A woman who spent seven years bedbound after a misunderstood illness describes a practical framework she created—“the cost of trying” plotted against the cost of failure—to decide when to act, when to prepare, and when to avoid reckless odds.
When you’re staring at a challenge you can’t afford to get wrong, the hardest part isn’t always effort. It’s deciding how much effort to put in before you pitch your idea, ship your plan, or make your move.
At 21, she learned that lesson the painful way. She became sick with a complicated and poorly understood illness. For seven years she was homebound and bedbound. Eventually, test results suggested surgery might be able to cure her.
The problem was brutal and simple: no good surgery existed.
She wasn’t a surgeon or a doctor. But she wasn’t willing to wait out the possibility of getting well. She decided to invent the surgery and persuade someone to give it to her. What she needed, before she could ask for anything, wasn’t talent. It was timing—how to know when she was ready to pitch the idea to surgeons.
To make that decision, she developed a tool called “the cost of trying.”
In her framing, the cost of trying is the preparation it takes to put out a best effort. Some tasks are low cost to attempt; others are high. The real power comes from combining that with the cost of failure—then plotting both on a two-by-two matrix. The grid sorts tasks into four strategies.
Low cost of trying, low cost of failure: repeat action
When both the preparation needed for a best effort is low and the consequences of getting it wrong are also low, repeated action is the path forward.
Her example comes from the early stage of developing the surgery. The “low-cost-of-trying” version of the work was searching for medical papers on adrenal surgery. Even when the search came up empty, the only cost was her time and effort.
After a year of looking, she found a single page from an online Georgia State lab manual explaining how to do the surgery she needed on rats. It wasn’t a solution, but it gave her momentum.
If your task lands in the first quadrant, she says, the rule is straightforward: keep trying until you succeed.
High cost of trying, low cost of failure: try early
This quadrant is built for speed. When the cost of putting out a best effort is high but the cost of failure is low, the best move is to try early.
Her description is closely tied to the tech instinct to move quickly and learn as you go. She points to examples like beta testing for an app or feature—trying early to see whether you can succeed while avoiding some of the preparation that comes with aiming for “best effort.” Preselling a book or online course. and iterating with an audience on a product. are also examples.
High cost of trying, high cost of failure: preparation
In the third quadrant, everything feels heavier. Preparation can determine whether you succeed or suffer a costly mistake.
She calls this the high-stakes quadrant: meticulous preparation can set you up for success. but anything less steers you toward costly failure. And while it can feel like the hardest to manage, she argues it’s not helplessness—it’s leverage. Preparation gives you a strong way to influence the outcome.
Low cost of trying, high cost of failure: speculation
The final quadrant is where she draws the sharpest line. Low cost of trying and high cost of failure describes risky work where preparation can’t meaningfully bend the odds.
Her warning is blunt: she compares it to Russian roulette—no way to mitigate risk if the effort needed to try is low but the consequences of failure are death. For most real-world problems, she says, it’s a no-go zone.
There are two situations where it can make sense. First, when you have a new insight and you can find a way to prepare the task. In that case, the goal is to shift the challenge into the preparation quadrant.
The second situation is when the payoff is high and you can weather the loss. She connects that to much of the venture capital world. where teams expect failures to cost millions while waiting for the success that makes them billions. If the odds swing and you can afford the losses, it can become a competitive advantage.
She used the matrix to save herself
When she looked back at her own life’s biggest challenge, she didn’t treat it as a motivational story. She used the tool as a decision system.
She realized she was in quadrant 3—high cost of trying and high cost of failure. The conclusion followed: she needed to prepare, and then prepare some more.
It took four years to develop the surgery and build the medical team to undertake it.
Her surgery was successful. It was eventually done on both of her adrenal glands. She got her health back. And the surgery is now the standard of care at several hospitals for a related rare disease.
In the end, the matrix wasn’t just something she used to survive one crisis. She argues you don’t have to wait for your life to be on the line to apply it.
Plot your to-do list and work tasks onto the cost-of-trying matrix, and you’ll know when you should be taking action—and when you should be building the preparation that makes action safe.
cost of trying procrastination decision framework risk preparation venture capital healthcare surgery strategy