Stoics would encourage all of us to internalize our own mortality, not for morbidity’s sake, but because it helps live in the moment. The wake up call stories like this should be simulated by everyone. Imagine if this were you? Live with a fraction of that pain in your heart and try to internalize it. How does it impact our choices? Things like fingers and walking become amazing. I am always happy people share their stories, it helps us all remember our mortality and make good choices every day. Also, I wish the author a speedy and continued recovery in their journey.
> I am always happy people share their stories, it helps us all remember our mortality and make good choices every day.
Not for me. When confronted to death or intense pain, everything else becomes insignificant and futile. And when things go back to normal, I tend to forget. I suppose that to be fully functional human beings, we need to ignore the harsh reality of life! Is it really possible to "internalize mortality"? I know some people try very hard but are they immune to anxiety and daily worries, are they happier? I haven't met such a person yet.
> and I would be fully present for all the moments that mattered.
This quote stood out, because as a promise to your family, it really sucks. We never know what the moments that matter to other people are going to be. Big events are nice. But when you think back on your life, how many important moments were from small events? Just having a nice talk, doing a chore with your dad, telling your mom about your day? How many idle comments from friends ended up having a large impact on you?
When dealing with family, you need to be there enough that moments happen, because the scope of their impact on the lives of those around you are not predictable.
On of the things my wife insisted on was that we always got together as a family for dinner. That definitely had a negative impact on my career in that I couldn't be the 'last guy to leave', but it gave me a solid relationship with my kids as they grew. I am glad to this day that she insisted.
Agreed. I hardly ever see my daughter in the morning but make sure that 99% of the time I'm home in time to put her to bed and read a story (she's 8), often it's at bedtime that any worries come out, and I'm so glad I'm able to be there to listen.
If you are a founder/CEO type, you are missing the important events, period. I don't care what your Facebook/Insta/LinkedIn says. On your deathbed, all your success wont buy you another second with your children.
I'm fine with people sacrificing for their work, but don't try to sell the "I'm doing it all" crap.
I was going to say “I recall when I had sepsis in my teens”, but the truth of it is that I don’t - there’s a six week hole in my memory, that skips straight from lying in a pool of blood and puss on the floor of the kitchen at school, having a mop thrust in my face, to lying in a bed in hospital with tubes snaking out of me.
The weird thing is, despite being unconscious for over a month, I woke up feeling like I hadn’t missed anything, and even now I look back at this with slight disbelief - surely you’re thinking of someone else, surely it wasn’t that long. I felt like I’d been out longer after a general for surgery a few years ago.
They did run a whole battery of neurological tests on me once I was conscious and eating - they were pretty surprised I had no obvious brain damage - I had maintained a fever over 108 for several days, despite ice baths and the, what, 20g of daily antibiotics? I do wonder if there was some, but rather more subtle than what was being looked for.
Re-integrating was weird. For everyone else I’d been as good as dead - they’d seen me carted off in an ambulance, and then a few weeks later term had ended. I on the other hand basically went straight from the end of one school term to the beginning of the next with zero intervening time, and nobody could figure out why I was pissed off. They kept asking me about what had happened - and I answered honestly that they probably knew more than I did.
It also sucked that I had no soft landing back into classes, and in the time I’d been unconscious they’d started calculus - I came back and had to differentiate and integrate and had no frigging idea what I was actually doing - I remember sitting in an A-level maths exam a year later and finally having the revelation that it was about curves and rates of change.
All this because I had what looked like a zit on my knee. It grew until I couldn’t fit trousers over my leg, school offered me a sticking plaster, and said I wasn’t getting out of sport that easily. Then my leg opened up one night fetching water in the kitchen, and I lost consciousness. I’ll never forget the sight of custard in crude oil swirling over the linoleum - perhaps that’s one side effect of the coma - my last conscious moment is vivid in the extreme.
