Captain Phillips meets Admiral Howard

Tom Hanks is one of my favorite actors - he is simply amazing at what does!  Just look at his list of awards - he's been nominated for an Academy Award six times, winning two times in a row for his lead roles in the movies Philadelphia and Forrest Gump.  You probably knew about that already, but did you know that he's been nominated for a Tony Award (for the play Lucky Guy) and twelve Prime Time Emmy Awards (winning seven times)?  He's won a number of Screen Actor's Guild Awards, Golden Globes, and People's Choice Awards, and President Barack Obama awarded him the Presidential Medal of Freedom in 2016.  Most recently, he served as the television host for President Joe Biden's Inauguration Celebration.

Hanks stayed busy during the COVID-19 pandemic (despite being hospitalized briefly for COVID-19 for a few days this past March).  So without question, my wife and I recently sat down to watch a Tom Hanks movie that we've never heard of before (maybe that should have been our first warning).  The 2016 movie was called A Hologram for the King.  Let's just say that you can take a pass on this one - the movie proves that not every Tom Hanks touches turns to gold!  

If you are looking for a good Tom Hanks movie, check out the 2013 movie, Captain Phillips.  Based on a true story, this movie tells about the 2009 Maersk Alabama hijacking by Somali pirates.  The film was a box office success and earned six Academy Award nominations, though Tom Hanks wasn't nominated for his role in this film (he was, however, nominated for a BAFTA).  What is disappointing about this movie is that it fails to highlight the role played by Admiral Michelle Howard.  Admiral Howard retired on December 1, 2017 after serving for 36 years in the United States Navy.  

If you are looking for heroes, please look no further.  Here are just a few of now retired Admiral Howard's accomplishments:

1. United States Naval Academy graduate (she was actually the first in her class to reach flag rank)

2. First African American female to serve as commanding officer of a Navy ship (USS Rushmore)

3. First African American female to reach a three star rank in the military 

4. First four-star female Admiral in the U.S. Navy

5. First African American and first female to serve as Vice Chief of Naval Operations, the second highest-ranking commissioned United States Navy officer in the Department of the Navy

During the events depicted in the movie, Captain Phillips, Admiral Howard served as Task Force Commander aboard the USS Boxer.  She had actually just taken over command of the Task Force for a week.  

I recently came across an article in Forbes magazine entitled "Leadership Lessons from the Navy's Top Female Commander".  These lessons are quite good, so I will refer you to the original article and highlight them here below:

1. "Diverse teams generate better ideas" - this concept is generally very well known and well accepted, but unfortunately easily forgotten.  As Admiral Howard states, "I often quote Dr. Linus Pauling who talks about how it's not a matter of having a good idea, it's a matter of generating a lot of ideas and then picking the best one.  If you have homogeneous teams, you end up with very similar solutions."  In other words, if you have diverse teams, you will have many more ideas to choose from!

2. "You need to preach the diversity gospel" - unfortunately, Admiral Howard's first point is often forgotten.  In order for us to generate diverse teams, all of us need to educate ourselves on the issues of integration, diversity, equity, and inclusion, so that we can "speak about those issues with authority".

3. "To lead, you need to let go" - Admiral Howard explains, "You have to let go of your own biases and negative experiences you've already had and continue to try to be the successful person you want to be."  I think "learning from failures" goes hand in hand with "letting go."  If you fail, move on.  Learn from the past and don't repeat it.

4. "Mentors don't need to look just like you" - unfortunately, there is not a lot of diversity at the leadership level in most industries, especially health care.  You can serve as a mentor even if you are not the same gender or race.  

5. "Meet resistance head on" - don't be afraid to face resistance and tackle it, especially when it comes to issues involving diversity, equity, and inclusion.  Admiral Howard says, "I came to the conclusion that if I couldn't get the courage to speak to someone about what was a difficult situation, I was probably never going to get the courage to lead people into combat."  I would say that courage is needed to be a leader - you are probably (thankfully) in a situation where you will never be required to lead people into combat.  That's good.  But you will also encounter difficult situations that require courage.  

"The harder the conflict, the more glorious the triumph."

Thomas Paine, American philosopher, political activist, writer, and patriot, who was born on this day in 1736 wrote a 47 page pamphlet called Common Sense which called on the American colonists to seek their independence from England.  While Paine is perhaps best known for this pamphlet, he is also known for a famous quotation that came from his essay, The American Crisis, published on December 23, 1776.  You've probably heard the first part of the quote many times : "These are the times that try men's souls."  

The second part of the quotation is just as important.  Paine continued, "The summer soldier and the sunshine patriot will, in this crisis, shrink from the service of their country; but he that stands by it now, deserves the love and thanks of man and woman.  Tyranny, like Hell, is not easily conquered; yet we have this consolation with us, that the harder the conflict, the more glorious the triumph."

