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The Slim shady year, part three

Next time you see a brother down
Stop and pick him up,
Cause you might be the next one stuck
– Grand Puba, Mind Your Business

I’ve written parts one and two before.

Around week 5 out of 12 I had allocated to my 2018 Basel stay, it was getting increasingly clear that in addition to the original muscle problem I came to fix, there was another, the larger monster lurking around the corner.

I was going through rapid, uncontrolled changes in my muscle function and tightness. I was intensely determined to figure out a pattern that would give my team in Basel and me a clue. I was constantly experimenting with activities and monitoring (subjectively) my muscle tightness. I also added JP Meersseman from Como as an external counselor.

To my horror, the more we looked, the more mysteries we would uncover. For example, here’s what I wrote in my week five notes:

We did “sinking into fingers” during neck massage, which triggered an unexpected reaction: the skin over my right quad became numb. I discovered this by accident and got spooked due to a strong numbness. It went away after a few minutes, but Fabienne took a note. It is significant.

It was a particularly eerie moment: I was literally losing sensation in my leg. This episode motivated me to try even harder to find at least some clues. The life advice commonly shared is that focus often trumps everything else. What people discuss less often is that focus can become manic.

I would wake up in the morning and fill out “tension scores” in a table I made myself to monitor daily changes. The key idea was to combine somewhat objective, numerical scores with a column of subjective word commentary on what I did that day and then aggregate the data over time with the hope of finding an if-then-that link. It was a great system — I could unquestionably see that my adductor tension is becoming more frequent and unpredictable. And while the use of pen and paper to work out the trend panned out how I intended it (by writing it down, you see more), the reality of being hyper-focused on the tiniest issues was insufferable. For example, I would walk into the bathroom feeling okay, and while brushing my teeth, a strong tension would kick in, and a wave of questions would rush through my self-talk:

  • is this real, or I’m becoming paranoid?
  • Or did I stand a little off?
  • Maybe my pelvis was rotated in these last two minutes, and I was careless?
  • Could it be an issue with that JP Meersseman mentioned on my last trip to Como?
  • and so on, so on

I was desperately trying to pick up even the most subtle signals. My focus was becoming manic.

On top of that, a disappointing realization would follow: if this doesn’t go away, then we can’t do much at my physical therapy today; we’ll do some fire-fighting, and I’ll see no progress.

Fabienne did fire-fighting that day. It was clear that muscle tension turning on and off like via a light switch indicated this is not a muscle problem but a muscle control problem. In computer terms, it appeared that I didn’t have a hardware problem but a software bug.

It was a complete mystery how I could start with a relatively simple mechanical issue with my semimembranosus muscle, and over time acquire a debilitating tightness and an occasional spooky quad-area numbness. I convinced Fabienne to continue brainstorming. I had six weeks left in Basel, and my hope for recovery was gone by then; my new target became an accurate diagnosis.

In addition to my Como trips to see JP Meerseeman, Fabienne suggested trying to work with Luca, another physical therapist at Rennbahnklinik who was interested in the intersection of physical therapy and neurological disorders.

Luca’s view of the body’s kinesthetic system was through the lens of three intertwined systems: physical (muscular), visual, and inner ear. The idea is that these influence each other, and difficult-to-pin-down conditions might have an origin in their interaction. During the first session with Luca, we went through a series of diagnostics that I mentioned in my old week 5 and week 6 notes, so I’ll skip covering them again.

We examined many weak clues that ultimately didn’t lead us to any conclusion. However, the discovery of visual suppression firmly stood out and warranted further study. I described this specific event in detail in part 1 of this series. The conclusion: nothing to see here. Another branch of the hypothesis tree turned out to be a dead end.

