Saturday, July 30, 2022

"We were soldiers once..."

A few years ago (before the pandemic), I picked up and read a book about the Battle of Ia Drang Valley, the first major engagement between the U.S. Army and the People's Army of Vietnam in 1965.  The battle is also notable for being the first large-scale helicopter air assault and largely determined how both armies would fight during the rest of the Vietnam War.  The book is We Were Soldiers Once...And Young, which was co-written by Lt General Harold G. "Hal" Moore and war correspondent Joseph Galloway.  The book was subsequently made into a 2002 movie, "We Were Soldiers" starring Mel Gibson, Madeleine Stowe, Greg Kinnear, and Sam Elliott.  I really enjoyed the book, but for some reason I didn't watch the movie until the pandemic. 

Having read the book and now relatively recently watched the movie, I wanted to learn more about Lt General Moore.  I came across another book with a rather intriguing title, Hal Moore on Leadership: Winning When Outgunned and Outmanned co-written by Lt General Moore and Mike Guardia.  The book is part memoir and part leadership handbook, and it has become heavily dog-leafed!  I wanted to share a few observations and lessons that I've learned.

Definition of Leadership

Importantly, before talking about leadership, Moore and Guardia first define leadership in the opening pages of their book.  Leadership is about inspiring people to work hard and to execute tasks willingly.  In order to meet the challenge of leadership, leaders must demonstrate three characteristics.  First, the leader must be competent.  Second, the leader must exercise good judgement.  Third, the leader must have character.  Guardia writes, "By itself, competence is meaningless without character and good judgement.  If one were to look at the greatest leadership failures of the past 100 years, it would be clear that they were not failures of competence; they were failures of character and judgement."  He cites the Enron scandal as an example of these failures.

Lt General Moore also describes his four fundamental principles of leadership, stating "While learned in war, they apply in business, in government, in athletic competitions, in the home, in the family - anywhere."  Here they are:

1.  "Three strikes and you're not out."  He explained further that "If a leader thinks he might lose in whatever crisis or situation; then he has already lost.  He must exhibit a determination to prevail no matter what the odds or how difficult the situation.  He must have and display the will to prevail by his actions, his words, his tone of voice, his appearance, his demeanor, his countenance, and the look in his eyes.  He must never give off any hint or evidence that he is uncertain about a positive outcome."

2. "There's always one more thing you can do to influence any situation in your favor.  And after that, there's one more thing."  In other words, keep going no matter what.  He also lists the three things that a leader is paid to do: (i) Get the job done and get it done well; (ii) Plan ahead - be proactive, not reactive; (iii) Exercise good, sound judgement in doing all of the above.

3. "When nothing is wrong, there's nothing wrong - EXCEPT there's nothing wrong.  That's when a leader has to be the most alert."  That sounds a lot like the HRO principle of "Preoccupation with Failure"!

4. "Trust your instincts."  According to Lt General Moore, he learned one rule of thumb during his time at West Point, "If there's doubt in your mind, there's no doubt at all."  He explains, "In other words, if you know in your heart that an action is wrong, don't do it."

Toxic Leaders

Something that Lt General Moore said in another chapter also resonated, "Throughout your life, you will probably serve under more bad leaders than good leaders.  The irony, however, is that you can learn as much from a bad leader as you can from a good leader.  Toxic leaders will set a perfect example of what not to be."  He then talks about some of the toxic leaders that he served under during his long and distinguished career.  Apparently there is something taught at the U.S. Military Academy (West Point) called the "Definition of Discipline" which came from a speech delivered in 1879 by Major General John Schofield.  Army cadets are often forced to recite it verbatim from memory:

"The discipline which makes the soldiers of a free country reliable in battle is not to be gained by harsh or tyrannical treatment. On the contrary, such treatment is far more likely to destroy than to make an army. It is possible to impart instruction and give commands in such a manner and such a tone of voice as to inspire in the soldier no feeling, but an intense desire to obey, while the opposite manner and tone of voice cannot fail to excite strong resentment and a desire to disobey. The one mode or other of dealing with subordinates springs from a corresponding spirit in the breast of the commander. He who feels the respect which is due to others cannot fail to inspire in them respect for himself. While he who feels, and hence manifests, disrespect towards others, especially his subordinates, cannot fail to inspire hatred against himself."

