Paying not to go first.

How do you tell the story of what you're worth and why?

It’s 2010.

I get home from speaking and schmoozing my way through the massive SXSW event in Austin, Texas.

Load a bunch of photos onto my computer from my time on stage. Flip through them, with my wife by my side. She leans in, pointing at an image of me on stage, her finger hovering over my neck.

“Has your Adam’s apple always been that big?”

Weirdly, I have the same thought. It does look more bulge-like than I’d remembered. But, then, I’m not regularly tracking it, so who knows?

My regular is unavailable, so I set up an appointment with a doc I’ve never visited before.

They feel around. Raise an eyebrow.

“You’ve got what feels like some big nodules. I’m sure you’ve already googled this, we need to find out if they’re ‘hot or not.’”

Um, what? And, no, I hadn’t googled, because why would I?

Then I do. Well, damn (trust me, not the actual word I used).

Saying I might have thyroid cancer?

I don’t really know what any of this means, or where the thyroid even is.

Days later, I’m at the hospital getting ultrasound. The tech is moving the little goo-covered wandy thing around the base of my throat (sorry for the technical jargon). Like she’s hunting for something and not finding it. I hear a muted, yet decidedly exasperated exhale. “I’m not seeing anything,” she says. Which is weird, because normally they don’t tell you anything.

Actually, I respond, that’s not where my Adam’s apple is, which is where the doc was poking around, and designated as the area that seemed to have grown.

She raises an eyebrow. As if to silently transmit, “dude, doesn’t your doc know the diff between the two?” Apparently, I’d learn later, your thyroid is at the base of your throat, kinda nowhere near your Adam’s apple in gross anatomy terms.

She then slides the wand up, and gets a more confirming look on her face. Then, drops back into the more standard, poker-faced, “I’ll get these results over to your doctor.”

I leave.

Still freaking out. It takes a week and merciless calls to get a response from the doc who, it turns out, did not, in fact, know their Adam’s apple from their thyroid. At least, they didn’t at the time of my first visit.

It’s not your thyroid, they say. But you’ve got what appears to be a large mass wrapping around your mid-throat. Looks like a cyst and not a tumor, so I don’t think it’s anything to be alarmed about. But it probably still needs to come out.

Half relieved, half pissed off, I start looking for a surgeon.

I live in NYC at the time, so we’ve got the best of the best in nearly any specialty in the word. I find the surgeon in his seventies who specializes in this exact thing. Well, he actually specializes in complex neck surgeries, and removing stuff that shouldn’t be there. Been doing it for more than 40 years and is close to retiring by the time I land in his office.

He confirms, not cancer, but it’s gotta come out. His associate gives me the financial rundown. It’s a lotta money. I get a second, and maybe a third opinion, both of which come with way cheaper price-points.

Still, I go with Doctor Bougie. And pay more than twice what I’d have paid the others (yes, insurance helped, but these days, that’s not saying much).

Bada-bing, bada-boom, he does his thing, takes like 45-minutes, it goes great. I check out with a line of glue across my neck that’d slowly settle into yet another scar on a body that’s got a bunch more.

A few weeks later, I share an update with some friends, and of course, because they’re New Yorkers, my friends, and have no boundaries, they want to know what it cost. I tell them, and also tell them the competitors were way less.

“Dude,” they say, “it literally took the guy less than an hour. And, that’s what he made?”

I look them in their collective eyes and say, “I wasn’t paying for his time, I was paying not to go first.”

I was paying to be the 10,000th patient, so that he could do what he did as incredibly as he did it in less than an hour. I was paying for the 40 years of practice, so that he could open me up and remove something in a very delicate part of my body safely, meticulously, artfully in a matter of minutes.

And, then, this weird realization drops. Because I’m me, and my mind always makes strange connections to other parts of life.

Apologies, literally cannot turn it off.

By then, I’ve been consulting and doing client work for years.

Strategy, branding, marketing, positioning, and entrepreneurship. Charging, well, very good money. And, not infrequently, able to get to where we need to get fairly quickly. Like in minutes, or a few hours, rather than weeks or months. I am, what’s been called, lovingly blunt.

On occasion, when delivering an outcome with a whole lot of time left on the clock, then saying we’re done, someone might comment, “wow, nice hourly rate.” And, not in a complementary way.

I never quite knew how to respond. I’d talk about the value of the outcome or strategy or creative solution in the context of their business. Value-based pricing, they call it. Which was often a large multiple of what they’ve paid me.

Now, my experience in the operating theater has given me a new metaphor. Just like my grizzled surgeon, what they’re really paying for is the ability to not only not go first, but to be so far removed from those opening “experiments,” that by the time we dance, I’m capable of giving them what they need, with a high level of precision, and a high-likelihood of success in a fraction of the time.

That reframe has always stayed with me, both when I’m positioning the way I offer my own time, energy, mind-and-heart-share, or services, and evaluating those I’m considering working with.

And, this feels like a great place to end with a classic dentist joke (apologies, dentist friends, you know I love you).

A patient walks into a dentist’s office with two rotten teeth that need to come out. The dentist only has time for one, so they pull it.

Even with the numby stuff (again with the medical jargon), everything is so raw, the whole process hurts, and the sounds and smells, well, you know. Fifteen minutes later, the tooth is out. The dentist says, come back tomorrow for the other.

The patient head’s to the front desk to pay for the first tooth, with the dentist still by their side. Sees the bill.

WHAT?! Five-hundred dollars for fifteen-minute’s work?! That’s madness!

To which the dentist responds, “if you prefer, I can make the second one take twice the time.”

Just a little something to think about as you consider how to bring your own genius to the world.

Which now makes me curious, for those in our community who do offer some version of service-driven work, how does this all land with you?

Share your thoughts in the comments, and your approach to “languaging” your value, if you’re open to it.

With a whole lotta love & gratitude,

Jonathan