Luca was a fan of the Z-health program (another spin on the interplay between muscular and neurological systems), but he said he just started diving into it, and my case topped difficulty charts. He suggested I reach out to Michel Pham — to Luca’s knowledge, the best Z-health expert in Switzerland and maybe Europe (they weren’t that many of them). After a quick intro, Michel agreed to see me, and I was off to Zurich, where he had an office. During the first meeting, I quickly concluded that Michel Pham is on the far end of alternative medicine. He assessed that I have a combination of a mispositioned pelvis, a back tension (connected to the mispositioned pelvis), and TMJ fracture residuals. That was in line with what I heard from JP Meerseeman and what Fabiene observed. My confidence in Michel’s methods weakened due to his inability to credibly explain the two distinct features of my issues: rapid on/off switch for my muscle tension and numbness in my quad area.

I decided to give Michel the benefit of the doubt, though —rarely in medicine, the situation is clear-cut. We had a setup where Michel would be doing diagnostics (in practice: eyeballing my gait and tactile sensing of my muscles) and recommend exercise sets we would do with Luca in Basel. I had made a couple of trips to Zurich and have experienced modest improvements that didn’t feel like we’re influencing equilibria (i.e., they very much could have been noise). Unfortunately, I lost my Moleskine notebook with everyday notes from that period, so I can’t write a more in-depth account that I wish I would have written. I do remember that with the additional time passed, I didn’t get to hear much of a coherent story on my condition and how Michel would improve it. I accepted that Z-health wouldn’t help me.

As a side note: if you miraculously arrived at this blog post while googling for Z-health to find out whether that method/system has any merit to it, I don’t have a definitive answer. For all the talk about unlocking the last bits of the body’s performance, I couldn’t experience the benefits myself. My best take is that some aspects of what people call Z-health have real value, but its practitioners are overstretching the scope where Z-health applies. Having that said, there’s an enormous and underrated value to a neuro-muscular view of tension’s and pain’s origin, as I later discovered. Keep on reading this series if you want to learn more.

Going back to JP Meersseman, I commuted between Basel and Como for six weeks. On next visit, I shared with JP Meersseman that we’ve worked together for a while, my tension didn’t ease even one bit, and I was growing impatient. He responded he didn’t understand my problem, but he said he would send me to another chiropractor at his clinic, and he would join in a few minutes to brainstorm the next steps. He never showed up. That was my last trip to Como.

Both JP Meersseman and Michel displayed magnificent confidence they couldn’t back up with results.

Fighter’s State Of Mind

One of my favorite lines from Ben Horowitz is that the most difficult CEO skill is controlling your psychology. It captures the essence of the most difficult patient skill, too. Why do I mention CEOs and a boss-level venture capitalist in a post on a challenging health journey? To make a larger point: books helped me think clearly about my attitude during the recovery, especially when plans turned into crap.

When I fully realized my plans are in crumbles, I sought advice. In modern society, the implicit belief is to rely on experts. But what do you do about a highly complex and dynamic situation where experts say they have nothing else to offer? How do you find a way out? I talked about this meta-problem with friends: I didn’t know what to do next and whether there’s an angle I didn’t consider yet. One friend told me over the phone: “Grzegorz, you’re all alone in Basel, burning money on things that don’t work. I have a lot of admiration for you, but I think I would just have given up”. I appreciated my friend’s honesty, but it wasn’t what I wanted to hear. I’ve tried talking to others, and I ran into a huge frustration: nobody appreciated what it’s like to wake up with pain every day. You can quit a lousy job or toxic relationship, but there was no exit door for my pain. A few less thoughtful people would comment that I’m a spoiled dude looking for the world’s best doctor as a weird flex of hanging out with celebrities.

As my days were getting progressively darker, I decided to reach for a book I had read before about what to do in hard situations. It’s the Hard Thing About Hard Things by Ben Horowitz I mentioned earlier. It’s a business book that skips banality and cuts to the chase: what to do when nothing works. Many of my friends would visibly raise their eyebrows when I would tell them it was one of the most helpful books I read on how to think of my recovery. Here’s the classic piece by Ben on when an entrepreneur’s dream turns into a nightmare:

The Struggle is when you wonder why you started the company in the first place.

The Struggle is when people ask you why you don’t quit and you don’t know the answer.

The Struggle is when your employees think you are lying and you think they may be right.

The Struggle is when food loses its taste.

