Bitcoin Custody Before Surgery: Modeled Incapacity Stress and Inheritance Exposure
Pre-Surgery Custody Delegation and Documentation
This memo is published by CustodyStress, an independent Bitcoin custody stress test that produces reference documents for individuals, families, and professionals.
What Surgery Means for Custody Systems
A holder has surgery scheduled. The surgery carries risk. The holder may be unavailable for hours, days, or longer. The holder may not recover. The holder considers what happens to their Bitcoin if they cannot act. The surgery creates a deadline for questions that had no deadline before.
This memo describes bitcoin custody before surgery scenarios and how planned medical events function as near-term stress tests. It examines what surgery reveals about custody assumptions regarding availability, authority, and interpretability. It treats surgery as a bounded trigger that exposes gaps between what exists and what others can access.
The memo applies when surgery is scheduled and the custody system is reconsidered under the possibility of temporary or permanent incapacity. It models behavior when recovery may need to occur while the holder is unavailable to clarify intent or provide access. It remains descriptive of observed patterns without defining preparation steps or medical contingencies.
What Surgery Means for Custody Systems
Surgery introduces a specific kind of risk. The holder will be unconscious. The holder may be incapacitated for recovery. The holder may experience complications. The holder may not survive. These possibilities exist for any surgery, from minor to major.
The risk is time-bounded. The surgery has a date. The date creates urgency. Questions that could be deferred indefinitely now have a deadline. The deadline forces consideration. The deadline may not leave much time for action.
Surgery differs from abstract inheritance planning. Abstract planning has no deadline. Surgery has a specific date. The date transforms custody from a theoretical future problem to an immediate coordination question. The transformation happens whether the holder addresses it or not.
Bitcoin Custody Before Surgery: The Scenario
Bitcoin custody before surgery scenarios involve reconsidering custody under time pressure. The holder realizes surgery is coming. The holder realizes they may be unavailable. The holder realizes others may need to act. The holder has limited time to address these realizations.
The scenario exposes what the holder has assumed. The holder assumed they would always be available to explain. The holder assumed they would always be available to provide access. The holder assumed custody questions could wait. Surgery challenges these assumptions with a specific date.
The result exposes gaps between possession of assets and the ability of others to act. The holder possesses the Bitcoin. Others may not be able to access it. The gap existed before surgery. Surgery makes the gap visible and urgent.
Bitcoin Custody Surgery Planning: Rehearsal Dynamics
Bitcoin custody surgery planning functions as a rehearsal for inheritance. The holder considers what happens if they are unavailable. The holder considers who would act. The holder considers what those people would need. These are the same questions inheritance raises.
Recovery in a scenario mirrors inheritance conditions without finality. Surgery creates temporary unavailability. Inheritance creates permanent unavailability. The mechanics are similar. Someone other than the holder must understand the custody system. Someone other than the holder must be able to act.
The system reveals which dependencies require the holder's presence to function. Some parts of the custody system work without the holder. Some parts do not. Surgery identifies which is which. The identification may be surprising. The holder may have assumed more independence than exists.
Bitcoin Inheritance Surgery Risk: Immediate Exposure
Bitcoin inheritance surgery risk becomes immediate rather than abstract. Inheritance risk always exists. People can die unexpectedly at any time. Surgery makes the risk concrete. The risk has a date. The risk has a procedure. The risk has a probability that doctors can estimate.
The immediacy changes perception. Abstract risk is easy to defer. Concrete risk is harder to ignore. The holder faces the possibility of incapacity or death on a specific day. The holder may respond to this immediacy. The holder may not. Either way, the risk exists.
Recovery in a scenario becomes time-sensitive when assumptions about "I can explain later" no longer hold. The holder planned to explain everything someday. Someday may not arrive. Surgery may go badly. The explanations never given remain ungiven. The people who needed to understand do not understand.
Custody Review Before Surgery: What Gets Exposed
Custody review before surgery exposes assumptions that were never tested. The holder assumed the spouse knows about the Bitcoin. Does the spouse actually know? The holder assumed the instructions are clear. Are they actually clear? The holder assumed access would be straightforward. Is it actually straightforward?
The review exposes these assumptions by forcing them into explicit consideration. The holder thinks about what happens if they cannot explain. The holder thinks about what others would find. The holder thinks about what others would understand. The thinking reveals gaps.