Lt General Moore goes on to list and describe the several different kinds of toxic leaders (which I will come back to in a future post).

"Forcing Power Down"

Lt General Moore also talks about how he handled his direct reports.  He said, "A leader should surround himself with persons who fit his requirements and standards - and then turn them loose to do their jobs."  That sounds a lot like the HRO principle of "Deference to Expertise"!  He goes on, "In the large staff organizations and field commands I led, my policy was always to push the power down! If a subordinate staff officer, commander, or staff section leader felt comfortable and qualified to make a decision, he could so with my authority and my responsibility."  In other words, he empowered his teams to make decisions on his behalf, but he would accept 100% of the responsibility for those decisions!  

Lt General apparently had a set of rules that he called the "Rule of Doubts" to assist with the process of delegating authority.  Here they are:

1. Every job has an implied or specified level of authority and responsibility.  Use formally written job descriptions and personal counseling when on-boarding to ensure each individual understands the scope.

2. When confronted with a decision, the individual asks themselves "Does making this decision fall within my level of authority?"  If so, the individual makes the decision.  If not, he passes it up the chain of command.

3. The next person in the chain of command reviews the issue and, if the decision should have been made at the lower level, he passes it back without action; forcing power down.

4. Likewise, if the lower level decision should have been made at a higher level, the superior explains the reasons why to the subordinate to refine the subordinate's understanding of the scope of his authority.

"Four-way Confidence"

A few months after returning from combat duty in Vietnam, Lt General Moore (who was a Colonel at the time) wrote a monograph on leadership during combat ("Lieutenant Leadership in Combat") which was included as an Appendix.  He talked about how leaders should develop their teams and writes, "Among other attributes, I feel soldiers of any rank must have confidence in four directions."  He calls it "four-way confidence":

1. Self-confidence: "The primary source is expert knowledge of his assigned duties and readiness, at any time, to take on the next higher job.  In addition to creating confidence through individual expertise, his superiors facilitate its development through trust and how they treat him."

2. Confidence in the tools necessary for the job: Here he is talking about confidence in the weapons of war, but I think this could certainly apply to any discipline.  "Developing this takes leader-controlled and leader-supervised training."  

3. Confidence in the team: "At whatever level, the leader must strive to develop an intense esprit de corps.  But never by running down other units."  In other words, do not build up team confidence by "trash-talking" about other parts of the organization!

4. Confidence in leadership: "He must know and utterly believe his leaders are competent professionals who know what they are doing and are not careless or casual in their outlook toward their responsibilities.  For a subordinate to be confident in his leader, the subordinate must know the leader is aware of and appreciates what the subordinate must face and the life he must lead in performing his job.  The leader must make every effort to get inside the heads of his men and see their problems and the world from their viewpoint."

Of course, Lt General Moore wrote this monograph at a time when there weren't any female soldiers, so we can forgive him for his use of the male pronouns.  And, while he was directing this last lesson towards combat leadership, I do think that it applies to leadership in general.

I want to leave this post with one last quote from Lt General Moore, as I think it is particularly important.  He wrote, "Fewer things will impact a team’s morale than a leader who does not recognize their accomplishments and hard work."  I believe that recognizing the team for a job well done is part of building and instilling confidence in the team and in the leader.  

There's a lot more to learn from Lt General Moore in this book.  However, this post is getting long enough as it is, so I will return to some more leadership lessons from Lt General Moore in a future post (or two!).

Wednesday, July 27, 2022

"Want to get great at something? Get a coach!"