The Struggle is when you don’t believe you should be CEO of your company. The Struggle is when you know that you are in over your head and you know that you cannot be replaced. The Struggle is when everybody thinks > you are an idiot, but nobody will fire you. The Struggle is where self-doubt becomes self-hatred.

The Struggle is when you are having a conversation with someone and you can’t hear a word that they are saying because all you can hear is The Struggle.

The Struggle is when you want the pain to stop. The Struggle is unhappiness.

The Struggle is when you go on vacation to feel better and you feel worse.

The Struggle is when you are surrounded by people and you are all alone. The Struggle has no mercy.

The Struggle is the land of broken promises and crushed dreams. The Struggle is a cold sweat. The Struggle > is where your guts boil so much that you feel like you are going to spit blood.

The Struggle is not failure, but it causes failure. Especially if you are weak. Always if you are weak.

Most people are not strong enough.

Every great entrepreneur from Steve Jobs to Mark Zuckerberg went through The Struggle and struggle they did, so you are not alone. But that does not mean that you will make it. You may not make it. That is why it is The Struggle.

The Struggle is where greatness comes from.

Not only this passage better captured my soul’s wellbeing, but Ben also offered very actionable advice. “Don’t put it all on your shoulders” was the top one for me, someone who tends to believe I should deal with my problems on my own. Check out the whole piece: https://a16z.com/2012/06/15/the-struggle/; it’s great.

I listened to Ben and talked to my friends who live in Zurich about the whole situation. We went over my litany of things going wrong, and they wisely suggested that I take a break and we go for a hike together. I quickly accepted the offer. Conveniently, Swiss National Day (August 1st) was around the corner, and we picked it for a relatively easy hike on a ridge near Interlaken. Let share some views:

Riggenberg view

Down there is Riggenberg

Goldswil funicular train

A farnicular train from Goldswil

The hike was a true spirit lifter for the first half. The views were straight from a postcard, and we were going at a leisurely pace. However, once we crossed the ridge, my adductor tension started to rise suddenly. It became so strong that I began limping and losing my sense of balance. Then an acute pain kicked in, and I knew I was in trouble. I hoped it would go away, but deep inside, I was one with the pattern: once the tension kicks in, it persists until physical therapy eases it.

I told my friends about my pain and lost balance. We would have to take frequent breaks, and our pace floundered. We were at risk of catching late hours still on the mountain. The catch: my friends took their baby, less than a year old, for the hike (with a special backpack equipped for carrying small babies — a hyper Swiss thing to do). We had our safety margins on time on the mountain planned, but I could sense my friends getting nervous about the situation. The non-existent phone reception summoned an unspoken choice: either they leave me behind and call for help from the valley, or we would all be spending a night on the mountain, including the baby.

Fortunately, with the help of hiking sticks, I made slow but steady progress and descended together. However, on the trip that was supposed to cheer me up, I felt like crap. There wasn’t a more apparent sign that my condition was ruining my life. You can’t plan anything for the danger of being a let-down. After an experience like that, the next stage is when you quit planning with other people to avoid disappointing circumstances and turn a recluse.

Saddened and embarrassed for being a drag on the Swiss National Day celebration, I clenched my fists and relit my inner fire to do everything humanly possible to reverse my fate. The next day, looking for some inspiration, I picked up a second book. It was Viktor Frankl’s Searching for Meaning that I bought a year earlier and never read. Boy, was that a perfect fit.

On the surface, it seems like Viktor Frankl wrote a Nazi death camp memoir. However, the purpose of death camp stories is to build the case for his theory of logotherapy (named after “logos” — meaning). The central argument behind logotherapy is that our primary drive is not pleasure, as Fraud postulated, but the pursuit of what we personally find meaningful. Frankl builds its case on the extreme experience of death camps and argues that even under unthinkable duress, we can find meaning, and future orientation is what saves us from despair.

Needless to say, I was in despair of my own kind, and I devoured both the beautiful writing and the wisdom of seeing through the fog of personal struggle. In Frankl’s own words:

I had wanted simply to convey to the reader by way of a concrete example that life holds a potential meaning under any conditions, even the most miserable ones.

