[Editor's Note: Today's post is a little different, but provides a nice change of pace from our usual information-heavy approach. This one is a guest post from Bo Liu, a radiology resident who blogs at Future Proof MD. We have no financial relationship.]
“I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will allow my fear to pass over me and through me. And when it has gone I will turn my inner eye to see its path. And where the fear has gone there will be nothing. Only I will remain.” – From Frank Herbert's “Dune”.
We all have fears – that gripping sensation you feel when the possibility of a negative outcome enters your peripheral vision. You may fear something entirely different from me, but that sensation is shared. Fear can motivate us or petrify us. Some fears are common – fear of death, fear of illness, fear of hunger etc. But in modern civilization where the world runs on money, few fears rise higher in the ranks than the fear of poverty. Today I'm going to get a little personal and share with you my greatest financial fear.
My Background
Bo Liu, MD
A bit of background about me – I am a Chinese immigrant. I grew up in the biggest city in the northeast most province of China called Harbin. It’s a little bigger than Chicago by population size. Anywhere else in the world it would be considered a huge metro, but in China it’s just a regular sized city. My parents were well-educated professionals and very well compensated compared to their peers. So even though I grew up during a relatively impoverished period in Chinese economic history, I never knew what it was like to go hungry. In fact, mine was one of the very first private households in the entire city to get a telephone.
When we first arrived in the United States, my family came as illegal immigrants. So I had a drastically different experience. As a child, I remember driving in a car without air conditioning, raiding the trash at the local thrift store for clothes and moving from an apartment into someone’s basement to save on rent. Still I never went hungry – my mother worked at several local Chinese restaurants so there were always leftovers. What’s my point? I’ve known what it’s like to be poor, although not poor enough to be homeless or go hungry.
My Greatest Fear
Fast forward 20 years, I am now a resident physician in the great field of radiology, getting ready to apply for a fellowship in interventional radiology (IR). Despite my six figure student loan debt, most would say I am almost guaranteed an easy path to the American Dream. What do I have to fear? Not getting as many moonlighting hours as my co-residents, not matching into a good IR fellowship and not getting a good job afterwards? Sure, those are some of my financial fears. But above all others, I fear forgetting what it’s like to be poor. Believe it or not, I consider those first few tough years in America one of my most treasured memories. Sure it wasn’t fun to be made fun of at school because I wore clothes with holes and patches. But those early years were what taught me the importance of education, hard work, and good parenting, mostly through my mother. My mother was a traditional Chinese “Tiger Mom”. In addition to working multiple jobs at different local restaurants, she somehow always found time to go over my homework, and punished me for not doing them up to her standards. She loved to pinch me inside the thigh – in her words “minimum effort, maximum effect.” I would get a nice beating anytime I brought home anything less than a perfect score on a test or assignment although later on that standard was relaxed to getting an A in a class. Luckily that didn’t happen until my organic chemistry class in college – by then I was way too big for her to beat.
I have not had to go dumpster diving for clothes in as long as I care to remember. And I’ve grown accustomed to the creature comforts a resident’s income can afford. I eat out often and go on vacations with my college buddies. The problems I complain about now are typical “first world problems” like not having fast enough internet to stream an NBA game in HD. So there it is, my greatest financial fear – forgetting what it’s like to be poor and the lessons it brought. You may think it sounds cheesy but I consider it a real threat.
[Editor's Note: I suspect a lot of us fear being poor (for the second time for many of us.) However, I think it is important to recognize five things that should help us deal with this concern:
- Nobody in this country is truly destitute. The social safety net in this country ensures you will get a small income, food, a roof over your head (might be a homeless shelter), and some sort of health care. You won't be lying naked and hungry on a side walk.
- The same knowledge and skills that enabled you ( (the typical high-earning WCI reader) to acquire a high income and wealth in the first place would help you to do it again or even to live well at a lower income.
- Every year you will become more financially secure as debts decrease, net worth increases, and future income needs decrease (due to life expectancy.)
- It is both possible and inexpensive to insure against most of the things that would cause you to become poor- death of an earner, disability, illness, injury, fire, and liability.
- People adapt remarkably well to change in their lives. We often look at a patient's terrible health and tell ourselves we would hate to live like that. It turns out that when actually given that choice, most people not only choose to live like that, but find ways to still be happy in life while living like that.]
What do you think? Do you fear losing your income? Your wealth? Your health? What is your greatest financial fear? Is it logical? Do you do anything weird because of that fear? Comment below!
Must be nice to have never seen a truly destitute person in the US. Pretty sure I saw 3 on way to work tonight.