While Common Sense may have started the American Revolution, it was The American Crisis that saved it.  General George Washington and the Continental Army had just suffered one of its worst defeats at the Battle of New York (technically, there was a series of battles involving portions of New York and New Jersey, but that probably doesn't matter to my point).  Whether from overconfidence, inexperience, or a combination of both, Washington's army was nearly routed (hence the passage, "These are the times that try men's souls").  They escaped to fight - just barely - to fight another day.

Just a few days later, Washington had the essay read out loud to his troops at McConkey’s Ferry on the Delaware River. He had reached a pivotal moment in the life of the newly independent United States of America.  The British General William Howe was offering pardons to all of the local residents, and the re-enlistment periods for a number of the volunteers in the Contintental Army was coming to an end.  The fate of the Continental Army, and thus the fate of the United States, was literally hanging by a thread.

Paine's words inspired Washington's men, who adopted the motto, “Victory or Death” for the famous Crossing of the Delaware Riveron Christmas Day.  The Continental Army surprised and defeated the Hessian garrison at Trenton, which was followed shortly by a second battle at Princeton.  The troops decided to re-enlist, morale improved, and a young nation was saved.

As I posted this past March (March 20 to be exact), we are still at a critical time in history.  We are deploying the SARS-CoV-2 vaccine, behavior is changing as more people are wearing masks and socially distancing, and COVID-19 numbers are finally starting to fall.  But let us remember that this past year, 2020, was marked not just by the worst pandemic in our lifetime.  The year was marked as well by political polarization and racial unrest as we are finally coming to the grips that our United States of America is not so united.  Systemic racism and inequality are no better now than they were a few months - - you could also say years, and decades for that matter - ago.  Just a few short weeks ago, our nation's Capitol, a symbol of democracy to the world, was under attack.  These are the times that truly try our souls.

And just as Paine said, those of us who stand united to confront all of these problems will deserve the love and thanks of man and woman.  We have work to do folks! The task won't be easy, but "the harder the conflict, the more glorious the triumph."       

The Challenger Seven

 Words matter.  Certain times call for leaders to use their powers of speech to show empathy, provide reassurance, and begin the process of healing.  Thirty-five years ago on this day, January 28, 1986, America witnessed the the deaths of 7 brave NASA astronauts on live television.  The Space Shuttle Challenger (OV-099) exploded and broke apart 73 seconds into its mission into space.  Everyone aboard - five of the astronauts and two payload specialists, including Christa McAuliffe, who would be the first teacher in space, perished.  Later that night, President Ronald Reagan addressed the nation, again via live television.  His words are a great example of leadership during a time of crisis.  They are testament to the fact that words do matter.  Here is President Reagan's speech:

Ladies and Gentlemen, I’d planned to speak to you tonight to report on the state of the Union, but the events of earlier today have led me to change those plans. Today is a day for mourning and remembering. Nancy and I are pained to the core by the tragedy of the shuttle Challenger. We know we share this pain with all of the people of our country. This is truly a national loss.

Nineteen years ago, almost to the day, we lost three astronauts in a terrible accident on the ground. But, we’ve never lost an astronaut in flight; we’ve never had a tragedy like this. And perhaps we’ve forgotten the courage it took for the crew of the shuttle; but they, the Challenger Seven, were aware of the dangers, but overcame them and did their jobs brilliantly. We mourn seven heroes: Michael Smith, Dick Scobee, Judith Resnik, Ronald McNair, Ellison Onizuka, Gregory Jarvis, and Christa McAuliffe. We mourn their loss as a nation together.

For the families of the seven, we cannot bear, as you do, the full impact of this tragedy. But we feel the loss, and we’re thinking about you so very much. Your loved ones were daring and brave, and they had that special grace, that special spirit that says, “give me a challenge and I’ll meet it with joy.” They had a hunger to explore the universe and discover its truths. They wished to serve, and they did. They served all of us.

We’ve grown used to wonders in this century. It’s hard to dazzle us. But for twenty-five years the United States space program has been doing just that. We’ve grown used to the idea of space, and perhaps we forget that we’ve only just begun. We’re still pioneers. They, the member of the Challenger crew, were pioneers.

And I want to say something to the schoolchildren of America who were watching the live coverage of the shuttle’s takeoff. I know it is hard to understand, but sometimes painful things like this happen. It’s all part of the process of exploration and discovery. It’s all part of taking a chance and expanding man’s horizons. The future doesn’t belong to the fainthearted; it belongs to the brave. The Challenger crew was pulling us into the future, and we’ll continue to follow them.

