had a cancer diagnosis given to me before, I wasn’t that traumatized. Still, lots of stuff floods through your mind when you find out you have a possible brain tumor. The first of which was to call my other neighbor—the neurosurgeon who is the head of the local tumor board in my region. (It sure is nice to have doctor friends!) I called him on Sunday at noon. He told me he would review all of the scans and speak with the other neuro-radiologists in town. I could see him the next day at noon in his clinic.
In a matter of 24 hours, my life had changed. All was going well, my career was humming along, my family was good, and I was financially secure. Now, I had to think about surgery for a mass on my brain stem with the possibility of becoming incapacitated or, worse yet, dead after surgery.
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Making Sure Our Financial House Was in Order
I’m not all that emotional with things like this, and I tend to run on the overly logical spectrum. My first thoughts were:
- “What if I can’t work after surgery because I lose some of my mental or physical ability that prevents me from doing surgery?”
- “What will we do for income moving forward?”
- “What if I can’t even tell my wife where our money is located?”
The balloon had popped. It was time to get my wife involved in our finances—whether she wanted to or not. Rapid trial by fire was going to have to work for her.
Unlike many do-it-yourself Bogleheads and WCIers, I still have a financial advisor. He has relatively low fees and has helped add value to my portfolio by searching out some great private real estate funds. Because of this, my wife’s learning curve would be slightly easier. We immediately set up a meeting between our financial advisor and my wife and me. It helped get her somewhat on board. But I still had additional investments set up that she had no idea how to access. Our kids' 529 college funds, some real estate, a trading “fun fund,” our large allocation of Bitcoin in cold storage, and a venture capital fund are just a few of the things that neither our financial advisor nor my wife could easily access. Over the course of a week, it was time to get all of these things straightened out.
For the sake of brevity, I will just say that we got in gear and accomplished many things over the course of 1-2 weeks. And although my wife has no desire to become a personal finance expert, she at least will have an easier time finding all of our various investments if she needs them. We are also very happy to have that expensive long-term disability insurance we have been paying for over the past 14 years.
And now for the good/semi-good news. After meeting with my neurosurgeon and the tumor board, they all agree that this mass on my thalamus is most likely either a very benign tumor that may not need surgery for some time or an incidental congenital/trauma finding that is unrelated to my symptoms. As of this writing, I am undergoing a more complete cardiac workup and audiology workup to see if we can find another source of my symptoms, and I will continue my follow-up for this brain mass.
I hope my experience helps highlight many of the reasons to get your financial house in order at a young age. I have done many things right over the years but obviously made a few mistakes along the way, as well. The biggest was obviously not having my spouse on board. Either way, there is always room for improvement and reassessment of our financial situations and financial life. As life changes, we must adapt and change with it. And as I like to say, prepare for the worst and hope for the best!
Is your financial house in order in case you or your partner is no longer around? What have you done to plan around this? Comment below!
[Editor's Note: NapoleonDynamite is an anonymous US-based surgeon. This article was submitted and approved according to our Guest Post Policy. We have no financial relationship.]
