More on Leadership

Christian Soschner
3 years ago
Steve Jobs' Secrets Revealed
From 1984 until 2011, he ran Apple using the same template.
What is a founder CEO's most crucial skill?
Presentation, communication, and sales
As a Business Angel Investor, I saw many pitch presentations and met with investors one-on-one to promote my companies.
There is always the conception of “Investors have to invest,” so there is no need to care about the presentation.
It's false. Nobody must invest. Many investors believe that entrepreneurs must convince them to invest in their business.
Sometimes — like in 2018–2022 — too much money enters the market, and everyone makes good money.
Do you recall the Buy Now, Pay Later Movement? This amazing narrative had no return potential. Only buyers who couldn't acquire financing elsewhere shopped at these companies.
Klarna's failing business concept led to high valuations.
Investors become more cautious when the economy falters. 2022 sees rising inflation, interest rates, wars, and civil instability. It's like the apocalypse's four horsemen have arrived.
Storytelling is important in rough economies.
When investors draw back, how can entrepreneurs stand out?
In Q2/2022, every study I've read said:
Investors cease investing
Deals are down in almost all IT industries from previous quarters.
What do founders need to do?
Differentiate yourself.
Storytelling talents help.
The Steve Jobs Way
Every time I watch a Steve Jobs presentation, I'm enthralled.
I'm a techie. Everything technical interests me. But, I skim most presentations.
What's Steve Jobs's secret?
Steve Jobs created Apple in 1976 and made it a profitable software and hardware firm in the 1980s. Macintosh goods couldn't beat IBM's. This mistake sacked him in 1985.
Before rejoining Apple in 1997, Steve Jobs founded Next Inc. and Pixar.
From then on, Apple became America's most valuable firm.
Steve Jobs understood people's needs. He said:
“People don’t know what they want until you show it to them. That’s why I never rely on market research. Our task is to read things that are not yet on the page.”
In his opinion, people talk about problems. A lot. Entrepreneurs must learn what the population's pressing problems are and create a solution.
Steve Jobs showed people what they needed before they realized it.
I'll explain:
Present a Big Vision
Steve Jobs starts every presentation by describing his long-term goals for Apple.
1984's Macintosh presentation set up David vs. Goliath. In a George Orwell-style dystopia, IBM computers were bad. It was 1984.
Apple will save the world, like Jedis.
Why do customers and investors like Big Vision?
People want a wider perspective, I think. Humans love improving the planet.
Apple users often cite emotional reasons for buying the brand.
Revolutionizing several industries with breakthrough inventions
Establish Authority
Everyone knows Apple in 2022. It's hard to find folks who confuse Apple with an apple around the world.
Apple wasn't as famous as it is today until Steve Jobs left in 2011.
Most entrepreneurs lack experience. They may market their company or items to folks who haven't heard of it.
Steve Jobs presented the company's historical accomplishments to overcome opposition.
In his presentation of the first iPhone, he talked about the Apple Macintosh, which altered the computing sector, and the iPod, which changed the music industry.
People who have never heard of Apple feel like they're seeing a winner. It raises expectations that the new product will be game-changing and must-have.
The Big Reveal
A pitch or product presentation always has something new.
Steve Jobs doesn't only demonstrate the product. I don't think he'd skip the major point of a company presentation.
He consistently discusses present market solutions, their faults, and a better consumer solution.
No solution exists yet.
It's a multi-faceted play:
It's comparing the new product to something familiar. This makes novelty and the product more relatable.
Describe a desirable solution.
He's funny. He demonstrated an iPod with an 80s phone dial in his iPhone presentation.
Then he reveals the new product. Macintosh presented itself.
Show the benefits
He outlines what Apple is doing differently after demonstrating the product.
How do you distinguish from others? The Big Breakthrough Presentation.
A few hundred slides might list all benefits.
Everyone would fall asleep. Have you ever had similar presentations?
When the brain is overloaded with knowledge, the limbic system changes to other duties, like lunch planning.
What should a speaker do? There's a classic proverb:
“Tell me and I forget, teach me and I may remember, involve me and I learn” (— Not Benjamin Franklin).
Steve Jobs showcased the product live.
Again, using ordinary scenarios to highlight the product's benefits makes it relatable.
The 2010 iPad Presentation uses this technique.
Invite the Team and Let Them Run the Presentation
CEOs spend most time outside the organization. Many companies elect to have only one presenter.
It sends the incorrect message to investors. Product presentations should always include the whole team.
Let me explain why.
Companies needing investment money frequently have shaky business strategies or no product-market fit or robust corporate structure.
Investors solely bet on a team's ability to implement ideas and make a profit.
Early team involvement helps investors understand the company's drivers. Travel costs are worthwhile.
But why for product presentations?
Presenters of varied ages, genders, social backgrounds, and skillsets are relatable. CEOs want relatable products.
Some customers may not believe a white man's message. A black woman's message may be more accepted.
Make the story relatable when you have the best product that solves people's concerns.
Best example: 1984 Macintosh presentation with development team panel.
What is the largest error people make when companies fail?
Saving money on the corporate and product presentation.
Invite your team to five partner meetings when five investors are shortlisted.