I know nothing about Dr. Atul Gawande's clinical skills, but I do know he is a wonderful writer.  He has been a long-time staff writer for The New Yorker magazine and has written four New York Times best-selling books: Complications, Better, The Checklist Manifesto, and Being Mortal.  He is currently the Assistant Administrator for Global Health at USAID, which he began in January 2022.  From 2018 to 2020, he was CEO of Haven, the Amazon, Berkshire Hathaway, and JPMorgan Chase healthcare venture.  I have thoroughly enjoyed reading all of his articles and books (which I highly recommend).

I recently read an article that he wrote for The New Yorker, which was published on September 26, 2011, "The Coach in the Operating Room".  Dr Gawande also gave a TED talk "Want to get great at something?  Get a coach!" which is related to the article.  He begins the article by referring to the fact that elite-level, professional athletes, singers, and even musicians all have coaches.  These coaches observe and critique their performance, help design their practice sessions, and often teach them better ways to complete their task.  

Dr. Gawande logically concludes that, if experts can benefit from coaching, then why don't physicians have coaches too?  He then tells a story of how he once invited a mentor into the operating room suite to observe and critique his surgical skills and clinical decision-making.  When the surgery was finished, Dr. Gawande thought, "That went very well."  He didn't expect his mentor to have too much to say.  In fact, his "coach" had several pages of notes, offering suggestions on how he positioned the surgical lights and how he positioned his hands and feet.  In other words, he coached Dr. Gawande towards better performance.

If surgeons could benefit from coaching, why not leaders too?  Leadership coaching has become a whole industry in and of itself.  I've had leadership coaches over the years, some good ones and some not so good ones.  But here's the thing - I learned something new from every single one of them.  So, at least in my own personal experience (and studies have confirmed my anecdotal experience), leaders can definitely "train" to become better leaders through coaching.

Where does the term "coach" come from?  As it turns out, the word "coach" comes from the mid 16th century French word "coche" and the Hungarian word "kocsi", both of which refer to a large four-wheeled covered carriage (apparently, these carriages were first designed and built in the small town of Kocs, Hungary).  Fast forward to the 1830's at Oxford University in England, when "coach" referred to a tutor who would "carry" a student through an exam.  Coaches literally carry us through on our journey to high performance!

Coaches became prominent in the sporting world, but it wasn't until a book written by the sports psychologist and college tennis coach W. Timothy Gallwey came out in the 1970's entitled The Inner Game of Tennis that some similar coaching methods were applied to the business world.

Incidentally, Dr. Gawande finishes his article with another story.  As it turns out, he enjoyed having his coach/mentor observe and critique him in the operating room so much, that he invited him back on a regular basis.  One day, one of his patients who was being prepped for surgery asked Dr. Gawande who the other individual with him was, particularly since he had a notebook in hand.  Dr. Gawande responded, "He's a colleague.  I asked him along to observe and see if he saw things I could improve."  He finishes the article with:

"The patient gave me a look that was somewhere between puzzlement and alarm.  'He's like a coach,' I finally said.  She did not seem reassured."

Tuesday, July 26, 2022

"As God as my witness, I thought turkeys could fly"

I saw a post a week or so ago on my Linked In news feed that caught my attention.  The story claimed that there is a poster hanging at the NASA Space Center that says:

"The aerodynamic body of bumblebees is not fit to fly, but it's good that the bumblebee doesn't know about it."

I think that the poster is suggesting that the scientists and engineers at NASA could learn a thing or two from nature in that sometimes, what seems impossible according to the laws of physics is actually possible.

I don't know if there is actually a poster hanging at the NASA Space Science Center about bumblebees or not.  I am not even sure that there is such a thing called the NASA Space Science Center (I looked it up on the Internet and it isn't listed among the different NASA Centers and Facilities).  And I certainly have never pondered how a bumblebee flies through the air.  I was interested in researching this a little more, so I decided to look to see what I could find on the science of bumblebee flight.