I’ve always had great faith in and respect for our space program, and what happened today does nothing to diminish it. We don’t hide our space program. We don’t keep secrets and cover things up. We do it all up front and in public. That’s the way freedom is, and we wouldn’t change it for a minute. We’ll continue our quest in space. There will be more shuttle flights and more shuttle crews and, yes, more volunteers, more civilians, more teachers in space. Nothing ends here; our hopes and our journeys continue. I want to add that I wish I could talk to every man and woman who works for NASA or who worked on this mission and tell them: “Your dedication and professionalism have moved an impressed us for decades. And we know of your anguish. We share it.”

There’s a coincidence today. On this day 390 years ago, the great explorer Sir Francis Drake died aboard ship off the coast of Panama. In his lifetime the great frontiers were the oceans, and a historian later said, “He lived by the sea, died on it, and was buried in it.” Well, today we can say of the challenger crew: Their dedication was, like Drake’s, complete.

The crew of the space shuttle Challenger honored us by the manner in which they lived their lives. We will never forget them, nor the last time we saw them, this morning, as they prepared for the journey and waved goodbye and “slipped the surly bonds of earth” to “touch the face of God.”

Three days later, President Reagan again spoke to a grieving nation to begin the process of healing at a memorial service held in Houston, Texas.  Today, we remember those seven brave astronauts.

COVID-19 and women

According to the most recent statistics today from the Johns Hopkins Coronavirus Resource Center (see link here), there have been 100 million cases of COVID-19 worldwide with 2.16 million deaths.  Here in the United States, we have had 25.5 million cases and just over 425,000 deaths.  By way of comparison, the 1918 H1N1 Influenza pandemic (frequently and more importantly wrongly called the "Spanish Flu" - note that this pandemic didn't even originate in Spain) affected 500 million individuals worldwide, or roughly 1/3 of the population at the time.  The 1918 pandemic led to 50 million deaths worldwide and approximately 675,000 deaths in the United States.    

The COVID-19 worldwide pandemic is getting closer and closer to legitimate comparisons with the 1918 pandemic!  As a matter of fact, a research letter published by the Journal of American Medical Association this past summer noted that "the mortality associated with COVID-19 during the early phase of the New York City outbreak was comparable to the peak mortality observed during the 1918 H1N1 influenza pandemic."  Just as important, similar to the 1918 influenza pandemic (see one analysis by the National Bureau of Economic Research here), COVID-19 has had a tremendous social and economic impact on the world today.  As Frank Snowden wrote in a book called Epidemics and Society: From the Black Death to the Present released last year, pandemics like the 1918 Influenza Pandemic (and now, COVID-19) shape society in ways similar to wars, revolutions, and economic crises.

With all of that as context, it is clear that COVID-19 has had a disproportionate impact on women and minorities.  Many of the gender and racial disparities already existed pre-COVID, but the pandemic has only worsened them.  For example, a number of reports (see, for example, here and here),  have highlighted the stark contrast in disease severity and mortality in Hispanics and Blacks compared to Whites.  And, while men appear to be at higher risk of COVID-19-related morbidity and mortality, the social and economic impact of COVID-19 has largely fallen on women.  

The United Nations Development Program and UN Women this past September gave most nations a failing grade on whether they were successful in shielding women from the adverse economic and social consequences of COVID-19.  Similarly, the International Labor Organization has gone on record to say that any gains in gender equality (which they said represented "modest progress" at best) in the past several years will have been erased in the post-pandemic world.  For example, this is the first recession in U.S. history that caused significantly more job losses for women compared to men.  According to the most recent jobs report, employers cut 140,000 jobs in December - all of them were women (women lost 156,000 jobs while men gained 16,000 jobs)!

Balancing work and family obligations has always been challenging for women in the workforce.  For example, women working full-time outside the home spend 50% more time each day caring for children compared to men working full-time outside the home.  Early and throughout the pandemic, with schools shifting to remote learning and child care centers either closing temporarily or going out of business for good, childcare and home teaching responsibilities fell even more disproportionately on women.  As a result, many women have left the workforce altogether (labor force participation from February to September fell by 3 percentage points for women versus only 1.2 percentage points for men).

COVID-19 has had an incredible (and when I say "incredible" I mean "incredibly bad") impact on women in academic medicine.  I would kindly call your attention to a superb piece written by a few of my former colleagues in Cincinnati ("Collateral Damage: How COVID-19 is adversely impacting women physicians").  Drs. Jones, Durand, Morton, Ottolini, Shaughnessy, Spector, and O'Toole write, "The coronavirus disease of 2019 (COVID-19) pandemic has affected every facet of our work and personal lives.  While many hope we will return to 'normal' with the pandemic's passing, there is reason to believe medicine, and society, will experience irrevocable changes."  

These physicians cite some of the same statistics that I report above.  Notably, during the pandemic, female physicians are spending more time on childcare activities compared to their male counterparts.  As I have previously highlighted, more women are entering the pediatric workforce than men.  While this is great news, there are still significant leadership gaps with fewer women in leadership positions in academic pediatrics (this is particularly true in my own specialty of pediatric critical care medicine).  If women continue to leave the workforce in academic medicine, as they are currently doing, the leadership gap will only get worse.  We simply can't afford that.