Rehearse the presentation till it's natural. Let the team speak.
Successful presentations require structure, rehearsal, and a team. Steve Jobs nailed it.

Florian Wahl
3 years ago
An Approach to Product Strategy
I've been pondering product strategy and how to articulate it. Frameworks helped guide our thinking.
If your teams aren't working together or there's no clear path to victory, your product strategy may not be well-articulated or communicated (if you have one).
Before diving into a product strategy's details, it's important to understand its role in the bigger picture — the pieces that move your organization forward.
the overall picture
A product strategy is crucial, in my opinion. It's part of a successful product or business. It's the showpiece.
To simplify, we'll discuss four main components:
Vision
Product Management
Goals
Roadmap
Vision
Your company's mission? Your company/product in 35 years? Which headlines?
The vision defines everything your organization will do in the long term. It shows how your company impacted the world. It's your organization's rallying cry.
An ambitious but realistic vision is needed.
Without a clear vision, your product strategy may be inconsistent.
Product Management
Our main subject. Product strategy connects everything. It fulfills the vision.
In Part 2, we'll discuss product strategy.
Goals
This component can be goals, objectives, key results, targets, milestones, or whatever goal-tracking framework works best for your organization.
These product strategy metrics will help your team prioritize strategies and roadmaps.
Your company's goals should be unified. This fuels success.
Roadmap
The roadmap is your product strategy's timeline. It provides a prioritized view of your team's upcoming deliverables.
A roadmap is time-bound and includes measurable goals for your company. Your team's steps and capabilities for executing product strategy.
If your team has trouble prioritizing or defining a roadmap, your product strategy or vision is likely unclear.
Formulation of a Product Strategy
Now that we've discussed where your product strategy fits in the big picture, let's look at a framework.
A product strategy should include challenges, an approach, and actions.
Challenges
First, analyze the problems/situations you're solving. It can be customer- or company-focused.
The analysis should explain the problems and why they're important. Try to simplify the situation and identify critical aspects.
Some questions:
What issues are we attempting to resolve?
What obstacles—internal or otherwise—are we attempting to overcome?
What is the opportunity, and why should we pursue it, in your opinion?
Decided Method
Second, describe your approach. This can be a set of company policies for handling the challenge. It's the overall approach to the first part's analysis.
The approach can be your company's bets, the solutions you've found, or how you'll solve the problems you've identified.
Again, these questions can help:
What is the value that we hope to offer to our clients?
Which market are we focusing on first?
What makes us stand out? Our benefit over rivals?
Actions
Third, identify actions that result from your approach. Second-part actions should be these.
Coordinate these actions. You may need to add products or features to your roadmap, acquire new capabilities through partnerships, or launch new marketing campaigns. Whatever fits your challenges and strategy.
Final questions:
What skills do we need to develop or obtain?
What is the chosen remedy? What are the main outputs?
What else ought to be added to our road map?
Put everything together
… and iterate!
Strategy isn't one-and-done. Changes occur. Economies change. Competitors emerge. Customer expectations change.
One unexpected event can make strategies obsolete quickly. Muscle it. Review, evaluate, and course-correct your strategies with your teams. Quarterly works. In a new or unstable industry, more often.

Aniket
3 years ago
Yahoo could have purchased Google for $1 billion
Let's see this once-dominant IT corporation crumble.
What's the capital of Kazakhstan? If you don't know the answer, you can probably find it by Googling. Google Search returned results for Nur-Sultan in 0.66 seconds.
Google is the best search engine I've ever used. Did you know another search engine ruled the Internet? I'm sure you guessed Yahoo!
Google's friendly UI and wide selection of services make it my top choice. Let's explore Yahoo's decline.
Yahoo!
YAHOO stands for Yet Another Hierarchically Organized Oracle. Jerry Yang and David Filo established Yahoo.
Yahoo is primarily a search engine and email provider. It offers News and an advertising platform. It was a popular website in 1995 that let people search the Internet directly. Yahoo began offering free email in 1997 by acquiring RocketMail.
According to a study, Yahoo used Google Search Engine technology until 2000 and then developed its own in 2004.
Yahoo! rejected buying Google for $1 billion
Larry Page and Sergey Brin, Google's founders, approached Yahoo in 1998 to sell Google for $1 billion so they could focus on their studies. Yahoo denied the offer, thinking it was overvalued at the time.
Yahoo realized its error and offered Google $3 billion in 2002, but Google demanded $5 billion since it was more valuable. Yahoo thought $5 billion was overpriced for the existing market.
In 2022, Google is worth $1.56 Trillion.
What happened to Yahoo!
Yahoo refused to buy Google, and Google's valuation rose, making a purchase unfeasible.
Yahoo started losing users when Google launched Gmail. Google's UI was far cleaner than Yahoo's.
Yahoo offered $1 billion to buy Facebook in July 2006, but Zuckerberg and the board sought $1.1 billion. Yahoo rejected, and Facebook's valuation rose, making it difficult to buy.
Yahoo was losing users daily while Google and Facebook gained many. Google and Facebook's popularity soared. Yahoo lost value daily.
