Financial Lessons from a Doctor Who Became the ICU Patient

I am an academic pulmonary and critical care physician, husband, and father to four young children. I am the sole income earner in our household of six, and I am the finance nerd. My personal finance journey began in 2021. That year, I discovered The White Coat Investor, took an online course, and fired our “financial advisor.” I became a DIY investor.

All of that helped my family and me during some of the scariest moments of my life.

The 2024-2025 influenza season was the worst since the 2009 H1N1 pandemic. Following a week working in the ICU in February 2025, caring for patients critically ill with influenza, I came down with the flu myself. It triggered my asthma, and I eventually got sick enough that I drove myself to a local hospital. After being treated in the ED, I was admitted and then quickly transferred to the ICU.

I spent more than a week in the ICU, which included some harrowing moments, and then was discharged home to continue my recovery. On high-dose steroids, I lost over 10 pounds of muscle, could not get up the stairs without a cane, and could not sleep. It was humbling and disorienting.

Nearly two months after my initial symptoms—with excellent medical and psychological care and physical rehabilitation—I returned to work. I had regained my strength and stamina, and I was excited to get back to the clinical job I loved. At home, I could again be the husband and father I wanted to be.

Throughout this journey of illness and recovery, I learned much about myself, my family, and my work. In the process, I confronted, in an immediate way, many of the concepts that pervade the physician personal finance space.

Financial Planning Can Help DIY Investors

In the months leading up to my unexpected illness, my wife and I had a series of meetings with a fee-only financial planner. It was a different experience than we had previously with an insurance salesperson working as an advisor. For a low four-figure fee, our new planner offered a service that would validate and tweak the financial plan my family had in place. Since I am the personal finance hobbyist in our household, this approach would help provide “Ian gets hit by a bus” insurance—peace of mind that my wife would have a detailed understanding of our financial life and an initial point of contact in the event I became incapacitated.

When we started meeting with the planner, we had no idea that we might get close to needing that peace of mind so soon.

Have an Emergency Fund

One suggestion our planner made was to increase the size of our emergency fund. As an “optimizer,” I had been keeping our cash lean, about a month's worth of expenses. But in response to our planner’s suggestion, we started building up cash in our bank account and in a money market fund in our brokerage account—close to three months of expenses in total. Lying in an ICU bed, it gave me great solace to know that my family had immediate access to those liquid assets should the need arise. I felt particularly grateful, knowing many of my patients do not have the same privilege.

Get Own-Occupation Disability Insurance from an Independent Agent

When I started following WCI, I took a closer look at my disability policy. I had obtained the policy—along with term and small whole life policies—through the “financial adviser” we met nearly a decade previously, in response to the anxiety induced by the impending birth of my first child. When I went DIY, I canceled the whole life policy after putting in place appropriate term insurance, chalking it up to a “stupid tax” on my personal finance journey. Fortunately, the whole life only had three-figure monthly premiums. Perhaps not surprisingly, the disability policy did not have a true own-occupation rider, did not provide a sufficient benefit, and seemed relatively costly.

After engaging with an independent agent, I obtained quotes for true own-occupation policies from several of the “Big 5” companies. I was offered a policy with an adequate benefit but with an exclusion for my asthma (since I was on several controller medications and had received steroid bursts for exacerbations). In the time between when my first policy was issued and the new policy underwriting, the respiratory viruses my children transmitted every few weeks throughout the winter months had taken a toll.

Nevertheless, since my asthma was well controlled most of the time and it seemed like an unlikely cause of long-term disability, I decided to pursue the new policy. I was somewhat reassured by the fact that I had employer-provided short- and long-term policies, which did not have the asthma exclusion.

Fast forward to my admission to the hospital after my asthma had been triggered. I thought about what would happen if I got so sick that my illness caused a long-term disability. I knew my employer policy would help. But I was frustrated that I had not used an independent agent to obtain a better policy when I was younger, before my asthma became a problem.

My experience is a reminder to young physicians to contact an independent agent and obtain an appropriate disability policy, if they have not already.