What should academic health centers do?  I won't even begin to suggest that I speak for women physicians.  Instead, I offer up six recommendations from Drs. Jones, Durand, Morton, Ottolini, Shaughnessy, Spector, and O'Toole:

1. Closely monitor the direct and indirect effects of COVID-19 on female physicians (they specifically state hospitalists in their article, but I think their recommendation universally applies to all female physicians).

2. Inquire about the needs of women in your organization and secure the support they need.

3. Provide a mechanism to account for lack of academic productivity during this time.

4. Recognize and reward increased efforts in the areas of clinical or administrative contribution.

5. Support diversity, inclusion, and equity efforts.

6. Advocate for fair compensation for providers caring for COVID-19 patients.

Now would be a great time to remind everyone that we will be celebrating National Women Physicians Day exactly one week from today (February 3, 2021).  In addition to recognizing our female colleagues in medicine, wouldn't it be great if we sat down and had an honest conversation about the disproportionate impact of COVID-19 on women?  

Risk Homeostasis and COVID-19

There was one story from the sports world that took a backseat to arguably a much more important and relevant news story this week, the Inauguration and transfer of political power.  Last week, during the National Football League's AFC Division Play-off football game between the Kansas City Chiefs and the Cleveland Browns, Chief's quarterback Patrick Mahomes suffered a concussion and had to sit out the rest of the game.  There was a chance that he wouldn't be cleared to play for today's AFC Championship Game with the Buffalo Bills.  Football concussions have received a lot of attention in both the medical literature and lay press in the past several years, particularly due to the long-term health implications of multiple and repetitive concussions and association with something known as chronic traumatic encephalopathy.  NFL players have suffered from chronic and debilitating headaches, memory loss, depression, anxiety, sleep disturbances, and even early death as a result of this disorder.  It's great that the NFL has finally recognized that this is a major problem.  Whether or not the rules changes to decrease the risk of concussion, as well as the so-called concussion protocol that the NFL has implemented to determine when players can return to competition after suffering a concussion will be effective or sufficient is another question.  Only time (and further research) will tell.

Here's where things get a little interesting.  Football players wear protective gear - mouthguards, helmets, neck rolls, etc - to try to decrease the risk of concussion.  The football helmets that the players wear today are high-tech and certainly worlds better than what I wore when I played little league football.  There have been more than a few experts, however, that have suggested that football helmets are part of the problem.  In other words, some experts have suggested that football should be played without wearing a helmet!  Wow!  Does that even make sense?  It turns out, that is does.

These experts argue that players get a false sense of security by wearing a helmet, and as a result, players are much likelier to do things that are dangerous (tackle helmet first, throw their body around, etc).  As it turns out, there is ample evidence for this phenomenon, which is known in the psychology literature as risk homeostasis or risk compensation.  Strictly define, risk homeostasis suggests that individuals adjust their behaviors in response to a perceived level of risk.  They become more careful when they sense greater risk and less careful if they feel more protected.  

There are numerous examples of risk homeostasis or risk compensation in the literature.  For example, individuals have been shown to drive more recklessly (generally, they drive faster) following the introduction of anti-lock braking systems and seatbelts.  Similarly, studies have shown an increase in risky behaviors following passage of laws and/or regulations requiring bicycle helmets, motorcycle helmets, and ski helmets.  The economist, Gordon Tullock went so far as to suggest that if governments were really serious about reducing the number of traffic fatalities in their country, they would mandate that automobile manufacturers install a sharp spike ("Tullock's Spike") on the steering wheel of every car that they produce.  When you consider this outlandish suggestion, perhaps doing away with football helmets doesn't seem like such a strange idea.

We are starting to see evidence of "risk homeostasis" with the COVID-19 pandemic today.  While there are a number of reports suggesting that the roll-out of the COVID-19 vaccine has been anything but smooth, I am worried that people will generally be more willing to take risks once that they are vaccinated.  Unfortunately, this would be a disastrous result!  We know that the two vaccines that are currently being used in the United States are 95% effective at reducing the chance of COVID-19 disease.  In other words, if you have received both doses of the vaccine, your chances of getting sick from SARS-CoV-2 is fairly low.  However, we still don't know if the vaccine will reduce the risk of infection.  The important distinction here is infection versus disease - people can still be infected with the SAR-CoV-2 virus without getting the disease, COVID-19.  

If we are going to come out of this pandemic, we need to wait until enough people around the world have acquired either natural immunity (from actual infection with the virus) or acquired immunity (from vaccination).  Until that happens, we need to remain vigilant and continue to wash hands, wear a mask, and socially distance.  Now is not the time for risky behavior.  We've come so far, we cannot let our guard slip now.  Let's not add another example of risk homeostasis to the medical literature!