Microsoft offered $45 billion to buy Yahoo in February 2008, but Yahoo declined. Microsoft increased its bid to $47 billion after Yahoo said it was too low, but Yahoo rejected it. Then Microsoft rejected Yahoo’s 10% bid increase in May 2008.
In 2015, Verizon bought Yahoo for $4.5 billion, and Apollo Global Management bought 90% of Yahoo's shares for $5 billion in May 2021. Verizon kept 10%.
Yahoo's opportunity to acquire Google and Facebook could have been a turning moment. It declined Microsoft's $45 billion deal in 2008 and was sold to Verizon for $4.5 billion in 2015. Poor decisions and lack of vision caused its downfall. Yahoo's aim wasn't obvious and it didn't stick to a single domain.
Hence, a corporation needs a clear vision and a leader who can see its future.
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Victoria Kurichenko
3 years ago
Here's what happened after I launched my second product on Gumroad.
One-hour ebook sales, affiliate relationships, and more.
If you follow me, you may know I started a new ebook in August 2022.
Despite publishing on this platform, my website, and Quora, I'm not a writer.
My writing speed is slow, 2,000 words a day, and I struggle to communicate cohesively.
In April 2022, I wrote a successful guide on How to Write Google-Friendly Blog Posts.
I had no email list or social media presence. I've made $1,600+ selling ebooks.
Evidence:
My first digital offering isn't a book.
It's an actionable guide with my tried-and-true process for writing Google-friendly content.
I'm not bragging.
Established authors like Tim Denning make more from my ebook sales with one newsletter.
This experience taught me writing isn't a privilege.
Writing a book and making money online doesn't require expertise.
Many don't consult experts. They want someone approachable.
Two years passed before I realized my own limits.
I have a brain, two hands, and Internet to spread my message.
I wrote and published a second ebook after the first's success.
On Gumroad, I released my second digital product.
Here's my complete Gumroad evaluation.
Gumroad is a marketplace for content providers to develop and sell sales pages.
Gumroad handles payments and client requests. It's helpful when someone sends a bogus payment receipt requesting an ebook (actual story!).
You'll forget administrative concerns after your first ebook sale.
After my first ebook sale, I did this: I made additional cash!
After every sale, I tell myself, "I built a new semi-passive revenue source."
This thinking shift helps me become less busy while increasing my income and quality of life.
Besides helping others, folks sell evergreen digital things to earn passive money.
It's in my second ebook.
I explain how I built and sold 50+ copies of my SEO writing ebook without being an influencer.
I show how anyone can sell ebooks on Gumroad and automate their sales process.
This is my ebook.
After publicizing the ebook release, I sold three copies within an hour.
Wow, or meh?
I don’t know.
The answer is different for everyone.
These three sales came from a small email list of 40 motivated fans waiting for my ebook release.
I had bigger plans.
I'll market my ebook on Medium, my website, Quora, and email.
I'm testing affiliate partnerships this time.
One of my ebook buyers is now promoting it for 40% commission.
Become my affiliate if you think your readers would like my ebook.
My ebook is a few days old, but I'm interested to see where it goes.
My SEO writing book started without an email list, affiliates, or 4,000 website visitors. I've made four figures.
I'm slowly expanding my communication avenues to have more impact.
Even a small project can open doors you never knew existed.
So began my writing career.
In summary
If you dare, every concept can become a profitable trip.
Before, I couldn't conceive of creating an ebook.
How to Sell eBooks on Gumroad is my second digital product.
Marketing and writing taught me that anything can be sold online.

Justin Kuepper
3 years ago
Day Trading Introduction
Historically, only large financial institutions, brokerages, and trading houses could actively trade in the stock market. With instant global news dissemination and low commissions, developments such as discount brokerages and online trading have leveled the playing—or should we say trading—field. It's never been easier for retail investors to trade like pros thanks to trading platforms like Robinhood and zero commissions.
Day trading is a lucrative career (as long as you do it properly). But it can be difficult for newbies, especially if they aren't fully prepared with a strategy. Even the most experienced day traders can lose money.
So, how does day trading work?
Day Trading Basics
Day trading is the practice of buying and selling a security on the same trading day. It occurs in all markets, but is most common in forex and stock markets. Day traders are typically well educated and well funded. For small price movements in highly liquid stocks or currencies, they use leverage and short-term trading strategies.
Day traders are tuned into short-term market events. News trading is a popular strategy. Scheduled announcements like economic data, corporate earnings, or interest rates are influenced by market psychology. Markets react when expectations are not met or exceeded, usually with large moves, which can help day traders.
Intraday trading strategies abound. Among these are:
- Scalping: This strategy seeks to profit from minor price changes throughout the day.
- Range trading: To determine buy and sell levels, range traders use support and resistance levels.
- News-based trading exploits the increased volatility around news events.
- High-frequency trading (HFT): The use of sophisticated algorithms to exploit small or short-term market inefficiencies.
A Disputed Practice
Day trading's profit potential is often debated on Wall Street. Scammers have enticed novices by promising huge returns in a short time. Sadly, the notion that trading is a get-rich-quick scheme persists. Some daytrade without knowledge. But some day traders succeed despite—or perhaps because of—the risks.