I want here to clear any suspicion: my debilitating muscle tension doesn’t compare to the experience of a death camp. Instead, reading stories of people who maintained longing for something larger than themselves, even under such extreme conditions, proved to be a powerful inspiration. If they did it, maybe I could too?

At the beginning of my 2018 Basel chapter, I primarily relied on pure willpower and trust in one of the best people in sports medicine in the world. When that didn’t work, and backup options in my immediate surrounding didn’t work either, I needed something more subtle than a power-through. I needed a philosophy of struggle, if you will. For me, Ben Horowitz and Viktor Frankl became chief advisers in the fight.

I didn’t realize this immediately, but both had the same thing to say: sometimes you need to create your own legend to keep going. I’d recognize that much later.

The side door

In part one, I mentioned the equally mysterious and famous doctor in Munich that was my next lead to try. Fabienne, my physical therapist who came up with the idea, warned me that he would be hard to see. She undersold the difficulty. With a few weeks of my sabbatical left, I thought of taking on the slim chance of scheduling a visit before my return to California. Naturally, I did the first thing one should do. I looked at the clinic online and called them. I went straight to a voice mailbox. A few hours later, the second call also reached the voicemail.

I also sent an email and got a reply the next day that there’re no appointments available for the doctor. At all. Obviously, that was not true. What I was being told: you won’t get an appointment through the front door.

By this point, I’ve read many early stories of people who had an outsized life. The overarching theme I got that, in critical moments, they had to rely either on luck or hustle. In my situation, luck would correspond to knowing someone who could introduce me to the doctor. Hustle would mean finding my way on my own through a side door.

I booked the flight to Munich and told Fabienne about it the next day. She asked me what my plan was, and I said I didn’t know yet. I just knew I need to find a way to see the doctor before I fly to California. I contined by saing I wasn’t sure he can help me, but I wanted to avoid second thoughts and what-if scenarios. In fact, I was applying the Regret Minimization Framework.

So what was my plan? It had two legs. One was to find a way to get an introduction to the doctor. Another one was to show up and sell myself as a patient. Let me start with the story of making my own luck — broadening my network and looking for an introduction. I knew the clinic was famous for treating top soccer players in the world and was associated with the German National team. I had a few friends who were athletes or friends of top-level athletes in Europe. I wrote to all of them, explaining briefly the whole saga and how the Munich magicians seem to be my last resort and asking for an introduction. Everyone replied, saying that, unfortunately, they have no way to help. Nobody knew the doctor directly.

While researching the clinic online, I stumbled upon a news story of Usain Bolt, the fastest sprinter on earth, who was treated in Munich, in the clinic I was trying to reach! Digging a lot more (and relying on the Google Books trick I mentioned earlier), I learned an astonishing fact: Usain Bolt was born with scoliosis and had been battling associated back injuries for his whole career. The fastest man on earth with scoliosis! I remember thinking to myself that moment that if Bolt could overcome such an obstacle, maybe there’s a vast space for me to explore. And at that moment, a crazy idea popped into my head: I would track down Usain Bolt’s physical therapist, try to reach him, explain the story, and ask for an intro to the doctor. It sounded far-fetched, but it was the best lead I had. In my mind, I was betting on an unspoken bond over the health struggle that Bolt and his team were deeply familiar with.

I identified the physical therapist and chiropractor Bolt worked with regularly in Florida, and a few hours later, I found both an email address and the phone number. Naturally, I wrote and called. The conversation went like this:

  • hi, is this XYZ
  • yes?
  • I’m calling about Usain Bolt’s treatment in Munich
  • are you a journalist?
  • no
  • are you calling from Germany?
  • no, if you give me a minute, I’ll explain, and this is really importa…
  • hung up

I didn’t give up that easily, so I called again and hit the assistant this time. I explained my debilitating muscle tension and said I try to reach the doctor Bolt saw. I said that I read the story of Usain’s battle with scoliosis, and I thought he might have empathy for a chronic condition that grinds one’s spirit into a dry powder. The assistant said she couldn’t help me. I asked if she could relate the story to the physical therapist and let him decide if he wants to call me back. She reluctantly agreed. I was applying the “show empathy and let them have an easy way out” rule I found extremely helpful in winning over the people I needed help from.