Sucker's walk

When I was growing up, a lot of the kids in our neigborhood used to play football in somebody's backyard - we usually tried to play in the largest backyard that was available.  It was always more fun that way.  We generally followed the usual football rules, but given the nature of the game, we occasionally had to make a few exceptions ("five apple rush" and "two completions for a first down" being a couple of the more common ones we used).  Whenever one team scored a touchdown, there would of course be a kick-off.  The other team was always the one that had to walk to the other end of the yard - you could call it the "walk of shame" but we preferred to just call it the "sucker's walk."  Wow, not very sportsmanlike of us, right!?!?  There was always a funny thing about being on the side that had to make the "sucker's walk" to the other end of the yard though.  We would all talk about how we were going to do better on the next series and score.  We would rally together, give each other a pep talk, and get ready to "do some damage" to the other team!  

I guess that I shouldn't be surprised by our response way back then.  If we are resilient, patient, and persistent, failure can do that to us.  We learn.  We move on.  And we try harder next time.  Building upon my last blog post ("I wish you bad luck"), some times when we fail, we ultimately win.  It's a subject I have written a lot about (see, for example, "The agony of defeat", "Sometimes, it rains", "The greatest teacher, failure is" or "Success is a lousy teacher" for a few of my personal favorites), perhaps because I have experienced so many failures myself.  It's like the old adage says, "If at first you don't succeed, try and try again."

Losing is a powerful motivator.  Our aversion to losing (the technical term in psychology is loss aversion) is incredible - some would argue that the "pain" of losing is about twice as powerful as the satisfaction that we get from winning.  Here's proof.  Jonah Berger and Devin Pope, both at the Wharton School of Business at the University of Pennsylvania analyzed over 45,000 college and 18,000 professional basketball games.  What they found was stunning.  Teams that were slightly behind (i.e. losing) at halftime win approximately 2% (college) and 6% (professional) more often than expected.  The boost in winning percentage due to the fact that teams were behind at halftime is actually stronger than having a homecourt advantage.  Berger and Pope concluded that "losing can sometimes lead to winning!"

There's more here than just extra motivation though.  As I stated in my last post, a group of scientists from Northwestern University recently published a study that found that young scientists who failed - just barely - when applying for their first research grant were more successful in the long run compared to those scientists who were just barely successful in their first grant application.  Failure is certainly motivation.  But unfortunately, not everyone gets back up after being knocked down.  Ten percent of the scientists who just barely missed the cut for the research grant dropped out and never applied for another grant again.  In other words, learning from failure comes with a price - in order to do so, you have to be persistent, patient, and resilient!  The psychologist Dr. Angela Duckworth calls it grit.  

I honestly remember taking the "sucker's walk" more than a few times.  But we always came back and tried harder to win in the end.  Grit and motivation.  Sometimes, with both, "losing can sometimes lead to winning."

"I wish you bad luck"

Chief Supreme Court Justice John Roberts once gave a commencement address (in this particular case, at his son's boarding school in New Hampshire) where he actually more or less told the graduating class, "I wish you bad luck."  I remember reading about it at the time, and I ended up writing a blog post about it, as I thought it was so powerful (see "The only easy day was yesterday").  Chief Justice Roberts is not an evil man, nor is he a mean one.  He was merely trying to make a point - by experiencing failure, at least occasionally, each and every one of us, if we remain persistent and if we remain resilient, will learn, improve, and emerge stronger in the long run. 

It's scientifically proven actually!  Just take a look at a study from Northwestern University by Yang Wang, Benjamin Jones, and Dashung Wang.  These investigators examined first-time applicants for the National Institutes of Health's (NIH) R01 grant funding mechanism between the years 1990 and 2005.  They divided those scientists receiving a similar high score based on whether or not they were awarded the grant - in other words, those who just missed being awarded the grant versus those who just succeeded in being awarded one.  Their analysis revealed 561 scientists who just succeeded ("narrow wins") and 623 who just missed ("near misses").  These scientists, as a group, were indistinguishable from one another, with the notable exception that the "narrow win" scientists had received an average $1.3 million, five year R01 grant.    

The measure of future scientific success (the outcome variable of interest, if you will) was the number of publications, as well as the impact of those publications (in terms of being published in a more prestigious journal, the number of citations those publications received, and whether the publication resulted in a new scientific advance).  Note that while future success in NIH grant funding was not directly assessed, successfully publishing one's research is critically dependent on having the necessary grant funds to conduct that research.  There were two important findings of this analysis.  First, 10% of the scientists in the "near miss" group ended up dropping out from conducting further research.  In other words, failing to secure the NIH grant was a "weeding out" process.  The second finding, however, suggested that those scientists in the "near miss" group who stayed persistent and re-applied for grant funding, in general, were more successful than those scientists in the "narrow win" group!