Anyway, that brush with death didn’t change my outlook one bit, but then again I was an invincible 16 year old. The ones since then have definitely left their mark.
Wow - when I read that article and your experience my brush with sepsis seems quite tame.
I went from feeling fine to I might need a repeat prescription, to having to get a taxi home.
The next day I ended up doing an end run around A&E and went from the lower risk renal ward to the high risk to the ic ward and spent two weeks in Lister.
I am surprised that the US hospital didn't recognise it though - senior Nephrologist who saw me after said its "bloody easy to diagnose"
And yes I did get a blocking for not calling 999 (911) when it happened
20,000mg, am I reading that right? According to my non-medical background that's a shitload of drugs. Good to be reading this knowing you came out of it ok.
for some reason I assumed that he would write about how this trauma would give him a new perspective on what was really important in life, but at the end it sounded like the experience didn’t really change his perspective on desiring to work all the time on his startup and that he was only stepping down because he couldn’t perform 100% and not because this experience changed anything about how he prioritized work/career?
I agree. I find it heartbreaking that the brightest minds of our generation are working on better ways to get spam into people's mailboxes. He more or less worked himself to death just to "enable our customers to deliver a highly responsive, on-demand experience with their marketing and their content."
Surely the world would be better off without further optimising targeted spam.
A high temperature like 104, combined with pain, definitely warrants a doctor visit. Which doctor (GP, urgent care, ER/A&E)? Let the time, day, and how you feel be your guide.
In the case of one of my relatives, the result was confirmation they had the flu (and too late for Tamiflu or the like to be effective). In my case, it was intestinal perforation that (six months later) led to part of my large intestine being taken out.
Considering the bills for a condition like this, I'd be wondering if it's even worth it to go to the doctor. My life isn't worth the destitution visited on everyone I know necessary to keep me alive, and I can't imagine the moral calculus his family had to go through.
I'm glad this guy could get the care needed to survive, and I wish him the very best in his recovery.
He's Canadian I believe; so while I'm not sure how his care in NYC would be billed, I think it would be still covered by OHIP (the public health insurance in Ontario Canada) or maybe travel insurance.
Certainly all the care he received in Toronto would have been covered, assuming he's Canadian.
I entertain similar thoughts, though less out of lack of value for my own life than sheer stubborn spitefulness for the predatory health care industry in the US. Sure, i could exhaust all my money and I might live, but I think I might actually rather die just to keep it out of their grubby hands.
What? Go to the ER, save your life, then declare bankruptcy. That's the American way. What destitution on everyone you know? I don't understand what you mean. You think your family would be happier with you dead instead of bankrupt?
A friend of mine had her young brother suddenly developing a narrow line on the skin, growing quickly; 24 hours later both his arms and legs were amputated to keep him alive.
I am wondering if having allowed emergency wide-spectrum antibiotics freely for such cases would help? Time seems to be extremely critical in such cases.
> I am wondering if having allowed emergency wide-spectrum antibiotics freely for such cases would help?
The problem is you also need emergency physicians available equally freely and ubiquitously to identify the need. Unnecessary use of powerful, broad spectrum antibiotics has significant potential adverse personal and public health consequences, and the general public is not qualified to appropriately assess need for use.
I would consider it a mandatory equipment of the household. Primarily I take them on trips to remote 3rd world countries where you can't rely on quick quality health care, even though most of the time I come back home with them untouched. For me its usually Sumamed, plus whatever specific for destination (malaria pills, stomach/throat, eyes etc.). Just beware of the expiration - they may lose potency and better renew them.
I am not sure I would use them at home in case you describe though - I would just run to emergency if possible. Also antibiotics don't work with viruses, fungus or parasites, so its not a panacea.
Wow. Mark was the CEO of one of the first startups that I worked at in Toronto. I recall him being very driven and focused. It seems like these qualities helped him overcome this enormous challenge.