Miraculously, the PT actually did call back and said that he had an admiration for my persistence and a sympathy for my struggle but can’t help me. He would have been fired for breaching the privacy rules they have within the team if he shared the contact details I was looking for. I tried to turn it around again by the same rule as before and said maybe he could contact people in Munich and let them decide whether they want to reach back to me. Unfortunately, that didn’t work.

Simultaneously, I tried another crazy idea: ask Hacker News (the programming community) for help. Here’s my request: https://news.ycombinator.com/item?id=17711191. Nobody responded. With the benefit of hindsight, I would have worded it differently to press the right internet buttons that spark a discussion. Also, I appreciated my lack of internet karma. A thought experiment: if patio11, a prominent Hacker News contributor, had posted, he would have a much larger reception. I took note to myself to publish more on the internet. I didn’t succeed at it, and this series is an attempt at fixing my weak spot.

Extending my network didn’t work so I had to try the other way. The inspiration was Colin Powell’s quote:

You know you’re a good leader when people will follow you… if only out of curiosity.

I decided to come to Munich without an appointment and explain how this thorny health issue is my top priority in life. Showing up in person would add self-evident weight to that statement, and I hoped it would draw people’s attention. It’s not what everyday patient does.

It was perfectly clear it wasn’t an easy project, so I booked four full days for my stay. Why? To give myself a safety margin. Many mundane things could go wrong: I could be unlucky that the doctor wouldn’t be in his office, he was too busy, etc. And why four days? If I can’t get through in four days, having more time wouldn’t help. And I had the flight to San Francisco to catch the next day.

I told Fabienne about this plan; she smiled and said she was curious about how it would turn out.

For the rest of my stay in Basel, we kept going with my physio, and we were still searching for clues to pinpoint my problems. We cut it shorter one week when yet another piece of bad news arrived. It was when I thought I couldn’t dip lower than I already was. However, during the summer, I started to develop another medical condition that I don’t want to go into details of publicly. It was unrelated (at least that’s how it appeared to be) to my muscle woes, and it required a surgery. Naturally, it felt like a hard punch in the face.

Having experienced the aberration that US medical billing is before, I knew I didn’t want to deal with this in San Francisco. Also, I learned in my previous health sagas a trick of an economic arbitrage: earn an American salary and spend on health services in Poland. For a modest amount according to American standards, I could get a top-notch doctor in Poland, which would be a much better choice than an average one I would find in San Francisco. So I frantically tried to arrange an appointment in Warsaw, playing the same deadline card that I found worked surprisingly often: instead o asking for open slots, I would hand my dates, and ask for an opening.

While hashing out the details of my surgery in Warsaw with the doctor, I asked when is the earliest time I could fly after the surgery and explained I had a genuinely urgent business in Munich. He recommended waiting four days which I didn’t have. After a bit back and forth, we agreed I would acknowledge I’m at the edge of a sound risk-taking, I would go in two days. I would have to be extremely careful, avoid prolonged sitting and any sudden or straining moves. We also talked about my return trip to California, which is roughly 12 hours of sitting. The doctor was horrified at the prospect and said I should really not fly for at least two weeks after the surgery.

I thought maybe I could work remotely these two weeks after my sabbatical ran its course. I contacted my manager at Stripe, explained the details, and made him uncomfortable about breaking employment laws related to health privacy. I didn’t give a damn about them; all I wanted to communicate was that I had to do this surgery. It was unplanned, so I couldn’t have done it during my sabbatical and needed flexibility on my return date. My manager said he would talk to HR on my behalf. The answer came as no, with a gentle suggestion that I might leave no choice but to terminate my employment if I didn’t show up on time. I was devasted.

