Sudden death and the discount rate

It’s six years today since my mother passed away. She died in the early hours of Friday, 23rd October 2009 following a rather brief illness. The official death summary that the hospital issued reported the cause of her death as “sepsis”. She only officially died on the 23rd. As far as I’m concerned, I’d lost her two Mondays earlier, on 12th October 2009, when she complained of extreme breathing difficulty and was put on ventilator in the ICU.

Looking back (this year’s calendar is identical to that of 2009, so memories of that year have been coming back rather strongly this year), I realise that the suddenness with which it all happened have left me with a deep sense of paranoia, which can be described in financial terms as a “high discount rate”.

Having moved back from Gurgaon in June of that year, my mother and I had settled down in a rented house in Tata Silk Farm (she didn’t want to go back to our own house in Kathriguppe where we’d lived until 2008). She had settled well, and living not far from her sisters, had developed a nice routine. There were certain temples she would visit on certain days of the week, for example.

And then suddenly one day in September she complained of breathing trouble (she took thirty minutes to walk from our then house to my aunt’s house, which is only a ten minute walk away). Initial medical tests revealed nothing. More tests were prescribed, as her breathing got worse. There was no diagnosis yet.

She started seeing specialists – a pulmonologist and her cardiovascular surgeon (she had had trouble with some veins for a few years). More tests. Things getting worse. And before we knew it, she was in hospital – for a “routine three day admission” for an invasive test. The test got postponed, and the surgery finally done a week later. She got out of the ICU and remained there for hardly two days before she complained of insane breathing trouble and had to be put on ventilator – the only purpose the 12 days she spent on that served was to help me prepare for her impending death.

In all, it took less than a month end to end – from initially complaining of breathlessness to going on ventilator. What seemed to be a harmless problem leading to death.

I realise it’s caused insane paranoia in me which I’m yet to come out of. Every time I, or a relative or a friend, show minor signs of sickness, I start fearing the worst. I stop thinking about the symptoms in a Bayesian fashion – by looking at prior probabilities of the various illnesses that could be causing them – and overweight the more morbid causes of the symptoms. And that adds paranoia and anxiety to what I’m already suffering from.

Like two weeks back I had a little trouble breathing, but no apparent cold. It wasn’t something that happens to me normally. A quick Bayesian analysis would have revealed that the most probable cause is a sinus (which it was), but I spent half a day wondering what had become of me before I applied Vicks and quickly recovered. When my wife told me a week after she reached the US that she had got a high fever, I got paranoid again before realising that the most probable cause was a flu caused due to a change of seasons (which it was!).

Another consequence of my mother’s rather sudden death in 2009 (and my father’s death in 2007, though that was by no means sudden, as he had been diagnosed with cancer two years earlier) was that I suddenly stopped being able to make plans. I started overestimating the odds of something drastic happening, and planning didn’t make sense in such scenarios, I reasoned. As a consequence I became extremely short-term in my thinking, and couldn’t see beyond a few days away.

There have been several occasions where I’ve left a decision (such as booking tickets for something, for example) until it has been too late. There have been times when I’ve optimised for too short a term in some of my decisions, effectively jacking up my “discount rate”.

I’d written a while earlier about how in case of rare events, the probabilities we observe can be much higher than actual probabilities, and how that can lead to impaired decision-making. Thinking about it now, I’ve seen that playing out in my life over the last six years.  And it will take a considerable amount of effort to become more rational (i.e. use the “true” rather than “observed” probabilities) in these things.

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