Low Fixed Costs Provide Flexibility

Contemplating a scenario in which our family income was significantly lower for a period of time—or even permanently—I was grateful that we had made several decisions to limit fixed costs in our budget. We bought a modest home after fellowship, and we refinanced when interest rates were below 3%. Despite our growing family, we stayed put when we looked at the market and realized what it would cost to move to a larger home. Two of our children share a room; they are surviving, even if begrudgingly at times. Thanks to good timing and prudent decisions, our housing costs consumed around 10% of our take-home pay.

We had also eliminated all non-mortgage debt in the preceding years. Having made several suboptimal decisions regarding new car purchases as we added children and their bulky car seats, we at least limited the damage by sticking to Hondas and Toyotas. We had paid off the most recent pair, so we had no car debt. Our student loans—which totaled over $300,000 combined at one point—were also gone. We paid off what was left of my wife’s loans–which she accrued in psychology graduate school–when she made the decision to stay home after our fourth child was born, and I had eliminated mine through a combination of IDR payments, NIH loan repayments, and PSLF. We carried no consumer debt.

With limited forced outlays, I knew we had flexibility if we needed to make significant changes in our family budget.

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Employed Physicians and Downside Risk Protection

There are many benefits to practice ownership, including professional autonomy and the ability to capture upside income. My experience does not discount that reality, and I am not arguing that one practice model is necessarily better than the other. But I gained a new appreciation for the downside risk protection I enjoyed as an employed physician facing a significant illness.

First, as a member of a large academic group, my employer could manage my absence from clinical services through a combination of our clinical backup schedule and the flexibility of a large group to absorb the shifts. Had I been an owner of a small or solo practice—or, frankly, a small-business owner of any kind—the reality could have been very different, and I might have faced professional and financial pressure to return to work before I was sufficiently recovered.

Second, I enjoyed several employee benefits relevant to my illness. I had short-term disability to mitigate near-term loss of income, and an employer-sponsored long-term policy in the event the effects of my illness lingered. I also benefited from highly subsidized, generous health insurance for myself and my family. The direct costs of my illness were unlikely to exceed $1,000, although the explanation of benefits made clear that with a different policy, I might have faced many thousands or even tens of thousands of dollars in out-of-pocket costs.

Money Is Just a Tool; Other Things Matter More

Of course, I am not a finance robot, and the most important lessons from my illness were not financial. I was overwhelmed by the outpouring of support from my friends and colleagues at work and from neighbors at home. They reminded me of the depth of the relationships I built over more than a decade at my current institution. And in the midst of the chaos of midlife with four children, I gained a renewed appreciation for my incredible wife and wonderful family.

Being a Physician Is a Privilege

I recognized how fortunate I was to have a job that I love, a job that provides me the means to support my family and cultivates professional meaning and purpose. I suppose some people might go through an illness like mine and feel jolted to make a professional change, sensing they were somehow wasting their time in life. Instead, as an ICU patient myself, I was reminded of how important my job is to my patients and their families. My fear was not that I would live with regrets about how I had been conducting my life, but rather that I might not return to the life I had been privileged to lead prior to my illness. I hoped to regain the position I held as an academic pulmonary and critical care attending, collaborating with wonderful team members to do important work in the ICU.

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Gratitude Helped Me Heal

Throughout my illness and recovery, I found connecting with gratitude to be healing. I am grateful to the medical professionals who helped me return home. Grateful to my patients and their families, through whom I have the privilege to be a physician. Grateful for the friends who helped my family get through a scary time. Grateful to my children for their love, bravery, and healing hugs. Grateful to my wife, who I am so fortunate to have as my partner in our life of mostly wonderful chaos. And yes, grateful to Dr. Jim Dahle and the WCI community for inspiring my own personal finance journey, which provided some peace of mind during a difficult period of my life.

What lessons have you taken away from a trip to the hospital or a longer-than-normal illness? Did you make changes in your financial life afterward? Did you find gratitude?