Several years ago (1968 in fact), Robert Merton, a sociologist at Columbia University, coined the term, "Matthew Effect" to explain why the most talent scientists typically had access to better resources and opportunities and were more successful as a result.  In other words, "the rich kept getting richer" and "the poor kept getting poorer."  The term comes from a famous Bible verse (Matthew 25:29) that states, "For to every one who has will more be given, and he will have abundance; but from him who has not, even what he has will be taken away."  As it turns out, there is a lot of evidence to support the existence of the "Matthew Effect" in a number of different settings and contexts.

The results of the present study by Wang, Jones, and Wang, suggest otherwise!  Rather, these results support the philosopher Friedrich Nietzche's classic admonition, "what doesn't kill me makes me stronger."  The key point that I think is lost somewhat in translation is the fact that 10% of the scientists dropped out and quit trying.  Persistence, patience, and resilience is necessary for success in academic research - these traits are what the psychologist Angela Duckworth calls grit.  I would argue that grit is important for success in more than just research.  I even would go as far to say that perhaps grit is just as important as talent in this regard.  

What would Dr. King say today?

Dr. Martin Luther King, Jr was born on January 15, 1929.  Today, we officially celebrate his birthday and honor his legacy.  Given all of the events and changes of the past year, I can only wonder what Dr. King would say about the state of our world today.  

I believe he would say something about how polarized our country has become and tie that fact back to the state of race relations that existed during his lifetime (and which unfortunately haven't changed all that much), using "The Other America" speech that he gave at Stanford University on April 14, 1967 (see also one of my old posts, "The Other America" from last Spring).  His words then are eerily poignant in light of recent events in the past couple of weeks, "What I'm trying to get across is that our nation has constantly taken a positive step forward on the question of racial justice and racial equality. But over and over again at the same time, it made certain backward steps. And this has been the persistence of the so called white backlash."  

In this same speech, Dr. King goes on further to talk about civil unrest and civil disobedience:

Let me say as I've always said, and I will always continue to say, that riots are socially destructive and self-defeating. I'm still convinced that nonviolence is the most potent weapon available to oppressed people in their struggle for freedom and justice. I feel that violence will only create more social problems than they will solve. That in a real sense it is impracticable for the Negro to even think of mounting a violent revolution in the United States. So I will continue to condemn riots, and continue to say to my brothers and sisters that this is not the way. And continue to affirm that there is another way.

But at the same time, it is as necessary for me to be as vigorous in condemning the conditions which cause persons to feel that they must engage in riotous activities as it is for me to condemn riots. I think America must see that riots do not develop out of thin air. Certain conditions continue to exist in our society which must be condemned as vigorously as we condemn riots. But in the final analysis, a riot is the language of the unheard. And what is it that America has failed to hear? It has failed to hear that the plight of the Negro poor has worsened over the last few years. It has failed to hear that the promises of freedom and justice have not been met. And it has failed to hear that large segments of white society are more concerned about tranquility and the status quo than about justice, equality, and humanity. And so in a real sense our nation's summers of riots are caused by our nation's winters of delay. And as long as America postpones justice, we stand in the position of having these recurrences of violence and riots over and over again. Social justice and progress are the absolute guarantors of riot prevention.

I would imagine that Dr. King would have a comment or two on the state of our health care system, especially in light of the racial and ethnic disparities that have persisted since his lifetime and are perhaps even worse now with the COVID-19 pandemic.  Back on March 25, 1966 in a Chicago press conference following the annual meeting of the Medical Committee for Human Rights, he said "Of all forms of discrimination and inequalities, injustice in health is the most shocking and inhuman.”  

And, rather than just talking about the problems we are experiencing today, Dr. King would offer a message of hope for the future, giving us a roadmap on how to move forward, just as he did in his famous, "Letter from Birmingham Jail".  He would likely tell us that we needed to do more, each and every one of us, both individually and collectively, to fight for social justice: "...all too many others have been more cautious than courageous and have remained silent behind the anesthetizing security of stained-glass windows."  

I think Dr. King would also tell us that in order to bend the long arc of the moral universe towards justice, we would need to go deeper to understand these issues, perhaps deeper than we are comfortable with: "Shallow understanding from people of good will is more frustrating than absolute misunderstanding from people of ill will. Lukewarm acceptance is much more bewildering than outright rejection."

I would love to have that conversation with Dr. King.  I think he would have a lot to teach me.  Today, I think that the best way that we can honor his legacy and his memory is to go back and read some of his speeches and truly begin to live by his words.  We have a long way to go still, but “Let us not seek to satisfy our thirst for freedom by drinking from the cup of bitterness and hatred.”  Let us move forward.  “Now is the time to rise from the dark and desolate valley of segregation to the sunlit path of racial justice.”  “Now is the time to make justice a reality for all of God’s children.”  “Now is the time to lift our nation from the quicksands of racial injustice to the solid rock of brotherhood.”

