Category Archives: leadership

See, Do, Teach

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NaBloPoMo 2018:  What I’m Learning

When did you first notice you were led well?  Who was it, what was the circumstance?

See

I was in 7th grade math class.  The teacher was Joe Alt.  I met him 33 years ago, when I was 12, and I still consider him one of my greatest and most important mentors.  He could teach anything and make it interesting, and we learned not only math and science, but how to be good people.  In a class that included both uber-nerd me and ultra-headbanger dude, he helped us both to see each other as people and get along so we could all learn.

Later I would find leadership role models in my athletic coaches, professors, program directors, committee colleagues, and hospital administrators.  At their best, these people were/are:

  • Attuned
  • Empathic
  • Reflective
  • Articulate
  • Intrinsically Motivated
  • Actively Engaged
  • Personal
  • Approachable
  • Genuine

I have also studied on my own, seeking guidance from sources like Benjamin and Rosamund Stone Zander, Simon Sinek, Brené Brown, Daniel Goleman, Chip and Dan Heath,  Rachel Naomi Remen, The Harvard Business Review, most recently Anthony Suchman, and, soon again, Marcus Aurelius.  I’m always looking for the next new or old related idea, the next dot to connect in order to draw my leadership map with more depth and detail.

Do

Recently I asked a new mentor what books he likes to read about leadership, organizations, etc.  He said he reads some, but prefers to simply do, always learning, adapting, applying, and evolving along the way.  I have had small leadership roles at school and work, in my professional society, as well as in my community, over the years.  They have all given me tremendous opportunities to practice what I read.  More and more, I see the value in getting my nose out of the books, looking up, and stepping forward.

Teach?

I spoke with a high school freshman athlete recently.  She plays two sports, both teams comprised of both upper and lower class(wo)men.  She contrasted the coaches’ personalities and styles, and how she learns about the respective sports as well as teamwork, integrity, etc.  We noted how much better it feels when the coach knows you personally, and pays attention to your state of mind as well as your performance.  The team with the less attuned coach will soon choose a captain for next year.  It’s usually a senior, perhaps regardless of leadership skill or potential.  She described the various candidates to me, and why she thought they would be good captains (or not).

I asked her whether the team feels like a true team, or more like just a group of individuals.  She said right now, it’s the latter.  I asked how she would show up if one of the less desirable candidates were named captain.  She had not really thought about it other than to continue working on her own sports skills.  I then found myself offering copious unsolicited advice:

You have a few choices, I told her.  First, you could remain an individual, holding your own goals as primary.  You may or may not improve, your team may or may not do well, and your personal contribution to the success of the whole will be proportional to your own individual performance.  Second, as you progress in your skills and newer kids join the team, you can help teach and mentor them.  You could observe the new captain, identify her weaknesses. If possible, and if you’re so inclined, you can fill in the gaps for the team—lead from within the pack.  You could help build morale, create a true team from its inside, cultivate relationships that will make the whole greater than the sum of its parts.  You could set your sights higher than your own personal achievement and really help the team succeed.  Third, you could take it to the next level by cultivating an advisory relationship with the captain herself.  If you have her trust, and exercise tact, you could help her see and maximize her strengths, navigate around her weaknesses—you can ‘coach up.’

The latter choices are, obviously, harder and more labor intensive.  I would also argue that they would make membership on the team exponentially more meaningful for everybody.  By serving as a connector among teammates (with boundaries, realistic expectations, and self-care, of course), this young athlete could make connectors of her teammates, too.  And a few years from now, if she herself is tapped to lead, she will have already earned her peers’ respect.  They’ll follow out of course; it will feel only natural.  And, they may then already be the cohesive team that she really wants to serve as leader.

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These ideas poured forth in a torrent of consciousness, forming sentences before I could actually think them.  As happens so often, I found myself saying words, advising someone else, that I myself needed to hear at exactly that moment.  Most of the time it’s about eating, sleep, or exercise.  This was an A-ha! moment on my personal leadership journey.

Now I see the true meaning behind the phrase, “See one, do one, teach one.”  It’s not about becoming a teacher.  It’s about always remaining a student, because the best way to truly understand anything is to try teaching it.

See, do, teach.  It’s not linear.  It is, no question, completely cyclic.

Culture of Medicine, Part II

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NaBloPoMo 2018:  What I’m Learning

So, what did you think of how trainees described the Culture of Medicine?  If you’re in medicine, how much did you resonate?  If you’re not in medicine, how much were you surprised, or not?  How do you think this affects our relationships with you, our patients?

Do you wonder how we get through any given day?

I asked the group:  What are characteristics or traits of Culture of Wellness (COW) Leaders?  Once again, I present their responses here, in order of discussion.

  1. “They ask how people are doing.” They are proactive about it, opening the door, making it safe to talk honestly about how we really are doing.  They exhibit the ‘body language of listening.’  It’s still hard to talk about it, one student pointed out.  The best leaders explicitly carve out time to talk, to invite feedback.  It also matters what they do with the information once they get it—empathizing and acting on it if needed, rather than dismissing.
  2. Mentor. This is someone who knows you and whose role it is to help you ‘unconditionally,’ different from any of your evaluators—maybe an advisor.  It can be an informal relationship, maybe just someone you want to emulate.  Trainees agreed that it often happens organically, and they seek it actively.  One resident identified her program director as ‘absolutely a COW leader.’
  3. Walk the Talk. Examples: work/life balance/integration, acceptance of mistakes, admitting when you don’t know something.  NO DEFLECTING; OWN YOUR SHIT.  This one hit home with me—this is Integrity.  As Brené Brown says, integrity is “choosing what’s right instead of what’s fun, fast, or easy.  It is living your values rather than simply professing them.”