My surgeon suggested that if I absolutely need to go back, I should fly business so I could stretch and lay down during the long flight. My sabbatical was unpaid, and I fully funded my Basel treatment out of my pocket, including the risky trips to Como and Zurich. All of it depleted me financially, and shelling out another $5k was the last thing I wanted to do. Mainly because my health project was anything but done - I didn’t even know what I had, let alone have any projections on how much it would cost to fix. I felt like walls were closing on me from all sides. I shared the state of my union with one of my friends and told him I’m close to the breaking point. It’s a stupid flight, but it’s just one drop in the bucket too much. He decided to buy this ticket for me on the spot. In the grand scheme of this story, that was a small act, but I a well timed. I would remember it for years to come and think about how to “pay it forward” one day.

A week before my surgery, I reached out to my old physical therapist in Warsaw and told her about my mysterious muscle tightness. I told her I would be coming in a week after three months spent unsuccessfully trying to work out what’s going on, and I was shopping for fresh ideas. To keep it focused, I asked if she knew a neurologist. With every week passing in Basel, we had more evidence collected for the neurological explanation of my condition. She suggested a doctor she worked with before, and I scheduled an appointment right away. When I arrived in Warsaw, I headed straight to the doctor’s office and explained my story once again. I had it practiced so much that I could recite it in a single breath if I was woken up in the middle of the night.

We proceeded with local tests of my nerve activity by sticking thin needles into my quad and measuring the electric activity. Ironically, we had trouble inserting the needles - my adductor was so stiff it was hard to break in. The results: nothing abnormal detectable with this kind of a diagnostic. I interrogated the doctor for any other clues, but he said he has no ideas to offer. From his point of view, I was healthy. Later on, I would learn that neurologists are incredibly narrow in their focus, and you can have a neural disorder that they would never diagnose. It’s overspecialization at its not finest.

At the beginning of September 2018, I had my surgery done, rested for two days, and boarded my short flight to Munich. For the two weeks before, I was researching every idea in the book for reaching unreachable people. I turned to one of the people I’ve read and always wondered how much his advice and life hacks are intellectual snacks - sound great on paper but are ultimately literary boosters for a narrative that doesn’t exist in the real world. Having nothing to lose, I decided to follow Tim Ferris’s early writing when he was documenting his hustling in the form of tactical tips. His advice boiled down to three things when it comes to meeting busy people:

  1. Show you care
  2. Don’t be a creep
  3. Be respectful of when someone says no

Tim Ferris wrote about something I haven’t considered: when trying to reach the very best, be okay with the second-best option. Tim mentioned athletes as an example, where a gold medalist gets all accolades and the spotlight but at the same time is incredibly overwhelmed. The second-best athlete might score a tiny bit less (due to pure bad luck) and be as insightful on what it takes to be the top performer. If you didn’t care about warming up in the spotlight at the top but looked for competence, you’d be happy with the second-best.

In any case, I remembered Fabienne’s advice that “Bavaria is not like California.” What she was telling me: Bavaria doesn’t have the hustling culture, so I had to tread carefully. The day I landed in Munich, I went to the clinic and introduced myself. I said I called and emailed, but I didn’t get an appointment. I had this recommendation from the Basel clinic, and I wanted to see if I could get a meeting in person. The lady at the reception was visibly surprised, and I could sense the tension in the air. She immediately responded that I shouldn’t be there if I didn’t have a meeting scheduled. I replied that my treatment in Basel has ended, and I had a few days to spare before I head back to California. Munich was on the way (that was a lie), and I decided to stay in Munich, hoping that maybe someone cancels and I could hop into the empty slot. The lady responded: we don’t make any cancellations (that was also a lie). I replied that this is okay; I’ve never been to Munich before, and it seems like a lovely city, so if nothing works out, I will consider this trip a tourist opportunity. She smiled slightly for the first time, so I was breaking through the defenses. I said I would leave my phone number, and if anything pops up, I could come anytime. She reluctantly took a piece of paper I scribbled on. Then I said I would go and explore Munich and come back tomorrow to briefly chat if we can find any creative solutions. Again, I got a response that if I don’t have an appointment, there’s no point in coming.