Feierabend

We all have our normal routines.  For example, I wake up (probably a little earlier than I need to) every morning, take a shower, get dressed, and then sit down with a book while enjoying a small breakfast and a cup of coffee.  Once I finish that cup of coffee (and not a moment before), I leave for work.

It's amazing how much we adapt to our normal routines.  We get so used to our routines that when something changes, even if it's a minor change, it can really impact us in a bad way.  In other words, disrupt your normal routine at your peril (for a humorous story, check out one of my old posts, "Today, I was a doofus, maybe I should use a checklist?").

Just like our morning cup of coffee, the morning work commute (and the evening one as well) is also part of our normal routine.  There are a number of studies - countless, in fact - that provide fairly convincing evidence that a longer work commute adversely affects mental health.  Rush hour traffic is stressful, it's noisy, and it's absolutely no fun.  Here's the crazy part - with the shift to remote work due to COVID-19, a lot of us are actually missing the morning and evening work commutes!  As a matter of fact, we are missing the commute so much, that it has become a thing - the so-called faux or fake commute!  Look it up!

As reported today in the Wall Street Journal by Jennifer Levitz, "work-from-home employees who used to slog to the office on the train, bus, ferry or highway are forcing themselves to take short walks, drives or other excursions to re-create commuting and provide a separation between their work and nonwork lives."  It turns out that we need a separation between work life and home life, and pre-pandemic, the morning and evening commutes served that purpose perfectly.

There is even a German wor for it - feierabend which literally means "the evening celebration" but now refers to the third space between work and home.  Feierabend offers a complete separation - a clean break, if you will, between the time when we finish work and when our period of leisure and rest at home begins.  Rather than a source of stress, many of us used the time spent traveling to and from work to listen to podcasts, read the newspaper, listen to an audiobook, or just think.  

Due to COVID, many workers have had to adjust and work remotely from home.  So rather than having that important feierabend, these workers wake up, get dressed, and go immediately to work.  There's no separation between home life and work life.  There's no so-called third space.  The solution?  Many workers have started a fake commute.  As Levitz reports in the WSJ, some individuals take a short walk outside, while others actually go for a drive!

Dr. Anna Cox from the University College London and her colleagues recently published the findings of a survey of nearly 350 workers who had shifted to remote work due to the COVID-19 pandemic.  Several of the workers reported that a "fake commute" forced them to engage in physical activity and provided an ideal separation between home life and work life (in other words, feierabend).

I completely understand.  I've had to self-quarantine on a couple of occasions during the pandemic, which has forced me to work remotely.  During my most recent quarantine, my wife asked me "How was work today?"  I told her, "I don't like working virtually."  She then commented that most of my actual meetings at work are virtual anyway - in other words, what's the difference?  I now recognize that virtual work for me eliminated my feierabend.  And I now know how to adjust!

Leave your door open

I came across a really superb article from the Harvard Business Review this morning by Drs. Washington (Georgetown University), Birch (University of Texas), and Hall (Emory University) entitled "How to Talk with Your Team About the Violence at the U.S. Capitol".  No matter how hard you try as a leader, you cannot escape major events such as this one from impacting the workplace.  It's inevitable that, regardless of political view, these kinds of events will affect everyone.  It's hard not to talk about them at work, nor is it probably a good idea to ignore having conversations about them.

The range of emotions after an event like this one are all across the spectrum.  We can feel anxious, scared, disillusioned, or disappointed.  We may feel grief or anger about the event itself.  I have always found (as do the three experts that wrote this article) that leaders should resist the temptation to shy away from having conversations about these strong opinions and emotions.  We never have the right words to say, but we can always listen.

According to Drs. Washington, Birch, and Hall, leaders should respond to these kinds of events by:

1. Creating space 

2. Acknowledging what happened

3. Affirming the range of emotions in how different individuals respond

4. Personalizing the experience by sharing your own

5. Offering support

6. Reinforcing the values of the organization and its commitment to diversity, equity, and inclusion

7. Highlighting the available resources to learn more

All of these are really great suggestions.  The most important thing that a leader can do is to leave the door open and be available to listen.  Really great advice!

Our America

I have tried to avoid getting too political with my blog posts the past few months (see my post, "A brief hiatus" from July 11, 2020).  Unfortunately, I really can't let the events of the past 24 hours go by without some comment.  The 18th century political philosopher, Edmund Burke, once said, "The only thing necessary for the triumph of evil is for good men to do nothing."