Terrifying. Could it be that stress caused the Streptococcus pyogenes infection? It would be the most sensible explanation. I imagine being a CEO of a startup is a very stressful role, causing suppression of the immune system and thereby S pyogenes had a chance to proliferate. I have no idea, just speculation.
It was absolutely caused by unconscious emotions (like stress). The following part just made me laugh out loud:
> This mainly involves infection by the Streptococcus pyogenes bacteria and more commonly affects young, healthy adults. I didn't do anything to get it, it just happened - like being struck by lightning.
The jarring contrast between medicine's ability to perform surgical miracles, like those described in the article, and it's total inability to understand what causes illness, is just comical. I guess there is money in one and not the other.
I am disturbed that he was almost sent away from the hospital if it weren’t for the persistence of his business partner that it was something that needed further investigation.
It’s a common thing due to the fact that doctors see too many trivial, common cases and apply Occam’s razor.
I had the same experience in a big, prestigious hospital. After a surgery went wrong they insisted I’m ok and getting better despite my less and less vigorous protests. When they finally accepted to investigate this more thoroughly they realized the severity. The story repeated itself through multiple surgeries. Even just hours before the last one they insisted I should be getting better and again only investigated after several pleas. Which was very surprising considering that when going into this last surgery my chances of survival were under 15%, I was basically in septic shock and already mostly unconscious due to the illness and medication.
I think a doctor’s diagnosis starts with assuming basic issues and escalating later rather than the other way around. It might make sense statistically... unless you’re among the unlucky few.
The thing with this man is that he assumed he had the flu:
> By the time I landed in New York that day in February, I felt a flu coming on. The next 48 hours was a marathon, so I resolved to push through.
And he also experienced some very non-flu like symptoms:
> by Wednesday night I was running a serious fever and my left leg was in a surprising amount of pain.
Despite having a high fever and pain, he didn't go to the hospital until he actually collapsed the next day. Had he sought medical treatment as soon as the leg pain manifested, his outcome might not have been as dire.
In many cases, probably nothing. But here's what I'd do:
Stay away from places where a lot of different people touch a lot of different things - and if you have to touch those things, wipe them down first with antiseptic wipes or similar.
In addition to this - take care not to let (or get, if possible - not always easy, depending on what you do for a living, your hobbies, and just life itself) wounds happen on your skin or mouth. If you do get a wound (cut, scratch, bite, etc) - try to take care of it properly immediately; clean it, apply dressing, etc. In the case of mouth wounds (ie - you bite your tongue or lip hard enough to draw blood), about all you can do is a salt rinse and keep your teeth brushed.
Stay away from hospitals and care homes and the like - seriously, one of the best places to get an infection is in a hospital or doctor's office. It seems counterintuitive, but when you have a place where sick people congregate, not everything is going to be "squeaky clean" even when they are regularly cleaned.
You might take the extreme step of wearing some kind of mask to reduce the inhalation of bacteria and/or viruses. It won't completely stop it, but it will reduce it a little.
Don't hang around sick people? If a coworker shows up to work sick, you might want to go home yourself (explain to your boss why, first - and let them make a decision as to who should go home - likely, they'll send the coworker home first). Unfortunately, so many people have kids, and are "carriers" of stuff that don't affect them much because they do have kids, but if you don't have kids and/or don't hang around kids much - you can pick up things that way easily.
Always wash your hands thoroughly after using the bathroom. Elbow out the door if possible (or use a paper towel to open the door).
Avoid stress (easier said than done for some people) - ultimately, though, stress does weaken the immune system; this is known. Better is to understand when you are stressed, and what forms stress can take, so you can know when you are under it. Some kinds of stress aren't always easily apparent. Note that this might also apply to "good stress"; I'm not sure. If you are tired and "stressed" from an extreme workout, I am not sure if that helps or hinders your immune system during your recovery...