As it turns out, scientists have been interested in how bumblebees can fly since at least the 1930's.  Apparently, a French scientist named Antoine Magnan wrote a book in 1934 called Le Vol des Insectes (meaning "Insect Flight") in which he suggested that the laws of physics could not explain how insects fly.  He wrote, "First prompted by what is done in aviation, I applied the laws of air resistance to insects, and I arrived, with Mr. Sainte-Laguë, at this conclusion that their flight is impossible" (Mr. Sainte-Laguë was another engineer and scientist working with him).  Their analysis was wrongly based on the assumption (probably a reasonable one at the time) that a bumblebee's wings were smooth and flat.  They are not.  The myth that bumblebees can't possibly fly (despite a number of everyday observations to the contrary - I just watched a bumblebee flying yesterday), has persisted to this day.

Scientists have studied how bumblebees seemingly defy the laws of physics to actually fly through the air.  The trick is that bumblebees do not actually flap their wings like a bird, but instead they flap their wings back and forth and create a mini-hurricane around their wings that creates lift.  In very simple terms that even I can understand, "bees fly by rotating their wings, which creates pockets of low air pressure, which in turn create small eddies above the bee’s wing which lift it into the air and, thus, grant it the ability to fly."

All of this reminds me of one of my favorite television episodes from the 1970's sitcom "WKRP in Cincinnati" - the famous Thanksgiving Turkey Drop episode from 1978.  The radio station ran a promotion on Thanksgiving Day in which 40 live turkeys were dropped from a helicopter to a unsuspecting crowd at a local shopping mall.  As you would expect, the promotion ended badly.  The episode ends with the station manager, Arthur "Big Guy" Carlson claiming, "As God as my witness, I thought turkeys could fly."

Okay, so what is the takeaway from all of this?  What can we, as leaders, learn from bumblebees and turkeys?  First, always test your assumptions.  Clearly Magnan and Sainte-Laguë made an assumption that proved to be incorrect.  Once they tested their assumption, their original hypothesis proved incorrect.  Second, always test someone else's assumptions.  You certainly can't believe everything that you read on the Internet (or in the scientific literature for that matter).  Science moves forward because scientists are skeptics at heart - they always test another scientist's assumptions before they make their own conclusion.  Third, and this probably relates to the underlying premise of the purported NASA poster, innovation occurs when we adopt a growth mindset and try to achieve what previously seemed impossible.  As the actress Audrey Hepburn once said, "Nothing is impossible, the word itself says I'm possible."

Saturday, July 23, 2022

"Serve and thou shall be served"

Queen Elizabeth II of the United Kingdom recently celebrated her "Platinum Jubilee" marking 70 years since she acceded to the throne on February 6, 1952.  She is the Queen of the United Kingdom as well as fourteen Commonwealth nations (including Canada, Australia, and New Zealand), and carries a number of titles as a result.  I have always been fascinated by the various titles and honors that individuals hold as a result of their position.  Of interest, during the early years of George Washington's presidency, Congress argued about what title he should carry, before settling on "Mr. President" (apparently, John Adams wanted to call the President "Your Highness" or "Your Most Benign Highness").    

I recently learned that the Pope also carries a number of titles.  My favorite is the "Servant of the servants of God" (which is translated into Latin as "Servus servorum Dei").  In other words, the Pope is recognized as a servant leader.  Servant leaders are leaders who focus primarily on the growth and well-being of the people and the communities to which they belong. Rather than accumulating and exercising power at the top of the leadership hierarchy, servant leaders share their power by putting the needs of others first and helping their teams to develop and grow personally and professionally.  "Servant leadership" is also embodied (in my opinion) in the High Reliability Organization (HRO) principle of "Deference to Expertise".