I woke up yesterday morning, January 6, 2020 with mixed emotions.  I knew the day would be eventful, for a variety of reasons.  As of yesterday morning, over half of the employees at our hospital had received their first dose of the SARS-CoV-2 vaccine.  More importantly, all of our employees had been given the opportunity to sign up for their first dose, so I felt that the time was right for me to do so as well.  I scheduled my appointment for 6:40 AM - I was finally able to get vaccinated.  

I also woke up yesterday to the news that the state of Georgia's run-off election finished with no major issues or incidents.  These days, that's saying something.  I was happy with the results as well, but I can certainly understand the disappointment on the other side.  It used to be that there were clear winners and losers with our local and federal elections, and win-or-lose, everyone accepted the results and moved on.  Whether you agreed or disagreed with the political views of the winner, you accepted the result and moved on.

And then...words just can't adequately convey what happened at the U.S. Capitol building yesterday afternoon.  I heard journalists and politicians alike use words and phrases such as domestic terrorism, insurrection, mob, and coup, all of which were more or less accurate.  The U.S. Capitol was attacked by a group of individuals who were inspired and incited by the current President of the United States.  The attack was deliberate and clearly planned with the single goal of disrupting the Constitutionally mandated certification of our Presidential election.  

Our current President, his family, and his supporters believe that the election was "rigged" and that he otherwise "won by a landslide."  He has falsely claimed (among several other wildly extravagant and blatantly false claims) that the voting machine system "deleted 2.7 million Trump votes nationwide" - this has been directly contradicted by election officials who have declared this year's election to be "the most secure in history."  The facts clearly state that he lost - facts now confirmed by state officials in the contested states, some of whom are members of his own political party.  Political leader at the local, state, and federal level (including members of the President's own Cabinet) have stated on record that "there is no evidence of widespread voter fraud."  The President and his legal advisers have filed more than 60 lawsuits contesting the election process and results.  Almost all were dismissed or dropped due to the lack of evidence.  

And yet...the President has persisted in his false claims and his delusions.  Case in point, he tweeted out this morning (incidentally, he also acknowledged that "there will be an orderly transition on January 20th"), "..this represents the end of the greatest first term in presidential history."  I don't think so.  Not even close.  As a matter of fact, I would make the claim - as many others have done, by the way - that his term represents the worst term in presidential history.  History will not be kind to this President.

The facts are clear that our President and his supporters incited an attack on our democracy.  Consider these statements, both yesterday and throughout his term in office:

"Liberate Michigan." (POTUS, April, 2020)

"Proud boys stand back and stand by." (POTUS, September, 2020)

"We're going to walk down Pennsylvania Avenue, and we're going to the Capitol, and we're going to cheer on our brave senators, and congressmen and women.  We're probably not going to be cheering so much for some of them because you'll never take back our country with weakness.  You have to show strength, and you have to be strong." (POTUS, January 6, 2021)

"Trial by combat!" (Rudy Giuliani, January 6, 2021)

"We're coming for you."  (DT Jr, January 6, 2021)

There are many, many more.  This national shame is on him.  The Senators and U.S. Representatives who voted against the will of the people yesterday - they deserve blame too.  They were motivated not by ideology or principles, but by power.  They wanted power.  

I am looking forward to our next President.  His Inauguration Day cannot come fast enough.  But make no mistake about the next 2 weeks - the United States remains in peril as long as this man is President.  It's not a political stunt or hyperbole that a number of individuals across our government have called for the President to resign, have urged Congress to start impeachment proceedings (again), or the Vice President and Cabinet to invoke the 25th Amendment.  

I have heard a number of individuals say in describing the events of the last 24 hours, "This is not America."  I wish that were true.  Unfortunately, those who particpated in yesterday's act of domestic terrorism, as well as those who incited it (our President and his supporters) showed the world exactly what America is about.  We've been watching this President for the past four years.  We know what he is all about, and so do the 74 million individuals who voted for him.  I hope this is not our America, but I am no longer so sure.

It’s also been asked a number of times in the last 24 hours - what if these individuals had been black?  Just look at the level of Capitol security before some of the Black Lives Matter protests this summer and compare it to the lack of preparation last night.  What if these individuals had been black?  I think we know the answer.  And that is part of our America too.

We have reached a critical point in our nation's history.  Who do we want to be as Americans?  Who and what do we stand for?  Not the America I saw yesterday.  While I am proud that our Congress came back to certify the election, I am still ashamed that 7 Senators and 138 Representatives (all Republicans) voted against certifying the election results.  

We have a lot of work ahead to change our ways.  It starts with accepting the truth, like it or not, on who we are as a nation today.  

One last point.  I know that some of you won't agree with me.  I wish that were not the case, but that is certainly your right.  Respect my right to express my opinion.  If you don't agree with me, please feel free to unfollow.  We have two different views of what America should be.  History will judge who was right.