My journey with a craniopharyngiome started in the fall of 2021, shortly after the birth of my fourth child.
I felt constantly exhausted, got some weight and assumed that it was just life with a newborn. Labs obtained to examine these symptoms showed a low testosterone level, which ultimately led to the diagnosis of a craniopharyngiome – a rare, benign but local aggressive brain tumor. In February 2022 I underwent a full surgical resection. The results were excellent: we got all the tumor and my pituitary gland was usually intact (I only needed testosterone and levothyroxine replacement), and although I had a temporary third nerve pink, it solved within six months.
My surgeon and I both believed that I was healed. Several clear MRIs reinforced that faith, and I continued life, grateful and optimistic. I even shared my story about a podcast episode of White Coat Investor, certainly that it was now just a chapter from the past.
Fast forward to the summer of 2025. I started to feel. . . out.
In the beginning it was nothing dramatic – only lower energy and a vague feeling that I was not at my best. Then I noticed that I urinated more often than normal and felt a bit thirsty than normal. I calved it to summer heat or a busy schedule.
Yet I decided to have some laboratories checked. Around the same time I realized that my vision was a bit blurry. Visual tests revealed a classic pattern of bitemporel hemianopia – loss of peripheral vision on both sides. That led to a crazy dashboard to get an MRI.
The result was a gut pot: my craniopharyngiome had returned. And this time it was even bigger than before.
The photo became even more complicated in the following week. My pituitary gland had completely failed. On top of the testosterone and levothyroxine that I have already taken from my first operation, I now had diabetes insipidus and adrenal insufficiency. I should replace any pituitary hormone – probably permanent – and carefully manage how much I drank, what activities I did and how and when I adjusted my steroids and DDAVP.
I quickly weighed the option of repeated surgery, but the risk of significant morbidity with a second operation was much higher – and the chance of completely removing the tumor without recurrence was much lower. Eventually I started targeted BRAF and MEK inhibition therapy – essentially an oral form of chemotherapy. And just like everything else, I imagined the worst: constant side effects, always feeling terrible and hardly any functioning.
But so far, a few weeks after my diagnosis, it has not been so bad. Yes, there are side effects, but it was nothing near the day-in, day out of misery I had imagined. It was another memory that, whether it is in health or finance, our mind quickly imagines the gloomy possible future – and to remember our ability to adjust.
The expectation was worse than the reality (so far)
In the first few days after the second craniopharyngiome was discovered, my mind went to dark places. I introduced a future in which my life was fragile, limited and dominated by medical management with constant concerns about sodium levels, liquids and steroid dosage. I suggested that my vision may be completely losing, being permanently disabled and never to do the things I like again – always tied to my illness. It was the same way as we sometimes imagine that a job loss, market crash or divorce will ruin us forever.
It is not to be denied that my life has shifted in fundamental ways. But to my surprise, reality – while difficult – has not been as bad as I feared. Even the intended therapy I feared has been manageable. And that brought me back to a concept that I wrote about before: Hedonic adjustment.
Hedonic adjustment: The underestimated good news
Most of us are familiar with hedonic adjustment in the form of ‘good news fades’. You buy a new car, land a dream job or move to your ideal house. You are happier. . . A while. Then you return to your basic line.
As is often discussed on the White Coat Investor, this always takes place in medicine. New doctors – actually, not only new doctors, but doctors in all phases – often make large lifestyle purchases after an income jump, who expect a lasting boost in happiness. It can be a larger house, a luxury car or a dream holiday. But the bump in happiness is fleeting and they quickly adapt to their new lifestyle. That is one of the reasons why Dr. Jim Dahle and others advise doctors to slowly increase their expenses, which can reinforce their financial position and at the same time avoid the fall of eternal lifestyle inflation.
But there is a less well -known downside: the same adjustment works in reverse. Bad things also fade into their emotional impact. We fear that they will make us miserable forever, but our emotional set point withdraws us faster than we expect. I also experienced this in other seasons of life – including walking through a divorce that I wrote about in a previous column – and over time I thought that life could be full and meaningful again.
The psychology literature supports this. In a famous study, researchers compared the happiness of lottery winners and people with recent spinal cord glasles. Within a year, the happiness levels of both groups were sent back to the baseline. Other studies have found the same pattern after divorce, job losses and serious illness.
Of course, not every hardship fades completely, and some losses change our daily lives permanently. But even then our mind are remarkably good at finding a new normal.
More information here:
Hedonia vs. Eudaimonia
Will more money make me happier?
My adjustment in real time
While I write this column, I am still very much in this. The first days after the diagnosis were just as intense as I imagined – false, sadness, anger and uncertainty all struck at the same time. The emotional weight was heavy, and it is still. But something unexpected has already started to happen. I felt the earliest signs to drive back to my baseline.
Managing Panhypopituitarism, which I presented as a constant crisis, has not been as bad as I thought. Hormone replacement becomes routine. Even the intended therapy that I thought would be sick and weakened has so far been acceptable. It is still a lot to take with you, and I know that there are rocky roads for you, with possible setbacks and surprises.
Yet the intensity of those first emotions has already begun to fade. Daily management feels a little less overwhelming than I feared. In addition to the psychology of adaptation, I also found hope in my faith in God, which anchors me through uncertainty and power of the love and support of family and friends. Life still has weight, but it also still has joy, goal and moments of normality – and that was something that I did not expect to feel so quickly.
Why this is important for money and medicines
For your finances
We make the same mistake in proposing financial setbacks. We imagine that we lose our jobs, be confronted with a market crash or even be bankrupt, and we imagine that we feel miserable for years. The reality is usually different. We adapt, find new paths and recover a new normal. If you know this, you can take calculated risks – Jobs change, start a business or retire early – without being paralyzed by fear of the “what if it”.
For medicine
As doctors, we have all seen that patients adapt to unimaginable diagnoses or life changes. But in the exam room, newly diagnosed patients often often believe that their lives are permanently reduced. For my repetition I understood the psychology of Hedonic adjustment from an academic perspective – especially the “good news fades” side. But due to a large setback of health care, I have given me a much deeper, experiential understanding of his other side. It is one thing to quote studies on resilience; It is another to feel that slowly but steady withdraws to an emotional basin in your own life.
That experience has deepened my empathy for patients in the rough early stages of sadness or fear, and it allows me to offer them a little more than theory: the lived certainty that although the road can be difficult, life can be meaningful, joyful and even unexpectedly normal – and often rather they imagine.
More information here:
Learned financial lessons from a doctor who has become a patient
How my recent diagnosis of the brain tumor made me evaluate my finances
Why I write this now
I write this about two weeks after my diagnosis – not because I have discovered it all “, but because I need this memory myself. I want to plant a mental flag in the ground that says:” You overestimated how bad this will be.
I am still in the middle of uncertainty. My tumor is still there and my medicines are permanent. I don’t know what the future has in store. But I am already closer to my basic line than I would ever have predicted in those first terrible days.
You are more resilient than you think. And if the worst happens, there is a good chance that it will not be so bad – or if you are afraid.
Have you experienced the Hedonic adjustment in the opposite way? How long did it take before you are normal again? Is there a comfort that it can and will get better?
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