Day trading is frowned upon by many professional money managers. They claim that the reward rarely outweighs the risk. Those who day trade, however, claim there are profits to be made. Profitable day trading is possible, but it is risky and requires considerable skill. Moreover, economists and financial professionals agree that active trading strategies tend to underperform passive index strategies over time, especially when fees and taxes are factored in.
Day trading is not for everyone and is risky. It also requires a thorough understanding of how markets work and various short-term profit strategies. Though day traders' success stories often get a lot of media attention, keep in mind that most day traders are not wealthy: Many will fail, while others will barely survive. Also, while skill is important, bad luck can sink even the most experienced day trader.
Characteristics of a Day Trader
Experts in the field are typically well-established professional day traders.
They usually have extensive market knowledge. Here are some prerequisites for successful day trading.
Market knowledge and experience
Those who try to day-trade without understanding market fundamentals frequently lose. Day traders should be able to perform technical analysis and read charts. Charts can be misleading if not fully understood. Do your homework and know the ins and outs of the products you trade.
Enough capital
Day traders only use risk capital they can lose. This not only saves them money but also helps them trade without emotion. To profit from intraday price movements, a lot of capital is often required. Most day traders use high levels of leverage in margin accounts, and volatile market swings can trigger large margin calls on short notice.
Strategy
A trader needs a competitive advantage. Swing trading, arbitrage, and trading news are all common day trading strategies. They tweak these strategies until they consistently profit and limit losses.
Strategy Breakdown:
Type | Risk | Reward
Swing Trading | High | High
Arbitrage | Low | Medium
Trading News | Medium | Medium
Mergers/Acquisitions | Medium | High
Discipline
A profitable strategy is useless without discipline. Many day traders lose money because they don't meet their own criteria. “Plan the trade and trade the plan,” they say. Success requires discipline.
Day traders profit from market volatility. For a day trader, a stock's daily movement is appealing. This could be due to an earnings report, investor sentiment, or even general economic or company news.
Day traders also prefer highly liquid stocks because they can change positions without affecting the stock's price. Traders may buy a stock if the price rises. If the price falls, a trader may decide to sell short to profit.
A day trader wants to trade a stock that moves (a lot).
Day Trading for a Living
Professional day traders can be self-employed or employed by a larger institution.
Most day traders work for large firms like hedge funds and banks' proprietary trading desks. These traders benefit from direct counterparty lines, a trading desk, large capital and leverage, and expensive analytical software (among other advantages). By taking advantage of arbitrage and news events, these traders can profit from less risky day trades before individual traders react.
Individual traders often manage other people’s money or simply trade with their own. They rarely have access to a trading desk, but they frequently have strong ties to a brokerage (due to high commissions) and other resources. However, their limited scope prevents them from directly competing with institutional day traders. Not to mention more risks. Individuals typically day trade highly liquid stocks using technical analysis and swing trades, with some leverage.
Day trading necessitates access to some of the most complex financial products and services. Day traders usually need:
Access to a trading desk
Traders who work for large institutions or manage large sums of money usually use this. The trading or dealing desk provides these traders with immediate order execution, which is critical during volatile market conditions. For example, when an acquisition is announced, day traders interested in merger arbitrage can place orders before the rest of the market.
News sources
The majority of day trading opportunities come from news, so being the first to know when something significant happens is critical. It has access to multiple leading newswires, constant news coverage, and software that continuously analyzes news sources for important stories.
Analytical tools
Most day traders rely on expensive trading software. Technical traders and swing traders rely on software more than news. This software's features include:
-
Automatic pattern recognition: It can identify technical indicators like flags and channels, or more complex indicators like Elliott Wave patterns.
-
Genetic and neural applications: These programs use neural networks and genetic algorithms to improve trading systems and make more accurate price predictions.
-
Broker integration: Some of these apps even connect directly to the brokerage, allowing for instant and even automatic trade execution. This reduces trading emotion and improves execution times.
-
Backtesting: This allows traders to look at past performance of a strategy to predict future performance. Remember that past results do not always predict future results.
Together, these tools give traders a competitive advantage. It's easy to see why inexperienced traders lose money without them. A day trader's earnings potential is also affected by the market in which they trade, their capital, and their time commitment.
Day Trading Risks
Day trading can be intimidating for the average investor due to the numerous risks involved. The SEC highlights the following risks of day trading:
Because day traders typically lose money in their first months of trading and many never make profits, they should only risk money they can afford to lose.
Trading is a full-time job that is stressful and costly: Observing dozens of ticker quotes and price fluctuations to spot market trends requires intense concentration. Day traders also spend a lot on commissions, training, and computers.
Day traders heavily rely on borrowing: Day-trading strategies rely on borrowed funds to make profits, which is why many day traders lose everything and end up in debt.
Avoid easy profit promises: Avoid “hot tips” and “expert advice” from day trading newsletters and websites, and be wary of day trading educational seminars and classes.
Should You Day Trade?
As stated previously, day trading as a career can be difficult and demanding.
- First, you must be familiar with the trading world and know your risk tolerance, capital, and goals.
