By Dr. Josh Daily, WCI Columnist

My journey with a craniopharyngioma started in the fall of 2021, shortly after the birth of my fourth child.

I felt constantly exhausted, gained some weight, and assumed it was just life with a newborn. Labs obtained to investigate these symptoms demonstrated a low testosterone level, which ultimately led to the diagnosis of a craniopharyngioma—a rare, benign but locally aggressive brain tumor. In February 2022, I underwent a complete surgical resection. The results were excellent: we got all of the tumor and my pituitary function was mostly intact (I only needed testosterone and levothyroxine replacement), and while I had a temporary third nerve palsy, it resolved within six months.

My surgeon and I both believed I was cured. Multiple clear MRIs reinforced that belief, and I moved on with life, grateful and optimistic. I even shared my story on a White Coat Investor podcast episode, certain it was now just a chapter from the past.

Fast forward to the summer of 2025. I started feeling . . . off.

It was nothing dramatic at first—just lower energy and a vague sense that I wasn’t at my best. Then, I noticed I was urinating more often than usual and feeling a little thirstier than normal. I chalked it up to summer heat or a busy schedule.

Still, I decided to get some labs checked. Around the same time, I realized my vision was a little blurry. Visual testing revealed a classic pattern of bitemporal hemianopia—loss of peripheral vision on both sides. That prompted a mad dash to get an MRI.

The result was a gut punch: my craniopharyngioma had returned. And this time, it was even larger than before.

Over the next week, the picture became even more complicated. My pituitary function had completely failed. On top of the testosterone and levothyroxine I was already taking from my initial surgery, I now had diabetes insipidus and adrenal insufficiency. I would need to replace every pituitary hormone—likely permanently—and carefully manage how much I drank, which activities I did, and how and when I adjusted my steroids and DDAVP.

I quickly weighed the option of repeat surgery, but the risk of significant morbidity with a second operation was much higher—and the odds of completely removing the tumor without recurrence were much lower. In the end, I started targeted BRAF and MEK inhibitor therapy—essentially an oral form of chemotherapy. And just like with everything else, I imagined the worst: constant side effects, feeling terrible all the time, and barely functioning.

Yet so far, a few weeks after my diagnosis, it hasn’t been that bad. Yes, there are side effects, but it's been nothing close to the day-in, day-out misery I pictured. It was another reminder that, whether in health or finances, our minds are quick to imagine the bleakest possible future—and slow to remember our capacity to adapt.

 

The Anticipation Was Worse Than the Reality (So Far)

In those first few days after the second craniopharyngioma was discovered, my mind went to dark places. I pictured a future where my life was fragile, limited, and dominated by medical management with constant worries about sodium levels, fluids, and steroid dosing. I imagined possibly losing my vision entirely, being permanently disabled, and never again doing the things I enjoy—always tethered to my disease. It was the same way we sometimes imagine that a job loss, market crash, or divorce will ruin us forever.

There’s no denying that my life has shifted in fundamental ways. But to my surprise, the reality—while difficult—hasn’t been as bad as I feared. Even the targeted therapy I dreaded has been manageable. And that’s brought me back to a concept I’ve written about before: hedonic adaptation.

 

Hedonic Adaptation: The Underrated Good News

Most of us are familiar with hedonic adaptation in its “good news fades” form. You buy a new car, land a dream job, or move into your ideal home. You’re happier . . . for a while. Then, you return to your baseline.

As is often discussed on The White Coat Investor, this plays out all the time in medicine. New doctors—actually, not just new doctors, but doctors at all stages—often make large lifestyle purchases after an income jump, expecting a lasting boost in happiness. It might be a bigger house, a luxury car, or a dream vacation. But the bump in happiness is fleeting, and they quickly adjust to their new lifestyle. That’s one of the reasons Dr. Jim Dahle and others advise physicians to increase their spending slowly, allowing their financial position to strengthen while avoiding the trap of perpetual lifestyle inflation.