I was thinking the same thing. I see many destitute people on my way to work each day. Sometimes they’re sleeping in boxes over subway vents (For the warmth) or other times they’re riding the actual subway. It seems like we have a pretty robust safety net here in the United States, but clearly lots of people fall through it. I hope to never have to test it.
Im my city a huge amount of these people are mentally ill, lacking the social or mental capabilities to navigate the safety net system. There’s free healthcare, place to live, transportation, and food all downtown if you know about them. I’d like to think that a majority of readers would have the wherewithal to avail themselves of these if they were destitute. Not that readers couldn’t be afflicted with some debilitating mental illness I guess…
A couple of times, I’ve served on board of a pretty large nonprofit that serves the homeless in Seattle, the Compass Housing Alliance. ($15M annual budget, about a $100M of real estate.)
FWIW, my practical education on the homeless leads me to conclude that the state of homelessness is often a symptom of addiction or mental health problems. People in the trenches often make statements like, “70% of the population is either mentally ill or chemically addicted or both.”
Oh, and one other sort of chilling element to this… Regularly, the actual condition of homelessness is triggered by a death. Mentally ill chemically addicted son was never homeless as long as he could crash on mom’s couch. But once she died, he lost that fallback shelter option…
P.S. to Bo: You’re not going to forget your early poverty. In my late 50s, I’m still very influenced by my family’s poverty during my preschool years due to my dad being in medical school and doing his residency at LA County General.
Thank you. I hope not. Although I’m already starting to recognize some entitlement mentality in myself…
Exactly. There’s a huge debate in Salt Lake City right now about what to do about homeless services as the crowds of homeless are affecting businesses in the area. If I were homeless, I could sleep for free in the shelter, eat for free in the soup kitchen, get groceries from the food bank, get free health care at the homeless clinic, get free clothes at the Salvation Army and enjoy free internet and entertainment at the library. I could raise a significant amount of cash every day standing on a corner for a couple of hours a day with a sign saying “I’m a vet! Give what you can.” Far, far, far from what I have seen in many other countries, even for someone working hard farming their small plot of land in a Mayan village in Guatemala. And I haven’t even gotten to government programs like welfare, Medicaid, and SS Disability.
The reason that most of our chronically homeless are mentally ill or addicted is that the resources are sufficient that those who aren’t can generally rectify the situation relatively rapidly.
I lean toward the sentiment that people living in the US are not “destitute”. It is very ethnocentric to not realize that most of the rest of the world is a totally different place. If you have never experienced many places in Africa, Asia, the Middle East, Central and South America, then it is difficult to understand why many of us feel that the US is an incredibly rich place. I agree with WCI although shy away from terms like “Nobody” “Never” and “Always” as they are too broad which is likely what set many of you off.
Agree. We do have destitute people in the US for a variety of reasons, no doubt about it. But the fact of the matter is that the opportunity exists for them to get a free ambulance ride to free healthcare to free social work to free shelter/food (usually) to free welfare payment. Comparing this to my experiences in Africa and South America…well, there is no comparison. Again, this is the “destitute” population, not the “poor” who cannot afford a $4 prescription but still smoke daily, have a smartphone (with data plan), a TV (with cable), might be 350,000 Calories overweight, etc etc–these folks are wealthy to much of the world outside of the typical tourist spots.
Well said and great insight. I really appreciate this piece as a surgical resident in a very similar situation. Thanks Bo.
Thanks Nolan. It’s always good to know others are in the same boat. Good luck with surgical residency!
While I get what others are saying re the destitute I also get the authors sentiment. There are few barriers to opportunity in the us other then yourself. There is no class system holding you back. There’s instant ability to communicate, move, etc for other opportunities. Finally there is capital for others to invest in you. That all means with education and drive there are very few financial situations you can’t dig out of. Few but not 0, however it allows you to take more risk then if losing your job meant never making another dime and starvation. By the sheer fact that you have access to a computer and are reading this you have more opportunities then many people around the world.
It is always fascinating to get a peek into the backgrounds of the bloggers I read. Thank you for sharing, Bo, and I’m glad to know you better! Count me guilty of taking my blessings for granted too often – my dog (Beau!) lives better than do many people in 3rd world countries. Crazy, isn’t it?
Thanks Johanna. Dogs are family too! Btw, I was kind of upset I didn’t choose “Beau” as the spelling of my name when I first came here. Would have been way more exotic :).
You’re in good company with Bo Jackson. Beau is actually Beauregard, named after my grandfather who was named after the civil war general of the same name. I am sure Papa is still rolling over in his grave that I named a mere dog after him.