There is a passage in Meditations by the Roman philosopher-king Marcus Aurelius that I believe perfectly summarizes the essence of what it means to be a servant leader.  He said:

"One person, on doing well by others, immediately accounts the expected favor in return. Another is not so quick, but still considers the person a debtor and knows the favor. A third kind of person acts as if not conscious of the deed, rather like a vine producing a cluster of grapes without making further demands, like a horse after its race, or a dog after its walk, or a bee after making its honey. Such a person, having done a good deed, won’t go shouting from rooftops but simply moves on to the next deed just like the vine produces another bunch of grapes in the right season."

Simply put, servant leaders don't make noise about performing a good deed or service to another.  They are like the vine that produces grapes without expecting anything in return!  As Winston Churchill once said, "We make a living by what we get.  We make a life by what we give."  And Ralph Waldo Emerson said, "It is one of the most beautiful compensations of life that no man can sincerely try to help another without helping himself.  Serve and thou shall be served."

Wednesday, July 20, 2022

Abandon all hope ye who enter here...

My first tour of duty with the Navy following completion of my residency training was at the U.S. Naval Hospital in Guam.  Moving a family of five (at the time) is always a challenge, but doing so half way across the world is perhaps even more so.  We took a very short plane ride from San Diego to Los Angeles.  Our next leg was a five hour flight from Los Angeles to Honolulu, followed by a short layover and another eight hour flight to Hagåtña, Guam.  I remember stepping off the plane with my wife and three tired kids and being told by one of my new colleagues, "Hafa adai and welcome to Guam.  Abandon all hope ye who enter here!"  I didn't know it at the time, but my colleague was referencing, rather tongue in cheek, a line from Dante's The Divine Comedy.  Apparently, the phrase is an inscription above the entrance to Hell.  Nothing like a cheery welcome, right!?!?

Actually, if I were to be 100% honest, Guam was a great place to spend a couple of years.  I could list a lot of reasons why living in Guam  made our lives interesting and, at times, difficult.  While we were there, we dealt with two separate (and very different) mass casualty events (the Korean Air Flight 801 crash resulting in 229 deaths and the crash of two school buses resulting thankfully in only minor injuries and no deaths), as well as supertyphoon Paka, which knocked out our electricity for over a month and our cable television for about 3 months.  It was difficult to travel back to the U.S. in order to visit family too.  However, for every negative experience, we had many more positive ones.  We formed some great friendships, we traveled to some exotic places, and our family of five became a family of six when our youngest daughter was born there.  Our family really enjoyed being part of the local community, and we have nothing but great memories of our time in Guam.  

As I look back and reflect, I've noticed that some of the most challenging situations I’ve experienced in my professional and personal life have been the times that I have learned and grown the most.  These challenging experiences have turned into ones that I would never trade in a million years.  While I know our experience in Guam was the farthest thing from a hardship, and most importantly doesn’t come anywhere close to his story, I am reminded of something that Vice Admiral James Stockdale once said about his experiences as a war prisoner in the infamous "Hanoi Hilton" during the Vietnam War.  Stockdale was a prisoner for over seven years, and he was tortured routinely.  When asked by Jim Collins, author of Good to Great, how he dealt with being a prisoner and what got him through, Stockdale replied, "I never lost faith in the end of the story. I never doubted not only that I would get out, but also that I would prevail in the end and turn the experience into the defining event of my life, which, in retrospect, I would not trade."

I am just so impressed how Stockdale could turn such a negative experience (he lost over 7 years of his life while a prisoner) into the "defining event of his life" and one that in retrospect he "would not trade."  I go back to what the author and psychologist Viktor Frankl, who survived in a concentration camp during the Holocaust wrote in his wonderful book, Man's Search for Meaning“Everything can be taken from a man but one thing: the last of the human freedoms—to choose one's attitude in any given set of circumstances, to choose one's own way.”  He also said, "Life is never made unbearable by circumstances, but only by lack of meaning and purpose.”  