- Day trading also takes a lot of time. You'll need to put in a lot of time if you want to perfect your strategies and make money. Part-time or whenever isn't going to cut it. You must be fully committed.
- If you decide trading is for you, remember to start small. Concentrate on a few stocks rather than jumping into the market blindly. Enlarging your trading strategy can result in big losses.
- Finally, keep your cool and avoid trading emotionally. The more you can do that, the better. Keeping a level head allows you to stay focused and on track.
If you follow these simple rules, you may be on your way to a successful day trading career.
Is Day Trading Illegal?
Day trading is not illegal or unethical, but it is risky. Because most day-trading strategies use margin accounts, day traders risk losing more than they invest and becoming heavily in debt.
How Can Arbitrage Be Used in Day Trading?
Arbitrage is the simultaneous purchase and sale of a security in multiple markets to profit from small price differences. Because arbitrage ensures that any deviation in an asset's price from its fair value is quickly corrected, arbitrage opportunities are rare.
Why Don’t Day Traders Hold Positions Overnight?
Day traders rarely hold overnight positions for several reasons: Overnight trades require more capital because most brokers require higher margin; stocks can gap up or down on overnight news, causing big trading losses; and holding a losing position overnight in the hope of recovering some or all of the losses may be against the trader's core day-trading philosophy.
What Are Day Trader Margin Requirements?
Regulation D requires that a pattern day trader client of a broker-dealer maintain at all times $25,000 in equity in their account.
How Much Buying Power Does Day Trading Have?
Buying power is the total amount of funds an investor has available to trade securities. FINRA rules allow a pattern day trader to trade up to four times their maintenance margin excess as of the previous day's close.
The Verdict
Although controversial, day trading can be a profitable strategy. Day traders, both institutional and retail, keep the markets efficient and liquid. Though day trading is still popular among novice traders, it should be left to those with the necessary skills and resources.

Kyle Planck
3 years ago
The chronicles of monkeypox.
or, how I spread monkeypox and got it myself.
This story contains nsfw (not safe for wife) stuff and shouldn't be read if you're under 18 or think I'm a newborn angel. After the opening, it's broken into three sections: a chronological explanation of my disease course, my ideas, and what I plan to do next.
Your journey awaits.
As early as mid-may, I was waltzing around the lab talking about monkeypox, a rare tropical disease with an inaccurate name. Monkeys are not its primary animal reservoir. It caused an outbreak among men who have sex with men across Europe, with unprecedented levels of person-to-person transmission. European health authorities speculated that the virus spread at raves and parties and was easily transferred through intimate, mainly sexual, contact. I had already read the nejm article about the first confirmed monkeypox patient in the u.s. and shared the photos on social media so people knew what to look for. The cdc information page only included 4 photographs of monkeypox lesions that looked like they were captured on a motorola razr.
I warned my ex-boyfriend about monkeypox. Monkeypox? responded.
Mom, I'm afraid about monkeypox. What's monkeypox?
My therapist is scared about monkeypox. What's monkeypox?
Was I alone? A few science gays on Twitter didn't make me feel overreacting.
This information got my gay head turning. The incubation period for the sickness is weeks. Many of my social media contacts are traveling to Europe this summer. What is pride? Travel, parties, and sex. Many people may become infected before attending these activities. Monkeypox will affect the lgbtq+ community.
Being right always stinks. My young scientist brain was right, though. Someone who saw this coming is one of the early victims. I'll talk about my feelings publicly, and trust me, I have many concerning what's occurring.
Part 1 is the specifics.
Wednesday nights are never smart but always entertaining. I didn't wake up until noon on june 23 and saw gay twitter blazing. Without warning, the nyc department of health announced a pop-up monkeypox immunization station in chelsea. Some days would be 11am-7pm. Walk-ins were welcome, however appointments were preferred. I tried to arrange an appointment after rubbing my eyes, but they were all taken. I got out of bed, washed my face, brushed my teeth, and put on short shorts because I wanted to get a walk-in dose and show off my legs. I got a 20-oz. cold brew on the way to the train and texted a chelsea-based acquaintance for help.
Clinic closed at 2pm. No more doses. Hundreds queued up. The government initially gave them only 1,000 dosages. For a city with 500,000 LGBT people, c'mon. What more could I do? I was upset by how things were handled. The evidence speaks for itself.
I decided to seek an appointment when additional doses were available and continued my weekend. I was celebrating nyc pride with pals. Fun! sex! *
On tuesday after that, I felt a little burn. This wasn't surprising because I'd been sexually active throughout the weekend, so I got a sti panel the next day. I expected to get results in a few days, take antibiotics, and move on.
Emerging germs had other intentions. Wednesday night, I felt sore, and thursday morning, I had a blazing temperature and had sweat through my bedding. I had fever, chills, and body-wide aches and pains for three days. I reached 102 degrees. I believed I had covid over pride weekend, but I tested negative for three days straight.
STDs don't induce fevers or other systemic symptoms. If lymphogranuloma venereum advances, it can cause flu-like symptoms and swollen lymph nodes. I was suspicious and desperate for answers, so I researched monkeypox on the cdc website (for healthcare professionals). Much of what I saw on screen about monkeypox prodrome matched my symptoms. Multiple-day fever, headache, muscle aches, chills, tiredness, enlarged lymph nodes. Pox were lacking.