Ultimately, though, you can't control everything, and you have to live your life. There's probably no way to trace back to where this guy picked up his infection. If I had to make a guess, maybe the gym? It could have easily have been during a run or a walk outside as well. Or just some door he pushed open to go into a room or building. The bacteria/viruses that cause these kinds of infections and issues are all around us, and our bodies do a fairly good job of keeping them at bay. But sometimes, bad luck happens.
This reminds me of the time that science fiction writer Peter Watts got necrotising fasciitis, and wrote a series of sardonic blog posts with gruesome photos (seriously - gruesome) about it:
If I'm an American visiting Canada then I would also be charged for any medical services I get in Canada as I do not pay taxes there nor have insurance in Canada.
The Wikipedia article mostly talks about Type I NF. The author of this post had Type II NF, which is not necessarily associated with the same preconditions as Type I NF.
You are not a licenced medical practitioner. Telling people that kind of stuff face to face gets you into serious trouble, what makes you think it's okay to do so on-line?
bitexploder|6 years ago
throw0101a|6 years ago
> That might be why you don't see me as someone angry and working out my demons onstage. It's that I love the thing that I most wish had not happened.
* https://twitter.com/AC360/status/1162183695270387712
Cooper was reading from a GQ interview:
* https://www.gq.com/story/stephen-colbert-gq-cover-story
Colbert was quoting Tolkien.
yodsanklai|6 years ago
Not for me. When confronted to death or intense pain, everything else becomes insignificant and futile. And when things go back to normal, I tend to forget. I suppose that to be fully functional human beings, we need to ignore the harsh reality of life! Is it really possible to "internalize mortality"? I know some people try very hard but are they immune to anxiety and daily worries, are they happier? I haven't met such a person yet.
jmkd|6 years ago
HNcantBtrustd|6 years ago
He started an idea, developed, and has a team to continue it.
He did his role.
What is next for him? Hopefully he has enough money to live without working. Then he can put his efforts into himself.
codingdave|6 years ago
This quote stood out, because as a promise to your family, it really sucks. We never know what the moments that matter to other people are going to be. Big events are nice. But when you think back on your life, how many important moments were from small events? Just having a nice talk, doing a chore with your dad, telling your mom about your day? How many idle comments from friends ended up having a large impact on you?
When dealing with family, you need to be there enough that moments happen, because the scope of their impact on the lives of those around you are not predictable.
ChuckMcM|6 years ago
jurasource|6 years ago
smrtinsert|6 years ago
I'm fine with people sacrificing for their work, but don't try to sell the "I'm doing it all" crap.
madaxe_again|6 years ago
The weird thing is, despite being unconscious for over a month, I woke up feeling like I hadn’t missed anything, and even now I look back at this with slight disbelief - surely you’re thinking of someone else, surely it wasn’t that long. I felt like I’d been out longer after a general for surgery a few years ago.
They did run a whole battery of neurological tests on me once I was conscious and eating - they were pretty surprised I had no obvious brain damage - I had maintained a fever over 108 for several days, despite ice baths and the, what, 20g of daily antibiotics? I do wonder if there was some, but rather more subtle than what was being looked for.
Re-integrating was weird. For everyone else I’d been as good as dead - they’d seen me carted off in an ambulance, and then a few weeks later term had ended. I on the other hand basically went straight from the end of one school term to the beginning of the next with zero intervening time, and nobody could figure out why I was pissed off. They kept asking me about what had happened - and I answered honestly that they probably knew more than I did.
It also sucked that I had no soft landing back into classes, and in the time I’d been unconscious they’d started calculus - I came back and had to differentiate and integrate and had no frigging idea what I was actually doing - I remember sitting in an A-level maths exam a year later and finally having the revelation that it was about curves and rates of change.
All this because I had what looked like a zit on my knee. It grew until I couldn’t fit trousers over my leg, school offered me a sticking plaster, and said I wasn’t getting out of sport that easily. Then my leg opened up one night fetching water in the kitchen, and I lost consciousness. I’ll never forget the sight of custard in crude oil swirling over the linoleum - perhaps that’s one side effect of the coma - my last conscious moment is vivid in the extreme.