I think it would be difficult to find meaning and purpose in as difficult of circumstances that Stockdale and Frankl went through.  However, I am impressed by the similarities in their thought processes and attitudes about their experiences.  Frankl said, "If there is a meaning in life at all, then there must be a meaning in suffering. Suffering is an eradicable part of life, even as fate and death. Without suffering and death, human life cannot be complete."  He continued, "The prisoner who had lost faith in the future – his future – was doomed. With his loss of belief in the future he also lost his spiritual hold; he let himself decline and become subject to mental and physical decay."

Neither Stockdale nor Frankl were overly optimistic about their situation.  Rather, they were what I would call "optimistic realists."  Stockdale told Collins that the optimists were the ones who never made it out of the prison camp.  He said, "Oh, they were the ones who said, ‘We’re going to be out by Christmas.’ And Christmas would come, and Christmas would go. Then they’d say, ‘We’re going to be out by Easter.’ And Easter would come, and Easter would go. And then Thanksgiving, and then it would be Christmas again. And they died of a broken heart … This is a very important lesson. You must never confuse faith that you will prevail in the end—which you can never afford to lose—with the discipline to confront the most brutal facts of your current reality, whatever they might be."

Here then is the essence of what Collins has called the "Stockdale Paradox".  The paradox involves holding two seemingly different thoughts or beliefs - faith in the future (optimism) and confronting the current reality, no matter how bad that reality actually is in the end.  I believe, and I think both Frankl and Stockdale would have as well, in the power of having a positive attitude.  There is a place for being optimistic about the future (as I have stated before in a couple of posts last month - "Our life is what our thoughts make it" and "Be the sun, not the salt"), but do not forget about your present situation either.  The ancient Roman Stoic philosopher (who lived life as a slave) Epictetus wrote, "What, then, is to be done? To make the best of what is in our power, and take the rest as it naturally happens."  In other words, have faith in the future, but also be realistic about the present.  And don't wait for someone else to save you.  Buddha said, "No one saves us but ourselves.  No one can and no one may.  We ourselves must walk the path."

I have found, particularly in the last two plus years of the COVID-19 pandemic, the "Stockdale Paradox" to be a powerful lesson for how to personally deal with a leadership crisis.  Thankfully, most, if not all, of us will never experience an event as challenging as the situations experienced by Viktor Frankl or James Stockdale.  However, we can learn a lot about how to deal with our own challenging situations by how they dealt with theirs.  I've already recommended Viktor Frankl's book, Man's Search for Meaning, which is one of the greatest books that I have ever read.  I would also highly recommend Thoughts of a Philosophical Fighter by James Stockdale, which is equally as powerful.

Monday, July 18, 2022

Stumbler-in-Chief

It's amazing what becomes newsworthy these days.  Just last month, there was a lot of press about the fact that President Biden tripped while climbing the stairs of Air Force One.  I suspect that the opposition political party would love to make this a bigger issue, but this may not have the intended impact on voters.  History repeats itself, or so it seems here.  During the early years of the television show, Saturday Night Live (in my opinion, the seasons with the original cast members will always be the best years), the comedian Chevy Chase used to impersonate President Gerald Ford.  Chase used to overplay the narrative that President Ford was a klutz.  President Ford had famously stumbled down the steps of Air Force One during a visit to Salzburg, Austria in 1975.  Reportedly, the young comedian Chase was indignant that Ford "had never been elected, period, so I never felt he deserved to be there to begin with" and wanted to poke fun at the President.  His impressions of Ford as a bumbling idiot did not have the intended effect.  Ford was humanized and perhaps more popular.

According to the Pratfall effect, when a person makes a mistake or acts in a clumsy way that makes people laugh, they are found to be more likeable, more human, less threatening, and maybe even more credible.  Avoiding politics this time, consider the actress Jennifer Lawrence and her famous stumble at the 2013 Academy Awards.  She had just won her first Academy Award for the movie Silver Linings Playbook.  As she ascended the stairs to the stage to accept the award, she fell.  Again, the fall made this talented movie star seem more like the rest of us, and the audience loved her even more for it.