I told my doctor my concerns pre-medically. I'm occasionally annoying.
On saturday night, my fever broke and I felt better. Still burning, I was optimistic till sunday, when I woke up with five red splotches on my arms and fingertips.
As spots formed, burning became pain. I observed as spots developed on my body throughout the day. I had more than a dozen by the end of the day, and the early spots were pustular. I had monkeypox, as feared.
Fourth of July weekend limited my options. I'm well-connected in my school's infectious disease academic community, so I texted a coworker for advice. He agreed it was likely monkeypox and scheduled me for testing on tuesday.
nyc health could only perform 10 monkeypox tests every day. Before doctors could take swabs and send them in, each test had to be approved by the department. Some commercial labs can now perform monkeypox testing, but the backlog is huge. I still don't have a positive orthopoxvirus test five days after my test. *My 12-day-old case may not be included in the official monkeypox tally. This outbreak is far wider than we first thought, therefore I'm attempting to spread the information and help contain it.
*Update, 7/11: I have orthopoxvirus.
I spent all day in the bathtub because of the agony. Warm lavender epsom salts helped me feel better. I can't stand lavender anymore. I brought my laptop into the bathroom and viewed everything everywhere at once (2022). If my ex and I hadn't recently broken up, I wouldn't have monkeypox. All of these things made me cry, and I sat in the bathtub on the 4th of July sobbing. I thought, Is this it? I felt like Bridesmaids' Kristen Wiig (2011). I'm a flop. From here, things can only improve.
Later that night, I wore a mask and went to my roof to see the fireworks. Even though I don't like fireworks, there was something wonderful about them this year: the colors, how they illuminated the black surfaces around me, and their transient beauty. Joyful moments rarely linger long in our life. We must enjoy them now.
Several roofs away, my neighbors gathered. Happy 4th! I heard a woman yell. Why is this godforsaken country so happy? Instead of being rude, I replied. I didn't tell them I had monkeypox. I thought that would kill the mood.
By the time I went to the hospital the next day to get my lesions swabbed, wearing long sleeves, pants, and a mask, they looked like this:
I had 30 lesions on my arms, hands, stomach, back, legs, buttcheeks, face, scalp, and right eyebrow. I had some in my mouth, gums, and throat. Current medical thought is that lesions on mucous membranes cause discomfort in sensitive places. Internal lesions are a new feature of this outbreak of monkeypox. Despite being unattractive, the other sores weren't unpleasant or bothersome.
I had a bacterial sti with the pox. Who knows if that would've created symptoms (often it doesn't), but different infections can happen at once. My care team remembered that having a sti doesn't exclude out monkeypox. doxycycline rocks!
The coworker who introduced me to testing also offered me his home. We share a restroom, and monkeypox can be spread through surfaces. (Being a dna virus gives it environmental hardiness that rna viruses like sars-cov-2 lack.) I disinfected our bathroom after every usage, but I was apprehensive. My friend's place has a guest room and second bathroom, so no cross-contamination. It was the ideal monkeypox isolation environment, so I accepted his offer and am writing this piece there. I don't know what I would have done without his hospitality and attention.
The next day, I started tecovirimat, or tpoxx, for 14 days. Smallpox has been eradicated worldwide since the 1980s but remains a bioterrorism concern. Tecovirimat has a unique, orthopoxvirus-specific method of action, which reduces side effects to headache and nausea. It hasn't been used in many people, therefore the cdc is encouraging patients who take it for monkeypox to track their disease and symptoms.
Tpoxx's oral absorption requires a fatty meal. The hospital ordered me to take the medication after a 600-calorie, 25-gram-fat meal every 12 hours. The coordinator joked, "Don't diet for the next two weeks." I wanted to get peanut butter delivered, but jif is recalling their supply due to salmonella. Please give pathogens a break. I got almond butter.
Tpoxx study enrollment was documented. After signing consent documents, my lesions were photographed and measured during a complete physical exam. I got bloodwork to assess my health. My medication delivery was precise; every step must be accounted for. I got a two-week supply and started taking it that night. I rewarded myself with McDonald's. I'd been hungry for a week. I was also prescribed ketorolac (aka toradol), a stronger ibuprofen, for my discomfort.
I thought tpoxx was a wonder medicine by day two of treatment. Early lesions looked like this.
however, They vanished. The three largest lesions on my back flattened and practically disappeared into my skin. Some pustular lesions were diminishing. Tpoxx+toradol has helped me sleep, focus, and feel human again. I'm down to twice-daily baths and feeling hungrier than ever in this illness. On day five of tpoxx, some of the lesions look like this:
I have a ways to go. We must believe I'll be contagious until the last of my patches scabs over, falls off, and sprouts new skin. There's no way to tell. After a week and a half of tremendous pain and psychological stress, any news is good news. I'm grateful for my slow but steady development.
Part 2 of the rant.
Being close to yet not in the medical world is interesting. It lets me know a lot about it without being persuaded by my involvement. Doctors identify and treat patients using a tool called differential diagnosis.
