Well, yesterday (although it seems like an age ago), I had laser surgery. I had a few tests, and then took up a poorly matched seat in the slightly too yellow cream coloured waiting room with the others. As I sat the interminable minutes, waiting for the actual surgery, I started to think about risk and poker.
I realised that I had essentially ignored the risk of something bad happening because the chance was small, but actually I knew from poker that you sometimes make calls with a small risk, but it’s not just the risk, it’s also the consequences that determines what the right choice is. As I sat and thought, the old man sitting across from me nervously swatted at a fat fly that had left the safety of the reception plant and landed, rather comically on his balding head.
The only stat I had with me was the video in the corner telling me that 98% get 20/20 vision or better. I didn’t have any other clinical outcome stats with me, but from what I vaugely recalled, I estimated the other 2% as 1.5% essentially unchanged (possibly after further correction), and 0.5% as worse vision that required me to wear glasses and take eye drops for the rest of my life. I didn’t really know if these figures were accurate, but they sounded about right. The old guy grinned at me as I slapped at my hair around where the fly was trying to land. Just because a risk is small doesn’t mean it shouldn’t be factored into your decision.
Anyway, pulling out my mobile phone I estimated how much I would be prepared to pay for surgery that was guarranteed success, and figured that would be around 7000 pounds. Then I estimated how much I would have to be given to be prepared to accept a lifetime of thick glasses and eyedrops. I couldn’t be completely sure, but I estimated it as around 2 million pounds. I was spending 3000 pounds on the surgery, and I could expect to save a minimum of 1000 pounds on glasses costs if it was successful. So what’s my expected value?
(7000 – 3000 + 1000) * 0.98 + (-3000) * 0.015 + (-2000000 -3000) * 0.005
I sat looking at my mobile phone calculator, realising that I’d made a decision with an expected value of -5160 quid, and no matter how I tweaked the numbers it wasn’t going to be positive.
After a little while of that, I went into surgery. It was horrible. I should say at this point that my experience is probably not typical, I certainly know other people who have had it done and found it strange, but not really all that bad, nobody else that I know has ever talked about the procedure being painful. I don’t know if he didn’t use enough anasthetic or if I just didn’t react to it very much, or what, but it was painful and very distressing. He didn’t seem to believe that it was hurting either, and even at one stage asked me with some incredulity in his South African accented voice “Is that hurting?”. That was in between berating me for not being able to keep my eyes still. Afterwards I sat in a darkened room for a while just getting over the trauma. Unable to keep my painful and bruised eyes open for more than a few seconds at a time, I was lucky to have my fiance to take me home. The next six hours were painful and uncomfortable, and after so much pain I was convinced something had gone wrong, but after that things started improving quickly. Even when I left the clinic, in the few seconds I could keep my eyes open I could tell that my distance vision, despite the glare and weird stuff was much better. Today, my vision is massively better. I can’t stop myself reading signs and number plates, and it’s nice to see slates on the roofs of houses without fuzz. I find that I expect to be able to read anything that’s writing even if it’s very very far away, and it confuses me when I can’t. We went to the park and watched squirrels and to the cinema and sat wherever we liked (I usually have to sit at the front). The after check up this morning told me that I was healing well and already slightly better than 20/20, with the possibility that it could improve even more over the next few weeks. There’s still glare around bright or white objects, I have to take a plethora of eyedrops every few hours for a couple of weeks, and wear eye shields at night, and I find it very weird focussing up close, but I already have a much better experience than I did before the surgery when trying to find my way around.
So I’m satisfied with the result, but as every poker player knows, it’s not the result, a thing chosen by chance, that determines whether something was the right decision or not. Knowing now how nasty it was I don’t think I would ever do it again (although perhaps talk to me in 5 years when the memory of the pain is gone and the experience of good vision is a persistent reality). My fiance told me afterwards that the old man who had gone in while I was recuperating in a darkened room had been rushed out to an ambulance. I hope he wasn’t experiencing the other side of that expected value calculation.