“No one knew how many transfusions would be necessary. Heated disagreement ensued. We were trying, as Isaac does now at the poker table, to calculate with incomplete information the probability of various outcomes. We knew that any action would have to be predicated on our understanding of probabilities.”, Brooks Haxton, Time Magazine
“In my opinion, and with the benefit of hindsight, the odds of the 2008 financial crisis occurring were so improbable, that no banker could have taken actions just prior to it occurring (say in 2007 or early 2008) that would have made a material difference, without looking like a wild speculator to their customers, employees, shareholders, and regulators. In point of fact, it was only a handful of unregulated, high risk speculators who got it (mostly) right and placed the appropriate bets to prosper when the unprecedented collapse occurred. And it is only because firms like Goldman Sachs were sought out by these speculators to help structure and create these bets (and importantly, they were not regulated banks at that time) that they were able to study these speculators information and arguments (essentially utilizing their inside information as market makers) and reduce risk themselves.” Mike Perry, former Chairman and CEO, IndyMac Bank
Playing the Cards
APRIL 25, 2014
Credit Illustration by Melinda Josie
By BROOKS HAXTON
A year ago, I found out that my son, Isaac, won $300,000 playing online poker the previous day. His mother, Francie, was pleased to hear about this on her way out the door for work. The next day, I learned that he won another $62,000.
A few weeks later, I discovered that Isaac had lost $800,000, probably the largest loss for anyone in the world that day, and his losses for several weeks looked similarly catastrophic. For Isaac, these results fall squarely within the kind of variance he expects. He had been playing poker online for 10 years and before his losing streak was up $1.6 million for that year alone.
Francie and I like to avoid risk as much as we can, and Isaac’s detachment from our sense of money makes us queasy. But 28 years ago, three days after he was born, we risked as much as we could imagine. The pediatrician sent Isaac directly from a routine checkup to the neonatal intensive care unit of Albert Einstein Medical College, in the Bronx. From work, I sped to the hospital in tears.
Isaac’s skin was the sickly yellow of an old bruise, and the toxicity of his blood rose steadily toward the level where, experts told us, permanent brain damage would set in. Every time one of the nurses jabbed his heel for another blood test, he began to cry, and Francie wept.
The bilirubin in his blood soon rose to the level that indicated a need for a total exchange transfusion, which meant removing all of Isaac’s blood through an umbilical catheter and replacing it with blood products from the hospital. But the blood products frightened us as much as the bilirubin. In 1985, the Bronx was a hot spot for the AIDS epidemic, then at its height, and we had doubts about the reliability of the new screening test.
The doctors in the I.C.U. insisted that we do the total exchange to avoid the crippling effects of the toxin in Isaac’s brain. My helplessness felt something like a trance. These doctors were excellent at their job, but I trusted Francie’s judgment more. She had been a nursing teacher and was now a third-year medical student.
Brooks Haxton Credit Frances Haxton
She was insisting, although no one mentioned this alternative, that we exchange half of Isaac’s blood for an equal volume of saline to dilute the bilirubin. Blood is, after all, mostly salt water. The partial exchange would remove some of the toxin and lower what remained in proportion to the overall volume of blood, giving Isaac a chance to make more good blood for himself. If this failed, Francie told me, we could still consider a transfusion with blood products. The terrible likelihood was that the source of the problem, which no one understood, would keep causing it. No one knew how many transfusions would be necessary.
Heated disagreement ensued. We were trying, as Isaac does now at the poker table, to calculate with incomplete information the probability of various outcomes. We knew that any action would have to be predicated on our understanding of probabilities.
The doctors described the risks. Francie nodded steadily, as if the physical act of nodding generated empathy and understanding on both sides. But she refused the permission necessary, and I stood behind her, while the doctors shot wild looks my way, in hopes that I might reason with her or take charge. Finally, they agreed to Francie’s plan, and it bought us time until the problem seemed to dissipate as inexplicably as it began.
We played the cards as they were dealt. Francie happened to have the presence of mind and the expertise to play them with great skill, and we got lucky.
I am not arguing that medical science is a game of chance. To think of the world primarily as a game is appalling. Einstein said that “the Old One,” his name for the ultimate cosmic power, “does not throw dice.” The logical crux of this statement for an agnostic like Einstein might have involved some gamesmanship. But Einstein’s refusal to accept a way of thinking that devalues the idea of consequence and choice has always struck me as admirable.
In Isaac’s case, the mathematical ability he uses to play poker, like his transient hyperbilirubinemia, must come from an improbable combination of genes. His mind-set under pressure, I believe, is inherited largely from his mother, who has never taken an interest in games. For reasons Einstein would approve, Isaac does not throw dice. He uses the cards.
Brooks Haxton teaches writing at Syracuse University. His memoir, “Fading Hearts on the River: A Life in High-Stakes Poker,” will be published next month.
Email submissions for Lives to email@example.com. Because of the volume of email, the magazine cannot respond to every submission. Share comments on this essay at nytimes.com/magazine.A version of this article appears in print on April 27, 2014, on page MM54 of the Sunday Magazine with the headline: Playing the Cards.