A doctor interviews a patient to learn about them and their symptoms. More is better. Doctors may ask, "Have you traveled recently?" sex life? Have pets? preferred streaming service? (No, really. (Hbomax is right.) After the inquisition, the doctor will complete a body exam ranging from looking in your eyes, ears, and throat to a thorough physical.
After collecting data, the doctor makes a mental (or physical) inventory of all the conceivable illnesses that could cause or explain the patient's symptoms. Differential diagnosis list. After establishing the differential, the clinician can eliminate options. The doctor will usually conduct nucleic acid tests on swab samples or bloodwork to learn more. This helps eliminate conditions from the differential or boosts a condition's likelihood. In an ideal circumstance, the doctor can eliminate all but one reason of your symptoms, leaving your formal diagnosis. Once diagnosed, treatment can begin. yay! Love medicine.
My symptoms two weeks ago did not suggest monkeypox. Fever, pains, weariness, and swollen lymph nodes are caused by several things. My scandalous symptoms weren't linked to common ones. My instance shows the importance of diversity and representation in healthcare. My doctor isn't gay, but he provides culturally sensitive care. I'd heard about monkeypox as a gay man in New York. I was hyper-aware of it and had heard of friends of friends who had contracted it the week before, even though the official case count in the US was 40. My physicians weren't concerned, but I was. How would it appear on his mental differential if it wasn't on his radar? Mental differential rhymes! I'll trademark it to prevent theft. differential!
I was in a rare position to recognize my condition and advocate for myself. I study infections. I'd spent months researching monkeypox. I work at a university where I rub shoulders with some of the country's greatest doctors. I'm a gay dude who follows nyc queer social networks online. All of these variables positioned me to think, "Maybe this is monkeypox," and to explain why.
This outbreak is another example of privilege at work. The brokenness of our healthcare system is once again exposed by the inequities produced by the vaccination rollout and the existence of people like myself who can pull strings owing to their line of work. I can't cure this situation on my own, but I can be a strong voice demanding the government do a better job addressing the outbreak and giving resources and advice to everyone I can.
lgbtqia+ community members' support has always impressed me in new york. The queer community has watched out for me and supported me in ways I never dreamed were possible.
Queer individuals are there for each other when societal structures fail. People went to the internet on the first day of the vaccine rollout to share appointment information and the vaccine clinic's message. Twitter timelines were more effective than marketing campaigns. Contrary to widespread anti-vaccine sentiment, the LGBT community was eager to protect themselves. Smallpox vaccination? sure. gimme. whether I'm safe. I credit the community's sex positivity. Many people are used to talking about STDs, so there's a reduced barrier to saying, "I think I have something, you should be on the watch too," and taking steps to protect our health.
Once I got monkeypox, I posted on Twitter and Instagram. Besides fueling my main character syndrome, I felt like I wasn't alone. My dc-based friend had monkeypox within hours. He told me about his experience and gave me ideas for managing the discomfort. I can't imagine life without him.
My buddy and colleague organized my medical care and let me remain in his home. His and his husband's friendliness and attention made a world of difference in my recovery. All of my friends and family who helped me, whether by venmo, doordash, or moral support, made me feel cared about. I don't deserve the amazing people in my life.
Finally, I think of everyone who commented on my social media posts regarding my trip. Friends from all sectors of my life and all sexualities have written me well wishes and complimented me for my vulnerability, but I feel the most gravitas from fellow lgbtq+ persons. They're learning to spot. They're learning where to go ill. They're learning self-advocacy. I'm another link in our network of caretaking. I've been cared for, therefore I want to do the same. Community and knowledge are powerful.
You're probably wondering where the diatribe is. You may believe he's gushing about his loved ones, and you'd be right. I say that just because the queer community can take care of itself doesn't mean we should.
Even when caused by the same pathogen, comparing health crises is risky. Aids is unlike covid-19 or monkeypox, yet all were caused by poorly understood viruses. The lgbtq+ community has a history of self-medicating. Queer people (and their supporters) have led the charge to protect themselves throughout history when the government refused. Surreal to experience this in real time.
First, vaccination access is a government failure. The strategic national stockpile contains tens of thousands of doses of jynneos, the newest fda-approved smallpox vaccine, and millions of doses of acam2000, an older vaccine for immunocompetent populations. Despite being a monkeypox hotspot and international crossroads, new york has only received 7,000 doses of the jynneos vaccine. Vaccine appointments are booked within minutes. It's showing Hunger Games, which bothers me.
Second, I think the government failed to recognize the severity of the european monkeypox outbreak. We saw abroad reports in may, but the first vaccines weren't available until june. Why was I a 26-year-old pharmacology grad student, able to see a monkeypox problem in europe but not the u.s. public health agency? Or was there too much bureaucracy and politicking, delaying action?
Lack of testing infrastructure for a known virus with vaccinations and therapies is appalling. More testing would have helped understand the problem's breadth. Many homosexual guys, including myself, didn't behave like monkeypox was a significant threat because there were only a dozen instances across the country. Our underestimating of the issue, spurred by a story of few infections, was huge.