The next day I came and politely asked if there were any cancellations or other options we haven’t considered. The response was simply “no,” and I was reminded that there’s no point in coming without an appointment. I responded that I would do some more sightseeing that day and asked if she could ask around for any solutions. Again, I was told that I would get a phone call if there’s anything available. I joked that I have only four days planned in Munich, so everyone can be sure that I will be gone soon. Truth be told, I was everything but in a joyful mood. I was totally determined to make progress, but simply asking wouldn’t cut it.

Carrying on with the sales analogy, I thought of the stories I read that the most sophisticated sales are driven by indirect marketing. Instead of blasting the product into people’s faces, you make them intrigued. And I came up with a game plan: I’d write the letter and hand it off to the front desk lady the next day. The letter’s recipient would be the doctor. There was a very slim chance it would be delivered, though. The front desk’s job is to be a firewall against endless requests, and mine looked as low of a priority as you can imagine. So why would I write it? The idea was that I wanted to create a little buzz, gossip in the office that I would hope would be overheard by the medical staff and make them curious about this mysterious letter. The essential point: it would not be front desk workers passing on, but doctors asking about it and shifting the burden of deciding what to do with that odd letter as a result. I liked to think of it as a variant of the Inversion principle Charlie Munger likes to talk about. In essence, it’s about attacking challenging problems backward. I wanted to see a hard-to-reach doctor, so how about making the doctor want to see me?

I can’t tell you whether this was my elaborate way of killing time and not going completely crazy due to the feeling of helplessness, or I truly believed this would work. As often in life, it’s probably the combination of both, but I was leaning on this actually working. I was playing up with the basics of human psychology: curiosity and the mechanics of gossip. It’s hustle 101.

I didn’t want my letter to feel wonky, so I went out to find high-quality printing paper and envelope. Here’s what I wrote:

letter to the doctor

I printed it on beautiful, thick paper in multiple copies and stuffed it in a high-quality envelope. It had a tactile feel of a letter of a diplomat.

The following day, I went in, wondering how to lead the conversation so I could hand over the letter naturally, avoiding an awkward moment. I greeted the front desk lady, saying I came in to check in one more time and ask if there’s any special route for highly motivated patients. I was ready to hear another “no” and take the letter out of my pocket in the leather jacket I was wearing and pass it as proof I’d go to great lengths to get an appointment. To my surprise, the lady responded with a stoic attitude: we have an appointment for you with Doctor Wagner (not his real name) would see me. I was amazed. I asked when I would be able to see the doctor; it was just four weeks away.

So what happened? I learned about this many months later. It turned out that the chief doctor went on German national television, and on a prime-time talk show, announced his autobiography that goes deep into how he developed his healing methods. He went from obscurely elite to being a celebrity overnight. Suddenly, people from all over Germany wanted to see him and were hammering down his office phone number. The phone line succumbed, and the clinic essentially stopped seeing new patients. Not out of exclusivity but out of necessity. I couldn’t get in, but it wasn’t about me. I got reminded of an important life lesson: whatever is happening more often than not, it’s not about you.

Doctor Wagner wasn’t the chief doctor I was seeking, but I remembered Tim Ferris’ point of the effectiveness of reaching for the second-best. Building on it, great people hire other great people, and my job was to get admitted into the social circle anyway. If I was in the clinic’s network, getting to the chief doctor that I believed I needed to see due to the extreme difficulty of my condition would be a minor step up. Using a compiler construction analogy: breaking the problem down into smaller steps reminds me of how compilers have multiple passes because doing all the work in one go is too hard to get right; the task is too complex.

In any case, I was ecstatic that I got my appointment. There was a minor problem of how I would explain a return trip seemingly the moment I unpacked my suitcases. I booked my flight from San Francisco to Munich and decided I would worry about it later.

Having read up more on the controversial practices of the Munich master, I was wondering deep inside if I was sliding more and more into a dangerous land of pseudo-medicine through a combination of despair and an unbounded instinct to keep fighting.

Thanks to Lyn Nagara for reading my drafts.