The next several descriptors emerged in a flurry.  The atmosphere in the room swelled with positive energy as one label after another of what we admire about our teachers and colleagues overtook the downtrodden mood just moments before:

  • Consistency
  • Proactivity
  • Openness
  • Empathy
  • Personally engaged
  • Curiosity
  • Caring
  • Kindness
  • Vulnerability—willing to share
  • Positivity—seeing mistakes as learning opportunities. Encouraging—“We’ got this!”
  • (Understand the importance of) Food: attending to physical needs
  • Humor—acknowledging the challenge and weight of the work and also holding it loosely
  • Validating
  • Appreciative
  • Grateful

The last one triggered a story.  One student rotated on an inpatient service.  Critically ill patients poured into the hospital; all work hour restrictions were necessarily violated.  Nerves were more than frayed, and people were at their worst.  He witnessed open hostility by senior residents toward interns, backstabbing, undermining.  The attending, present only minimally, was oblivious.  And, “They never said thank you.”  The student, who had planned to enter this field, considered switching.  It was that bad.  But somehow, he was able to get perspective and remind himself that this one bad experience did not represent the whole of this specialty.  It had been an unusually busy month at the end of a long, hard year.  Maybe the cumulative exposure to some of his COWL role model traits had rubbed off, and buoyed him when he stepped onto a leaky boat.

A senior student admitted that when she started medical school she had heard of burnout.  “I initially didn’t believe it could happen to me…  Then later I realized it can happen to anybody—it could absolutely be me, if I don’t take care of myself.”  I asked what that means, taking care of yourself?  They answered:

  • Sleep
  • Nutrition: “Any food your intern year; choices matter more when you’re PGY (post graduate year) 3!”
  • Outside interests
  • Finding a practice situation that fits: eg caring for the underserved, women’s health, hospital medicine, etc.
  • Find Your Tribe. The trainees did not use these words, but this is what I wrote in my notes—they expressed a need for belonging.
  • People at work: truly collegial relationships, especially across specialties
  • Confidants: safe people to share with, your emotional support network
  • Physician-Patient relationships: mutually vulnerable and open

I asked them what they needed to take care of themselves.

  1. Purpose
  2. Time—to be given by the system, and also to be responsible and efficient with themselves.
  3. Habits—established and also adaptible

Overall the discussion felt productive and successful in the end.  We had just mapped out the way(s) to Be The Change we seek in our profession.  Some of them took pictures of my notes (so Millennial), which made me feel gratifyingly connected.  I had tried to question more than lecture, to explore and facilitate more than ‘teach.’  I wanted each of them to own their own path to leading from any chair, now and forever.  I proposed that they could start the moment they walked out of the conference room door—no elevated status or title necessary.

This is why the calling still resounds compellingly, why our enthusiasm for the work persists resolutely, despite the hardships.  It’s Hope.  And at its foundation lies the bedrock of our best relationships—with ourselves, with one another, and with our patients.  On the march toward a true Culture of Wellness, real leaders go in front and set the example.  The rest of us learn by mimicking.  Thus we all have leadership potential and, dare I say, responsibility.  We are the system; we make the culture—each and every one of us makes a unique contribution.  Nothing we do is too small to matter.

Onward.

What The Best Teachers Do

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NaBloPoMo 2018:  What I’m Learning

The post last night was a long time coming, maybe.  It took longer than I thought it would to actually write, edit, and publish, but it poured out in a flurry of energy that has built up over several months.  I received immediate feedback from members of my Counsel of Wisdom, supportive and encouraging, gratifying.

As I thought more, I realized that my best teachers growing up practiced emergent design and strategy.  Imagine you teach the same subject, the same skill, the same content, year after year.  Your approach is to do it the same way, expecting the same result.  Would you not get bored?  And if you’re bored, no question your students may want to gore their eyeballs out with their writing implements.  In medical school my classmate and I met a physician in his office for a lecture on his area of expertise.  We sat across from him in his big armchair behind a mahogany desk piled high with papers in disarray, the sun shining through the window at his back.  He spoke in a slow, bass monotone.  The words that dribbled forth practically fused together, such that I strained to distinguish and make sense of them.  And I kid you not, he literally put his elbow on the desk and rested his face in his palm while he spoke, as if he may have a near death experience from the sheer dullness of it all. That was not his best teaching moment, I’m sure he would agree.

My best instructors, on the other hand, engaged us learners in real time, with rapt energy.  They asked us what we knew about the topic, encouraged us to consider and describe how core principles applied in real life situations.  In classrooms, my best teachers were both goal-oriented and open-minded.  They had a clear learning objective but held the map only loosely. They allowed space for the learning journey and path to unfold before the class, always with an eye on the destination. We learners all got to choose the way, and we still ended up where we needed to be.  And every time I bet it was a little different for the teachers, so it was fun for them and they always learned, too.  I know that’s how it feels for me.  That’s what keeps any of us engaged and improving, I think—the confidence of knowing we hold the reigns coupled with the excitement of not knowing which new trail our class will blaze to apprehend the learning.

My Counselor friend described it as, “The map becomes a new and storied journey with each iteration of participant-cartographers.”  Is she not eloquent?  I have invited her to write a post with me soon.

Coach Christine reminded me, “What you describe is coaching at its best – the fundamental philosophy of the coaching I’m trained in is, the client is naturally creative, resourceful and whole. Not broken, doesn’t need fixing.  Capable of digging deep to find the answers within themselves, and /or where to find the help they need.”  Creative, resourceful, and whole.  I had not heard or seen those words in this context in a long time.  So grateful for the reminder—Thanks, Christine!

What are you teaching these days?  How might you hold your leadership map more loosely and allow those you lead to point to a new or different way?  What might you all gain in the process?