The art of triangulation
Getting opinions that count, "believability," and escaping my children.
Opinions are everywhere, but thoughtful reasoning is rare. This applies to the internet and to conversations with your doctors, and became crystal clear as I navigated conflicting medical advice about my thyroid tumor.
After Sinai recommended removing my thyroid—the standard protocol—I began a quest not just for different opinions, but for the reasoning behind them. I spoke with:
A Cornell doctor known for minimally invasive "ablation" techniques (verdict: tumor too large)
A Columbia doctor running clinical trials (requirement: must be definitively benign)
A Tulane doctor known for treating large indeterminate tumors like mine (possible, but not covered by insurance)
A German doctor who routinely treats cancerous tumors of any size (definitely not covered by insurance)
I never planned on this medical odyssey, but each conflicting opinion led to deeper questions for the next doctor. When one warned that ablation could dangerously spread potential cancer, two others explained this risk applied to only one specific technique—and was theoretical, never documented. I worried that the cash-pay options might be sketchy money-making schemes, yet their detailed explanations often made more sense than the protocol-driven responses I got elsewhere.
The breakthrough came when I brought my accumulated knowledge back to the Cornell doctor. He asked if I was a medical professional, impressed by my questions. While reiterating that the standard of care protocol recommended thyroid removal, he listened intently as I shared what I'd learned about ablation from Tulane and Germany. Instead of dismissing these alternatives, he engaged with their reasoning. By the end, he said something that changed everything: "You know, you've given me a lot to think about. Thank you for the interesting conversation."
This was the validation I needed. As a mother of two small children, I couldn't afford to be reckless, especially with cancer in the equation. What the Cornell doctor effectively told me was: "While I must recommend the standard of care, your reasoning is sound." Sometimes the most valuable medical opinion isn't an opinion at all—it's acknowledgment that you're thinking clearly about your choices.
I decided I was going to go with the Germany option, and went into the holidays at peace with my plan.
Believability-weighting
My brief stint at Bridgewater—the world's largest hedge fund—taught me two key ideas that unexpectedly became my guide for medical decisions:
Triangulate your view with believable people who are willing to disagree.
Weight opinions based on the credibility of their reasoning, not just the conclusion.
In other words, when facing a high-stakes decision, don't just collect different opinions—analyze the reasoning behind them. The majority opinion isn't always right; what matters is the depth of thinking behind each perspective. You should weight their opinions based on how believable their track record and reasoning is.
This principle shaped how I approached each doctor consultation. Instead of just asking what they would do, I pressed them on their reasoning. When one doctor warned about ablation spreading cancer, I took that concern to other experts, uncovering that this risk was theoretical and specific to just one technique. When doctors gave protocol-driven answers, I asked them to explain the logic behind the protocol.
The most valuable responses weren't the opinions themselves, but the moments when doctors engaged with my questions and acknowledged the limits of their certainty. That Cornell doctor, impressed by my research, didn't change his official recommendation—but his willingness to engage with alternative approaches and admit I'd given him "something to think about" told me more than any single opinion could.
Highlights of the week
Kid-free getaways: it was my birthday on Monday and we left the kids behind for a Sunday night away upstate. I’m not going to pretend that one night is the same as a vacation, but when it’s a Sunday night, and you take Monday off of work, it’s a special type of indulgence with the thrill of playing hooky on all your regular responsibilities. And double fisting bone broth and sencha before a sauna and deep tissue massage? Perfection. And maybe the woo content you’re really here for :)
Song of the week: I was in one of those gourmet food stores that sells $9 chocolate bars and this version of Bulletproof by FARR came on and it’s just so good? (And so was the chocolate!) A nice anthem as we army crawl our way out out of February.
The gift of confidence: I enrolled Miles in after-school Taekwondo, mostly so our nanny had somewhere to take the kids indoors after school during these frigid temps. Marco and I never did martial arts as kids, and definitely don’t aspire to raising a “fighter,” but I’ve been shocked to watch his confidence explode in just 2 short months. He went from walking into his classroom at school timidly with eyes drawn, to announcing “Hello everybody!” as he traipsed across the threshold. Could be a coincidence but I’m claiming victory.
An average doctor will give you their opinion, and it will generally be based on a rules-based protocol. An excellent doctor will bring you along to their reasoning. I’d love to hear from any doctor readers out there on what’s coming up for them as they read what I’m writing. Our broken system is not their fault, and there are valid frustrations on both sides.
In next week’s post, I’m going to get more into what is woo, and share some of my reflections on the stories I’ve received from you all so far.
Take care out there!
Joanne
Love these posts Joanne! Bravo to you!
As a doctor, and I mean this respectfully, I will tell you doctors are rarely the smartest person in the room. They know a lot about one particular thing and most of that knowledge is gained from their training and in large part dependent on the mentors they had during training and the scope of their practice.
Unfortunately most doctors get stuck in the rut of practicing medicine ( driven by our healthcare/insurance system that too often rewards quantity over quality), as a result I would argue many don’t know about new treatment options and hence stick with the protocols that they were trained with and they stick with it - like biblical gospel.
All that to say I applaud your approach, self advocacy, and research. Hopefully someday in our young children’s lifetime US healthcare and doctors will wake up.
And while also a liberal and vaccinated I too applaud the vaccine debate and don’t understand why asking questions in America has somehow become a bad thing .
I love that you incorporated your learnings from the hedge fund days into your life in a positive way. I recently found myself doing something similar. While working for a startup focused on hyper growth (typical) my manager impressed upon me the value of making progress 1% at a time. I’m trying to bring that with me through postpartum depression…. Trying to get better 1% each day. 100% is insurmountable but I can do 1%.
Always looking forward to your next post!