The term "pratfall" means basically to fall on your butt.  Back in the late 1960's, the psychologist Elliot Aronson conducted a study in which he brought subjects from the University of Minnesota into the laboratory to listen to another college student (an actor) being interviewed for a trivia show called the College Bowl.  During some of the interviews, the actor would answer almost all of the trivia questions (all of which were difficult questions to answer) correctly, while in other interviews the actor would answer around one-third of the questions correctly.  The subjects were then told that the "superstar" contestant had a stellar high school career and was a star athlete, while the "average" contestant earned only average grades in high school and wasn't a star athlete.  Finally, towards the end of the interview, some of the videotaped portions of the interview recorded the contestant spilling a cup of coffee and apologizing for doing so, while in other cases this portion of the interview was left out. 

The study subjects were asked to rate the likeability and attractiveness of each contestant.  For the "average" contestant, the blunder at the end decreased his attractiveness.  Conversely, the blunder for the "superstar" contestant actually increased his attractiveness.  These findings were published in the journal Psychonomic Science in 1966 and have been replicated in a number of studies since that time.

Bottom line, making mistakes makes us seem more human.  As leaders, we don't need to be fearful about how we may be perceived following a mistake or error.  By acknowledging the mistake and taking responsibility for our actions, our teams will appreciate us even more for it.  As proof (perhaps), the Pratfall effect has famously been cited as one reason (maybe THE reason) why President John F. Kennedy's popularity actually increased following the botched Bay of Pigs invasion at the beginning of his presidency.  He was honest, open, and transparent following the mistakes his Administration made, and he accepted full responsibility for them.  And the people loved him for it.

Friday, July 15, 2022

The evolution (not revolution) of the Fosbury Flop

The World Track and Field Championships are coming soon (July 15-24, 2022), and for the first time ever, the United States is the host country!  The event will take place at Hayward Field on the campus of the University of Oregon in Eugene, Oregon.  The World Championships usually take place only in odd years, but the event was re-scheduled due to the COVID-19 pandemic and one-year delay of the Tokyo Olympics.  Track and Field is usually a very popular event at the Olympics, so I suspect that even the casual sports fan will be at least somewhat familiar with all of the events that will be taking place.  

If you do happen to watch the World Championships, pay particularly close attention the high jump event.  As you watch, you will notice that almost every single athlete uses the exact same technique.  It's called the "Fosbury Flop" (after the man who developed it, Dick Fosbury), and it revolutionized the high jump event in the sport of Track and Field.  When you study closely what happened with the high jump over its long history, it's easy to see that the "Fosbury Flop" truly represented a revolution as opposed to an evolution.  No one was using a technique even remotely similar to it until Dick Fosbury introduced it at the Mexico City Olympics in 1968.  In less than 10 years after that Olympics, everyone was using the technique and the world records continued to fall.

Most of the management literature describes two kinds of innovation - incremental and radical.  Incremental innovations come about through serial, step-by-step advances, while radical innovations (also known as discontinuous innovation) originate with a sudden stroke of ingenuity (a "spark of genius") followed by a revolution in thinking.  In other words, incremental innovation is similar to the slow evolution of an idea as opposed to the revolution, usually quite rapid, that is characteristic of radical innovation.  

Most innovations are incremental in nature.  However, every so often, a spontaneous, unpredictable "spark of genius" combines with a little bit of luck to produce a radical innovation.  Clayton Christensen (who wrote a great book several years ago called The Innovator's Dilemma) studied the disk-drive industry and found that technological change often occurs through incremental innovation punctuated occasionally by a more discontinuous, radical type of innovation (the so-called S-curve of innovation).  There are certain cultural elements in an organization that tend to favor one type of innovation over the other.  As such, organizations often invest heavily in order to design the "right kind" of climate that is necessary to remove the obstacles to creativity and discovery.    