My biggest fear is having an illness that is improperly diagnosed. Our ED sees a lot of patients with poor mental health and substance abuse, many of whom hallucinate. However, these symptoms can be remarkably similar to symptoms of encephalitis. Without (reliable) friends or family to vouch for them and tell us that this is not normal for them, these patients typically head down the psychiatric pathway instead of the LP/medical pathway.
If I started hallucinating and was out on the streets for a few days and ended up in the ED but my family didn’t know where I was, down which pathway would I be sent?
That’s definitely a serious issue. The one time I went into our own ER as a patient, I felt the treatment was quite impersonal – and that’s with special treatment because I was a doctor there! As medicine become more and more about generating revenue rather than providing actual patient care, I shudder to think what would happen if I fell into the situation you described…
An older teen- think he went to ICU on family medicine service- came in hallucinating. He had been away camping with his family and they denied drug use but docs were still skeptical. Chief Peds heard about it thankfully same day he came in and told us check for HSV! Which the poor fellow had.
Great catch!
We had a patient in her 50s with no psychiatric history who had this, but without knowing about prior psych history or if the patient is in the late teens to 20s, it’s probably missed more than we think.
Really enjoyed reading this guest post Future Proof. I think remembering what it’s like to be a regular person is so important. A lot of us going into high earning professions risk the “big head” syndrome. We think we’re suddenly all that just because we have a big income coming in. We forget where we came from or what it was like living off nothing while we were in school. And then we start getting into the comparison trap. This guy has a big house, the nice car. So I need to get it too. Remembering where you came from is a great way to avoid this problem.
I do a lot of weird side hustles that should be “beneath” me. As an example. I like to do bike messenger deliveries in some of my spare time. It keeps me grounded. I don’t earn a ton being a bike messenger, and it’s not a job a professional like myself “should” be doing, but I find it fun and importantly, it keeps me grounded. Nothing will help you avoid that big head syndrome than delivering food to some guy in a fancy apartment who thinks you’re just a delivery man.
Thanks Financial Panther! Side hustles are the best! I used to shuttle people around as an Uber driver and remember many passenger shocked to find out I’m a physician. I did it mostly for the conversations and it was a really great time. Unfortunately I have to focus on residency and running FPMD these days, otherwise I would still be Ubering!
Your experience and story are compelling. Thanks for sharing. I found myself being very curious about your parents motivations to bring their Family here and how they have handled this change in their life. It is quite overwhelming what people throughout the world endure and how many sacrifice so much to come to the US.
Thanks Mark. I would go into details about my folks’ story but I fear it would take up the whole screen LOL. Long story short – we initially came because my father had a fallout with his boss and we landed in St. Louis. It actually caused quite a ruckus back home – I heard my grandfather was interviewed by state police because the government feared my father defected with state secrets. Anyways, I can go into more detail about the whole saga. Feel free to reach out to me at http://futureproofmd.com/
Two topics:
1) There is no real poverty in the US except for the substance addicted or mentally ill. Everyone else has access to free food, free shelter, and free healthcare.
2) I would like to compare myself to a friend of mine. I grew up relatively poor and took out loans for all my education. My buddy grew up in a wealthy home with nice cars and a free private education. For me it wasn’t a far journey to feel better off than my family, but for my friend, he still has a long way to go. My buddy spent 4x what I did on his home, and spends more on life’s luxuries that he was used to as a child. On the other hand my wife and I are very comfortable and happy with our lifestyle. It is our upbringing that sets us apart and it is that same upbringing that allows me financial security early in my career while my friend will be working well into his 60s.
I disagree with point 2. Some people (like myself) who grew up in very affluent households may have observed that spending more did not bring more happiness and impeded the progression to financial security. I live far more modestly than I did as a teenager and make less than half of what my father did (even without adjusting for inflation). I’m really okay with that because I know I’m quickly building toward financial independence and will never have to worry as much about how much money is coming in this month as he did.
In contrast, I have plenty of colleagues who grew up poor and are “making up for it” by living a lavish lifestyle paycheck-to-paycheck. I think this is more of a personality thing and determined by whether you know yourself well enough to understand what will really make you happy and content. Rich kids and poor kids can both make good or bad financial decisions depending on their temperament.
What an interesting perspective! I don’t think many people have had the opportunity to see life in that way.
Great post. And I loved the quote from Dune.
I still cut my own grass, clean my own house, but all in all, it’s been a long time since I was ever poor. And even then, I had a good house to live in, clean clothes, and food. And then my summer jobs in construction were just summers, and maybe a few winters in between semesters of school.
There is value to knowing what it’s like to do without and having to do hard labor for an hour’s wage.