But there’s a lesser-known flip side: the same adaptation works in reverse. Bad things also fade in their emotional impact. We fear they’ll make us miserable forever, but our emotional set point pulls us back faster than we expect. I’ve experienced this in other seasons of life, too—including walking through a divorce I wrote about in a previous column—and in time, I found that life could be full and meaningful again.

The psychology literature backs this up. In one famous study, researchers compared the happiness of lottery winners and people with recent spinal cord injuries. Within a year, both groups’ happiness levels had drifted back toward baseline. Other studies have found the same pattern after divorce, job loss, and serious illness.

Of course, not every hardship fades completely, and some losses permanently change our day-to-day lives. But even then, our minds are remarkably good at finding a new normal.

More information here:

Hedonia vs. Eudaimonia

Will More Money Make Me Happier?

 

My Adaptation in Real Time

As I write this column, I’m still very much in the middle of this. The first days after the diagnosis were every bit as intense as I imagined—fear, sadness, anger, and uncertainty all hitting at once. The emotional weight was heavy, and it still is. But something unexpected has already begun to happen. I’ve felt the earliest signs of drifting back toward my baseline.

Managing the panhypopituitarism, which I pictured as a constant crisis, hasn’t been as bad as I thought. Hormone replacement is becoming more routine. Even the targeted therapy I thought would leave me sick and debilitated has been tolerable so far. It’s still a lot to carry, and I know there will be rocky roads ahead, with possible setbacks and surprises.

Yet the intensity of those first emotions has already begun to fade. The day-to-day management feels a little less overwhelming than I feared. Alongside the psychology of adaptation, I’ve also found hope in my faith in God, which anchors me through uncertainty, and strength from the love and support of family and friends. Life still has weight, but it also still has joy, purpose, and moments of normalcy—and that’s something I didn’t expect to feel so soon.

 

Why This Matters for Money and Medicine

 

For Your Finances

We make the same mistake when imagining financial setbacks. We picture losing our jobs, facing a market crash, or even becoming bankrupt, and we imagine being miserable for years. The reality is usually different. We adapt, find new paths, and reestablish a new normal. Knowing this can help you take calculated risks—changing jobs, starting a business, or retiring early—without being paralyzed by fear of the “what ifs.”

 

For Medicine

As physicians, we’ve all seen patients adapt to unimaginable diagnoses or life changes. Yet in the exam room, newly diagnosed patients often believe their lives are permanently diminished. Before my recurrence, I understood the psychology of hedonic adaptation from an academic perspective—especially its “good news fades” side. But living through a major health setback myself has given me a much deeper, experiential understanding of its other side. It’s one thing to cite studies about resilience; it’s another to feel that slow but steady pull back toward emotional baseline in your own life.

That experience has deepened my empathy for patients in the raw early stages of grief or fear, and it allows me to offer them something more than theory: the lived assurance that while the road may be hard, life can become meaningful, joyful, and even unexpectedly normal again—and often sooner than they imagine.

More information here:

Financial Lessons Learned from a Doctor Turned Patient

How My Recent Brain Tumor Diagnosis Made Me Reevaluate My Finances

 

Why I’m Writing This Now

I’m writing this about two weeks from my diagnosis—not because I’ve “figured it all out,” but because I need this reminder myself. I want to plant a mental flag in the ground that says, “You’re overestimating how bad this will be.” Writing is, for me, an act of hope. And if it helps me, maybe it will help you—whether you’re facing a financial setback, taking on a personal challenge, or helping a patient navigate their own.

I’m still in the middle of uncertainty. My tumor is still there, and my medications are permanent. I don’t know what the future holds. But I’m already finding myself closer to my baseline than I ever would have predicted in those first awful days.

You’re more resilient than you think. And when the worst happens, there’s a good chance it won’t be as bad—or as permanent—as you fear.

Have you experienced the hedonic adaptation in reverse? How long did it take you to return to normal? Is there some comfort that it can and will get better?