Surgery reframes custody from a theoretical future problem to an immediate coordination question. The question is no longer "someday." The question is "next Tuesday." The deadline changes how the question feels. The deadline may change whether the question gets addressed.
Bitcoin Custody Medical Event: Temporary Versus Permanent
A bitcoin custody medical event like surgery creates ambiguity between temporary and permanent incapacity. The holder goes into surgery. The holder does not come out responsive. Is this temporary? Is this permanent? No one knows immediately. The ambiguity affects how others respond.
The profile becomes sensitive to unclear boundaries between "waiting" and "acting." The spouse knows the holder has Bitcoin. The holder is in recovery and cannot communicate. Does the spouse wait for the holder to recover? Does the spouse act now? The boundary is unclear. The appropriate response is unclear.
Recovery in a scenario can stall when authority exists but action feels premature. The spouse has authority to access the Bitcoin. The spouse hesitates because the holder might recover soon. The spouse waits. The waiting continues. The spouse never acts because acting always feels premature. The situation remains frozen.
Failure Dynamics: Authority and Access Separation
The system distinguishes between who is legally allowed to act and who practically can act. The spouse may have legal authority through estate documents. The spouse may not have the passwords, seed phrases, or device access needed to actually move Bitcoin. Authority exists. Access does not.
Recovery in a scenario may be blocked even when authority pathways exist. The power of attorney is in place. The will is written. The legal structures are complete. The spouse still cannot access the Bitcoin because legal authority does not produce cryptographic access. The separation persists regardless of how complete the legal preparation seems.
Surgery exposes this separation with urgency. The holder is incapacitated. The spouse needs to act. The spouse has authority. The spouse cannot find the seed phrase. The authority is useless without the access materials. The gap between authority and access becomes painfully visible.
Failure Dynamics: Documentation Under Urgency
The system becomes constrained when documentation assumes calm review rather than urgent use. The holder wrote instructions. The instructions assume the reader has time to study them. The instructions assume the reader can ask questions. The instructions assume the reader is not stressed and grieving.
Recovery in a scenario exposes whether materials are understandable without explanation. The holder cannot explain. The instructions must stand alone. The instructions may not stand alone well. They may assume context the holder never wrote down. They may use terms the reader does not understand. They may skip steps the holder considered obvious.
Urgency compounds the problem. The spouse finds instructions. The spouse cannot understand them quickly. The spouse feels pressure. The surgery complication demands attention. Other family members need support. Time for careful document review does not exist. The instructions that assumed calm review meet urgent reality.
Failure Dynamics: Coordination Pressure
The profile becomes sensitive to whether others know what exists, where it is, and what role they play. Surgery puts pressure on coordination. The holder is unavailable. Others must coordinate without the holder. Others may not know how to coordinate. Others may not know they have roles.
Recovery in a scenario diverges when roles are assumed rather than explicitly defined. The holder assumed the spouse would handle the Bitcoin. The spouse does not know this assumption exists. The holder assumed the brother would help with technical details. The brother does not know this assumption exists. Assumptions are invisible to those who hold roles.
Coordination pressure increases with surgery complexity. Simple surgery with quick recovery puts less pressure. Complex surgery with extended recovery puts more pressure. The pressure accumulates. The people who must coordinate feel the pressure. Their coordination may suffer under the pressure.
Observed Pattern: Surgery as Deadline
Surgery creates a deadline that other inheritance planning lacks. Estate planning can be deferred indefinitely. No specific date forces action. Surgery has a date. The date creates pressure. The pressure may produce action that would not otherwise occur.
The deadline can reveal procrastination. The holder has thought about Bitcoin custody for years. The holder has done nothing. Surgery arrives. The holder suddenly faces what has been deferred. Years of deferral meet weeks or days of remaining time.
The deadline can be insufficient. The holder realizes custody gaps exist. The surgery is in three days. Three days is not enough time to address years of deferred questions. The holder faces the gap without enough time to close it. The surgery happens. The gaps remain.
Observed Pattern: Recovery Period Uncertainty
Surgery creates uncertainty about the recovery period. The holder may recover quickly. The holder may recover slowly. The holder may not recover. The timeline is uncertain. The uncertainty affects how others respond to the custody situation.