It is good to reflect and remember where we came from and take positive steps to try to avoid repeating the unglory days. But, those days also help make us who we are. And they tell us that we can overcome obstacles, often some very high ones.
Great post. I try to not be driven by fear and a favorite acrostic helps: False Evidence Appearing Real.
cd :O)
Thanks CD! You lost me at “acrostic” lol. Had to look it up – I like it. Thanks for sharing.
Ha! I love that quote from Herbert! I know it by heart! I tend to pull it out in situations with rather dire physical consequences.
Dr. Bo might not remember because he was too young when he was in China, but if he did , he, too, just like me, would be most scared of one day waking up behind the Iron Curtain again, in un-freedom, with the Big Brother deciding everything for you and controlling your destiny (which, by and large is just misery any way you slice it)
Call it a paranoia, but I get real scared when the same slogans me and Dr. Bo grew up with in a “worker’s paradise” are now heard on the main stream American TV.
The comments above have focused on the mentally ill and addicted. There is currently a three part ( two out now) series on the treatment of schizophrenics in the NEJM.org by Lisa Rosenbaum MD.
She skewers our wrong- headed deference to patient autonomy and choice over patient medical and psychiatric welfare. I STRONGLY RECOMMEND reading it if you care for patients with schizophrenia.
What’s she saying mostly? To go back to the classic “paternalistic” style of doctoring?
absolutely.
I was fascinated by this post, mainly because I didn’t understand it. I read the words and realized that it was so entirely different to my way of thinking that I couldn’t relate. That’s the great thing about philosophy, we ain’t all the same.
Bo does not seem to fear poverty, as WCI seems to suggest. To the contrary, he acknowledges that, when it comes to financial matters, he has (or will have) it made. What Bo seems to fear is the loss of a way of life that forced him to go to great lengths in search of perfection, and then to stretch a little more. That work ethic, infused by his mother, was the most important thing in his life for many years, and he seriously fears he may lose that. He fears complacency.
Most would say that Bo’s experiences and efforts were exemplary, and I would agree. What I find most interesting is that I cannot relate to Bo’s experience in any way. I was never pushed by my parents to succeed. Things always just worked out; I never had to study to get straight As. So I can’t imagine a fear of losing a work ethic, because I never had one in the first place. There is no lesson or moral here, it’s just about different strokes.
Thanks John for the comment. You are correct, I definitely don’t fear poverty. Sometimes I daydream about how life would have been if I didn’t have the childhood I had (I’m sure we all wonder sometimes). I would like to think I would have still made it to where I am today, but then again, who knows? We definitely seem to have drastically different experiences but that’s ok – it’s what makes us unique :).
If it makes you feel any better, I think I’m inherently lazy too. But if I objectively look at how much I work, maybe not. One good thing about lacking a work ethic is you are always looking to become more efficient so you can work less!
If you’re constantly working to find new shortcuts, does that make you hard-working? ;P
Nothing wrong with a little laziness. It wasn’t the unthinking grunt that invented the Wheel or the Steam Engine. It was probably the guy who sat in the shade and began to think, “hmmm, there has to be a better way….”
How much to push a child to excel is a debatable thing.
I had the notion that my daughter needs to get a 99% in all subjects especially the STEM fields. But I have now come to accept that she is strong in languages but not as great in science and math as I would have liked. But as long as she gets 90+ I am happy.
I used to dream that she is going to an Ivy League school but now accept that as long as she is happy anywhere that she goes, I am fine too. I don’t want to live vicariously through my child. She is her own being.
Sounds like you are a much more reasonable parent than my mother was. I would not wish the beatings I received on any child, but I do think it helped form my work ethic and my refusal to settle for “good enough”. I should have you speak with my mother, sometimes it still seems like she’s trying to live my life for me.
Future Proof MD
As you might have guessed I am an Asian Indian, first generation in this country. Indians are as bad if not worse in being Tiger Moms and Tiger Dads. All they want is kids to enter science / Math fields and become an engineer or a doctor. They goad them to achieve higher and higher scores, burn the candle at both ends, take tuition after school and not have any hobbies. At least Chinese want their kids to learn Piano or violin. Many Indian parents don’t care if their kids take up music or not – especially male kids.
Regarding corporal punishment – it is very common in India and almost accepted. My elder brother had a couple of them from my dad for lowish scores, even though my father was otherwise a reasonable dad. Luckily my younger brother and I scored the highest in our class and escaped any punishment. I decided in my teens that if I have any kids I will not beat or hit them, especially for any academic underachievement.
I have only padded my daughter twice for grossly disobeying me but both times I felt ashamed of myself 5 minutes after doing it and actually apologized to her. I feel that not hitting a child builds up trust and they will come to you with any fear they have and not get rebel and get into teenage sex, unwanted pregnancy, drugs etc. These are more important in the long term than a few points difference in GPA or SAT scores.