Anyway, that brush with death didn’t change my outlook one bit, but then again I was an invincible 16 year old. The ones since then have definitely left their mark.
lawlessone|6 years ago
C1sc0cat|6 years ago
I went from feeling fine to I might need a repeat prescription, to having to get a taxi home.
The next day I ended up doing an end run around A&E and went from the lower risk renal ward to the high risk to the ic ward and spent two weeks in Lister.
I am surprised that the US hospital didn't recognise it though - senior Nephrologist who saw me after said its "bloody easy to diagnose"
And yes I did get a blocking for not calling 999 (911) when it happened
magic_beans|6 years ago
Good lord, your school let the thing grow on you without sending you to the doctor!? That's unbelievable negligence!
libria|6 years ago
20,000mg, am I reading that right? According to my non-medical background that's a shitload of drugs. Good to be reading this knowing you came out of it ok.
dawhizkid|6 years ago
rtb|6 years ago
Surely the world would be better off without further optimising targeted spam.
brazzy|6 years ago
Theophraustous|6 years ago
Maybe this is simply because anything I read on LinkedIn gives me that feeling.
CaliforniaKarl|6 years ago
In the case of one of my relatives, the result was confirmation they had the flu (and too late for Tamiflu or the like to be effective). In my case, it was intestinal perforation that (six months later) led to part of my large intestine being taken out.
Big congrats to this guy for getting through it.
twoquestions|6 years ago
I'm glad this guy could get the care needed to survive, and I wish him the very best in his recovery.
corry|6 years ago
Certainly all the care he received in Toronto would have been covered, assuming he's Canadian.
realshowbiz|6 years ago
AnIdiotOnTheNet|6 years ago
udkl|6 years ago
mnm1|6 years ago
bitL|6 years ago
I am wondering if having allowed emergency wide-spectrum antibiotics freely for such cases would help? Time seems to be extremely critical in such cases.
dragonwriter|6 years ago
The problem is you also need emergency physicians available equally freely and ubiquitously to identify the need. Unnecessary use of powerful, broad spectrum antibiotics has significant potential adverse personal and public health consequences, and the general public is not qualified to appropriately assess need for use.
IAmGraydon|6 years ago
saiya-jin|6 years ago
I am not sure I would use them at home in case you describe though - I would just run to emergency if possible. Also antibiotics don't work with viruses, fungus or parasites, so its not a panacea.
yepthatsreality|6 years ago
pbourke|6 years ago
Wishing you the best, Mark.
_of|6 years ago
Pimpus|6 years ago
> This mainly involves infection by the Streptococcus pyogenes bacteria and more commonly affects young, healthy adults. I didn't do anything to get it, it just happened - like being struck by lightning.
The jarring contrast between medicine's ability to perform surgical miracles, like those described in the article, and it's total inability to understand what causes illness, is just comical. I guess there is money in one and not the other.
msie|6 years ago
close04|6 years ago
I had the same experience in a big, prestigious hospital. After a surgery went wrong they insisted I’m ok and getting better despite my less and less vigorous protests. When they finally accepted to investigate this more thoroughly they realized the severity. The story repeated itself through multiple surgeries. Even just hours before the last one they insisted I should be getting better and again only investigated after several pleas. Which was very surprising considering that when going into this last surgery my chances of survival were under 15%, I was basically in septic shock and already mostly unconscious due to the illness and medication.
I think a doctor’s diagnosis starts with assuming basic issues and escalating later rather than the other way around. It might make sense statistically... unless you’re among the unlucky few.
puranjay|6 years ago
How does an infection like this happen though? What can you do to prevent it?
magic_beans|6 years ago
> By the time I landed in New York that day in February, I felt a flu coming on. The next 48 hours was a marathon, so I resolved to push through.