During recovery, the holder may be partially available. The holder may be conscious but confused. The holder may be able to speak but not think clearly. The holder may recover gradually over weeks. Partial availability creates its own challenges. The holder is present but not capable. Others are uncertain whether to act.
The system behaves differently when the holder is temporarily unavailable but not deceased. Temporary unavailability creates waiting. Others wait for the holder to recover. Waiting may be appropriate. Waiting may also be a form of inaction that delays necessary steps. The appropriate response depends on information no one has: how long will recovery take?
Observed Pattern: Emotional Context
Surgery creates emotional context that affects custody behavior. The holder is anxious about the procedure. The spouse is anxious about the holder. Family members are focused on health, not finances. Bitcoin custody competes for attention with health concerns. Health usually wins.
The emotional context continues after surgery. If complications occur, the family focuses on medical decisions. Bitcoin is not the priority. Bitcoin custody questions feel inappropriate to raise. The questions go unasked. The custody situation remains unaddressed while medical situations take precedence.
Recovery in a scenario may be delayed because emotional context makes Bitcoin discussions feel wrong. The spouse knows the holder has Bitcoin. The spouse does not raise it during the medical crisis. Raising it feels like giving up. The spouse waits until it feels appropriate. The waiting may extend indefinitely.
What Surgery Does Not Change
Surgery does not change how Bitcoin works. Keys still control access. Custody arrangements still have the same characteristics. The Bitcoin network does not know about the holder's medical situation. The technology is unchanged. Only the holder's availability changes.
Surgery does not create new custody gaps. The gaps already existed. Surgery reveals gaps that were always present. The holder could have been hit by a bus yesterday. The gaps would have been the same. Surgery provides notice. Surgery provides a deadline. Surgery does not create the underlying situation.
Surgery does not guarantee gaps get addressed. The holder may acknowledge gaps and still not address them. Time may be too short. Energy may be focused on medical preparation. Addressing custody may feel less important than other concerns. The gaps may persist through surgery and beyond.
What Does Not Change
This memo does not evaluate specific surgical risks. Different surgeries have different risk profiles. Different holders have different medical situations. This document addresses surgery as a category of event without assessing specific procedures.
This memo does not provide guidance on preparing custody for surgery. It does not describe steps to take. It does not address timing. Such guidance would be prescriptive and outside the memo's scope.
This memo does not promise that any preparation eliminates surgery-related custody risk. Surgery introduces uncertainty. Uncertainty cannot be eliminated. The memo describes what surgery exposes without claiming any approach resolves it.
This memo applies to any planned medical event with incapacity risk. The dynamics described affect major surgery, minor surgery, and other procedures. The patterns are structural to planned medical risk, not specific to any procedure type.
Outcome
This memo looks at bitcoin custody before surgery scenarios and how planned medical events function as near-term stress tests. Bitcoin custody surgery planning functions as a rehearsal for inheritance that reveals which dependencies require the holder's presence. Bitcoin inheritance surgery risk becomes immediate rather than abstract when a procedure has a specific date.
Custody review before surgery exposes assumptions that were never tested. A bitcoin custody medical event creates ambiguity between temporary and permanent incapacity that affects how others respond.
Failure dynamics include authority-access separation under urgency, documentation that assumes calm review, and coordination pressure when roles are assumed rather than defined. Surgery creates a deadline that other inheritance planning lacks, forcing consideration of questions that had been deferred.
This assessment considers how custody systems behave when surgery introduces immediate incapacity risk. The profile remains descriptive and scenario-bound. It does not define preparation steps or medical contingencies. Outcomes depend on what the holder's custody situation looks like when the deadline arrives.
System Context
Examining Bitcoin Custody Under Stress
Bitcoin Accident Coma Communication Gaps
What If Incapacity Happens First With Bitcoin
For anyone who holds Bitcoin — on an exchange, in a wallet, through a service, or in self-custody — and wants to know what happens to it if something happens to them.
Start Bitcoin Custody Stress Test$179 · 12-month access · Unlimited assessments
A structured, scenario-based diagnostic that produces reference documents for your spouse, executor, or attorney — no accounts connected, no keys shared.
Sample what the assessment produces