Anyway enough of my rambling and hope you see the other side of the coin when you have your kids. Pinching the inner thighs does not help achieve higher grades, it only causes pain and resentment. If you disagree with that, that is also OK by me.
I don’t disagree with you at all! Sorry it’s probably not coming across right in the comments, but I don’t believe in physical discipline. I believe that those same lessons (hard work, valuing education etc.) can be taught without resorting to violence. Unfortunately my upbringing was much different. Like I said – you sound like a much more reasonable parent than my mom.
As a Chinese -American who had similarly demanding parents, this article struck a chord with me. Thankfully our family wasn’t as poor although my parents were also immigrants. Straight As were acceptable in our family; getting 100% was not required.
Those of us who were pushed became physicians, professionals, or at the least finished college. However, the people that had more prosperous parents seemed to have much less pressure and didn’t have much professional success even with many advantages.
A good balance is best in my humble opinion. Trying your best at the very least with straight As being the best outcome is what I’ll push my future kids to do.
One thing tiger parents don’t push is sports. I think you can have straight As with sports in addition to volunteering and other extracurricular activities. Of course of my future kids suck at sports then obviously they wouldn’t be expected to excel in that area haha.
Every kid is good at something, and will suck at something. It’s impossible to be good at everything. I think the people who care enough about their children’s education and future success to watch their grades like a hawk and put up strict minimum requirements just also happen to be the same people who are genetically advantaged to have successful children.
Oh I actually disagree. I think you can brute force your way to straight As at a normal HS, not a crazy top 10 usnews HS though.
The subjects I was good at were AP science ones or being a grade above for math. But it may be our Asian way of thinking. 🙂
I’m a day late, but no dollars short. I’ve got those, now, and no real fear of losing them.
My biggest money-related fear is regretting my decision to retire early. On the other hand, I don’t want to regret working much longer than necessary for money I can live without. Finding that balance, and minimizing the likelihood of regret, is what I’ve been working on lately. http://www.physicianonfire.com/early-retirement-likelihood-regret/
It was great to get to know you a bit better, Bo. In comparison, I’ve had it so easy. Thank you for sharing your story here.
-PoF
“I don’t want to regret working much longer than necessary for money I can live without.” Well said! Thanks PoF for all your wisdom and advice!
I never felt poor but plenty of my rich neighborhood kids thought I was. My folks grew up in rural South Dakota so brand new cars every year or three and designer jeans were ridiculous concepts. My dad went from farmer’s son (he’s the “& Son” on a silo that’s still standing) to math professor courtesy Space Race, my mom as a woman born in the ’40s was bright enough to have done the same but SD women weren’t allowed those opportunities then. I never had to work hard at school and fell into med school as a default- bet nowadays I might not demonstrate the extracurriculars and leadership to get into an Ivy and med school as I did, dunno. (But working after school every day babysitting may have excused the lack of anything else but math team.)
My husband comes from more blue collar roots yet international, and his mom was very hungry as a child in Germany after and during WW2. I raised my family with the concept that they shouldn’t be the bullying rich brats I went to school with, and while not sure they were never bullies at least know they understand money is not to be taken for granted.
We’ve produced a rocket scientist who takes some of my financial advice but won’t buy into my concept that she might want to quit working well before age 60, assuring me (correctly) that NASA is a lot better workplace environ than the VA or even US Army. (But we need to remind her especially in this political era that NASA is not guaranteed to never lay off employees.) The other is still in HS, and I worry that our keeping her bank account from running dry leads her to value things only to the degree of not making us decide she HAS to go on a budget. EG she is buying A NEW DRESS for every school dance… and they have 2-3 a year! Heresy to us.
BTW my husband is the lazy inventor. Eventually I calmed down my SD Lutheran work ethic enough to not be MAD that he finds the easy/lazy way to do things, and to take advantage of it. Now instead of asking him to come do a few hours of manual labor (and be left infuriated if he can do it in minutes due to better strength and/or ability) I ask him how (OR IF!) he thinks I should accomplish a chore and save a lot of work (and resentment) that way.
Great story! I genuinely believe that you will not forget your roots. Based on your honesty I think that the love of your family and the moments you shared with them made poverty bearable. And you will always have your mother’s “Time Mom State Of Mind” that will guide you through your financial decisions. However, knowing your roots and going back to your roots are two different stories. My personal financial fear is being poor again. I seriously think that I can’t go through that again.
Don’t you think that already knowing what you know now you could become wealthy again? I know I could.