And he also experienced some very non-flu like symptoms:
> by Wednesday night I was running a serious fever and my left leg was in a surprising amount of pain.
Despite having a high fever and pain, he didn't go to the hospital until he actually collapsed the next day. Had he sought medical treatment as soon as the leg pain manifested, his outcome might not have been as dire.
cr0sh|6 years ago
Stay away from places where a lot of different people touch a lot of different things - and if you have to touch those things, wipe them down first with antiseptic wipes or similar.
In addition to this - take care not to let (or get, if possible - not always easy, depending on what you do for a living, your hobbies, and just life itself) wounds happen on your skin or mouth. If you do get a wound (cut, scratch, bite, etc) - try to take care of it properly immediately; clean it, apply dressing, etc. In the case of mouth wounds (ie - you bite your tongue or lip hard enough to draw blood), about all you can do is a salt rinse and keep your teeth brushed.
Stay away from hospitals and care homes and the like - seriously, one of the best places to get an infection is in a hospital or doctor's office. It seems counterintuitive, but when you have a place where sick people congregate, not everything is going to be "squeaky clean" even when they are regularly cleaned.
You might take the extreme step of wearing some kind of mask to reduce the inhalation of bacteria and/or viruses. It won't completely stop it, but it will reduce it a little.
Don't hang around sick people? If a coworker shows up to work sick, you might want to go home yourself (explain to your boss why, first - and let them make a decision as to who should go home - likely, they'll send the coworker home first). Unfortunately, so many people have kids, and are "carriers" of stuff that don't affect them much because they do have kids, but if you don't have kids and/or don't hang around kids much - you can pick up things that way easily.
Always wash your hands thoroughly after using the bathroom. Elbow out the door if possible (or use a paper towel to open the door).
Avoid stress (easier said than done for some people) - ultimately, though, stress does weaken the immune system; this is known. Better is to understand when you are stressed, and what forms stress can take, so you can know when you are under it. Some kinds of stress aren't always easily apparent. Note that this might also apply to "good stress"; I'm not sure. If you are tired and "stressed" from an extreme workout, I am not sure if that helps or hinders your immune system during your recovery...
Ultimately, though, you can't control everything, and you have to live your life. There's probably no way to trace back to where this guy picked up his infection. If I had to make a guess, maybe the gym? It could have easily have been during a run or a walk outside as well. Or just some door he pushed open to go into a room or building. The bacteria/viruses that cause these kinds of infections and issues are all around us, and our bodies do a fairly good job of keeping them at bay. But sometimes, bad luck happens.
vagab0nd|6 years ago
Would bacteriophage have helped?
twic|6 years ago
https://www.rifters.com/crawl/?cat=41
He was never in a coma, though, so got to be a bit more chipper about the whole thing.
dennisgorelik|6 years ago
https://www.crunchbase.com/search/funding_rounds/field/organ...
Amount of traffic to pathfactory.com is negligible:
https://www.similarweb.com/website/pathfactory.com/
kerkeslager|6 years ago
The timing of his illness is rather unfortunate, as it caught him in New York, rather than Toronto, which probably cost him a lot of money.
marcinzm|6 years ago
edit: And the fees aren't trivial. https://www.qch.on.ca/uploads/Finance/Fees%20for%20Cdns%20wi...
aantix|6 years ago
No one works for free, the medicine costs money. The money comes from somewhere.
kuu|6 years ago
trevyn|6 years ago
[deleted]
wldlyinaccurate|6 years ago
deepsun|6 years ago
> For reasons that are unclear, it occasionally occurs in people with an apparently normal general condition.
somebadguy|6 years ago
[deleted]
irjustin|6 years ago
[deleted]
dana321|6 years ago
[deleted]
bmn__|6 years ago
targonca|6 years ago
Wtf. Adrenal crisis [1] would be fatal. You're talking nonsense.
[1] https://en.wikipedia.org/wiki/Adrenal_crisis
Hinrik|6 years ago