Public health officials' response to infectious diseases frustrates me. A wait-and-see approach to infectious diseases is unsatisfactory. Before a sick person is recognized, they've exposed and maybe contaminated numerous others. Vaccinating susceptible populations before a disease becomes entrenched prevents disease. CDC might operate this way. When it was easier, they didn't control or prevent monkeypox. We'll learn when. Sometimes I fear never. Emerging viral infections are a menace in the era of climate change and globalization, and I fear our government will repeat the same mistakes. I don't work at the cdc, thus I have no idea what they do. As a scientist, a homosexual guy, and a citizen of this country, I feel confident declaring that the cdc has not done enough about monkeypox. Will they do enough about monkeypox? The strategic national stockpile can respond to a bioterrorism disaster in 12 hours. I'm skeptical following this outbreak.
It's simple to criticize the cdc, but they're not to blame. Underfunding public health services, especially the cdc, is another way our government fails to safeguard its citizens. I may gripe about the vaccination rollout all I want, but local health departments are doing their best with limited resources. They may not have enough workers to keep up with demand and run a contact-tracing program. Since my orthopoxvirus test is still negative, the doh hasn't asked about my close contacts. By then, my illness will be two weeks old, too long to do anything productive. Not their fault. They're functioning in a broken system that's underfunded for the work it does.
*Update, 7/11: I have orthopoxvirus.
Monkeypox is slow, so i've had time to contemplate. Now that I'm better, I'm angry. furious and sad I want to help. I wish to spare others my pain. This was preventable and solvable, I hope. HOW?
Third, the duty.
Family, especially selected family, helps each other. So many people have helped me throughout this difficult time. How can I give back? I have ideas.
1. Education. I've already started doing this by writing incredibly detailed posts on Instagram about my physical sickness and my thoughts on the entire scandal. via tweets. by producing this essay. I'll keep doing it even if people start to resent me! It's crucial! On my Instagram profile (@kyleplanckton), you may discover a story highlight with links to all of my bizarre yet educational posts.
2. Resources. I've forwarded the contact information for my institution's infectious diseases clinic to several folks who will hopefully be able to get tpoxx under the expanded use policy. Through my social networks, I've learned of similar institutions. I've also shared crowdsourced resources about symptom relief and vaccine appointment availability on social media. DM me or see my Instagram highlight for more.
3. Community action. During my illness, my friends' willingness to aid me has meant the most. It was nice to know I had folks on my side. One of my pals (thanks, kenny) snagged me a mcgriddle this morning when seamless canceled my order. This scenario has me thinking about methods to help people with monkeypox isolation. A two-week isolation period is financially damaging for many hourly workers. Certain governments required paid sick leave for covid-19 to allow employees to recover and prevent spread. No comparable program exists for monkeypox, and none seems to be planned shortly.
I want to aid monkeypox patients in severe financial conditions. I'm willing to pick up and bring groceries or fund meals/expenses for sick neighbors. I've seen several GoFundMe accounts, but I wish there was a centralized mechanism to link those in need with those who can help. Please contact me if you have expertise with mutual aid organizations. I hope we can start this shortly.
4. lobbying. Personal narratives are powerful. My narrative is only one, but I think it's compelling. Over the next day or so, i'll write to local, state, and federal officials about monkeypox. I wanted a vaccine but couldn't acquire one, and I feel tpoxx helped my disease. As a pharmacologist-in-training, I believe collecting data on a novel medicine is important, and there are ethical problems when making a drug with limited patient data broadly available. Many folks I know can't receive tpoxx due of red tape and a lack of contacts. People shouldn't have to go to an ivy league hospital to obtain the greatest care. Based on my experience and other people's tales, I believe tpoxx can drastically lessen monkeypox patients' pain and potentially curb transmission chains if administered early enough. This outbreak is manageable. It's not too late if we use all the instruments we have (diagnostic, vaccine, treatment).
*UPDATE 7/15: I submitted the following letter to Chuck Schumer and Kirsten Gillibrand. I've addressed identical letters to local, state, and federal officials, including the CDC and HHS.
I hope to join RESPND-MI, an LGBTQ+ community-led assessment of monkeypox symptoms and networks in NYC. Visit their website to learn more and give to this community-based charity.
How I got monkeypox is a mystery. I received it through a pride physical interaction, but i'm not sure which one. This outbreak will expand unless leaders act quickly. Until then, I'll keep educating and connecting people to care in my neighborhood.
Despite my misgivings, I see some optimism. Health department social media efforts are underway. During the outbreak, the CDC provided nonjudgmental suggestions for safer social and sexual activity. There's additional information regarding the disease course online, including how to request tpoxx for sufferers. These materials can help people advocate for themselves if they're sick. Importantly, homosexual guys are listening when they discuss about monkeypox online and irl. Learners They're serious.
The government has a terrible track record with lgtbq+ health issues, and they're not off to a good start this time. I hope this time will be better. If I can aid even one individual, I'll do so.
Thanks for reading, supporting me, and spreading awareness about the 2022 monkeypox outbreak. My dms are accessible if you want info, resources, queries, or to chat.
y'all well
kyle
