3.4 Triangulate your view with believable people who are willing to disagree.
By questioning experts individually and encouraging them to have thoughtful disagreement with each other that I can listen to and ask questions about, I both raise my probability of being right and become much better educated. This is most true when the experts disagree with me or with each other. Smart people who can thoughtfully disagree are the greatest teachers, far better than a professor assigned to stand in front of a board and lecture at you. The knowledge I acquire usually leads to principles that I develop and refine for similar cases that raise in the future.
In some cases in which the subjects are just too complex for me to understand in the time required, I will turn over the decision making to knowledgeable others who are more believable than me, but I still want to listen in on their thoughtful disagreement. I find that most people don’t do that—they prefer to make their own decisions, even when they’re not qualified to make the kinds of judgments required. In doing so, they’re giving in to their lower-level selves.
This approach of triangulating the views of believable people can have a profound effect on your life. I know it has made the difference between life and death for me. In June 2013, I went to Johns Hopkins for an annual physical, where I was told that I had a precancerous condition called Barrett’s esophagus with high-grade dysplasia. Dysplasia is an early stage in the development for cancer, and the probability that it will turn into esophageal cancer is relatively high—about 15 percent of cases per year. Cancer of the esophagus is deadly, so if left untreated, the odds were that in something like three to five years I’d develop cancer and die. The standard protocol for cases like mine is to remove the esophagus, but I wasn’t candidate for that because of something specific to my condition. The doctor advised that I wait and see how things progressed.
In the weeks that followed, I started to plan for my eventual death, while also fighting to live, I like to:
a. Plan for the worst-case scenario to make it as good as possible.
I felt fortunate because this prognosis gave me enough time to ensure that the people I cared most about would be okay without me, and to savor life with them in the years I had left. I would have time to get to know my first grandson, who had just been born, but not so much time that I could take it for granted.
But as you know by now, rather than following what I am told is best, even by an expert, I like to triangulate opinions with believable people. So I also had my personal physician, Dr. Glazer, set up visits with four other experts on this particular disease.
The first call was with the head of thoracic surgery at a major cancer hospital. She explained that my condition had advanced quickly and that, contrary to what the first physician said, there was a surgery that could cure me. It would involve removing both my esophagus and my stomach and attaching my intesines to the remaining little bit of my esophagus I’d have left. She estimated I’d have a 10 percent chance of dying on the operating table and a 70 percent chance of a crippling outcome. But the odds were in favor of my living, so her recommendation was clearly worth taking seriously. Naturally I wanted her to speak with the doctor from Johns Hopkins who originally diagnosed me and recommended a watch-and-wait approach, so right then and there I called the other doctor to see what each would say about the other’s views. This was eye-opening. While the two doctors had told me completely different things when I met with them in person, when they were on the phone together, they sought to minimize their disagreement and make the other look good, putting professional courtesy ahead of thrashing things out to get at the best answer. Still, the differences in their views were clear, and listening to them depended my understanding.
The next day I met with a third doctor who as a world-renowned specialist and researcher at another esteemed hospital. He told me that my condition would basically cause me no problems so long as I came in for an endoscopic examination every three months. He explained that it was like skin cancer but on the inside—if it was watched and any new growth was clipped before it metastasized into the bloodstream, I’d be okay. According to him, the results for patients monitored in this way were no different than for those who had their esophagus removed. To put that plainly: They didn’t die from cancer. Life went on as normal for them except for those occasional examinations and procedures.
To recap: Over the course of forty-eight hours, I had gone from a likely death sentence to a likely cure that would essentially involve disemboweling me, and then finally to a simple, and only slightly inconvenient, way of watching for abnormalities and removing them before they could cause any harm. Was this doctor wrong?
Dr. Glazer and I went on to meet two other world-class specialists and they both agreed that undergoing the scoping procedure would do no harm, so I decided to go ahead with it. During the procedure, they clipped some tissue from my esophagus and sent it to the laboratory for testing. A few days after the procedure, exactly a week before my sixty-four birthday, I got the results. They were shocking to say the least. After analyzing the tissue, it turned out there wasn’t any high-grade dysplasia at all!
Even experts can make mistakes; my point is simply that it pays to be radically open-minded and triangulate with smart people. Had I not pushed for other opinions, my life would have taken a very different course. My point is that you can significantly raise your probabilities of making the right decisions by open-mindedly triangulating with believable people.
* Source: Principles by Ray Dalio