If you just take a look at Dick Fosbury's story, you would think that the "Fosbury Flop" came about due to radical innovation.  You would be wrong.  A deeper dive into Fosbury's story is instructive (special thanks to Jacob Goldenberg, Oded Lowengart, Shaul Oreg, and Michael Bar-Eli who published a wonderful case study).

Fosbury grew up in Oregon and started high jumping during high school.  The dominant method for high jumpers at the time was known as the "straddle method" (see a video of an athlete using this method here).  With this method, the jumper crosses the high jump bar face down with his or her legs straddling it.  Fosbury learned the "straddle method" at the age of eleven, though he preferred another method (and was actually better at it) known as the "scissors technique" (see a video of an athlete using this method here).  His high school track coach made him switch to the "straddle method" at which point Fosbury started to struggle (he was the first to be eliminated in one competition).  He asked his coach if he could switch back to the "scissors technique" again, and his coach let him continue to practice it.  

Fosbury was a lot more comfortable with his old "scissors technique," and his high jumping started to improve significantly (to the point where he was starting to compete for points for his team).  He began to experiment with different variations of the technique, adjusting his body position so that he could shift his center of gravity and clear higher jumps.  At one point, his coach pulled him aside to review and study films of his high-jumping performance.  No distinct style or technique had as yet been created, though he was starting to develop more of a hybrid technique that didn't fit with any of the commonly used techniques at the time.  Fosbury later recalled, "I knew I had to change my body position and that's what started first the revolution, and over the next two years, the evolution."

He continued to slowly change and refine his technique, and his performance continued to improve.  At some point in the 1964-1965, he started clearing the high jump bar with his back to it, arching his hips over, then straightening back to kick his heels over the bar.  Using this newer technique, he would land on his back in the high jump pit.  Luckily, by the time he was finishing up high school, the wood chips in the high jump pit were replaced with bundles of soft foam held together by a net.    Fosbury broke his school record during his junior year and placed second in the state the following year, jumping over a 6 feet 5.5 inch bar.

Fosbury enrolled at Oregon State University following high school graduation in 1965.  His college coach wasn't as convinced that he would be successful with his unconventional technique until he broke the school record as a sophomore, clearing 6 feet 10 inches.  He placed first in the 1968 NCAA championships and qualified for the 1968 Olympics, placing first at the U.S. Olympic Trials with a jump of 7 feet 1 inch.

At the 1968 Olympics in Mexico City, Fosbury used his unconventional technique, which had now been labeled "The Flop" and won the gold medal with a new Olympic record (and American record) of 7 feet 4 1/4 inches.  By the 1972 Olympics in Munich, 28 of the 40 competitors were using Fosbury's technique, though the gold medalist used the straddle technique.  Within 10 years, almost all high jumpers were using the technique that now is named after Fosbury, which is still the most popular technique used today.  

The case of the "Fosbury Flop" clearly shows that not all innovations arise through revolutions, but rather some occur through incremental innovation, evolving slowly over time.  As Goldenberg, Lowengart, Oreg, and Bar-Eli discuss, there are other examples of major innovations that occurred in a similar manner to the "Fosbury Flop", including the emergence of rollerblades (note that in-line skates were developed BEFORE roller skates but only became popular much later), the Macintosh computer, and the invention of aspirin.

As Clayton Christensen's theory of disruptive innovation describes "a process by which a product, service, or technology initially takes root in simple applications at the bottom of a market—typically by being less expensive and more accessible—and then relentlessly moves upmarket, eventually displacing established competitors."  The case of the "Fosbury Flop" builds upon Christensen's theory and strongly suggests that organizations should not take incremental innovations lightly (particularly when they are a competitor's incremental innovation).  Today's incremental innovation may become tomorrow's revolution.

Wednesday, July 13, 2022

Trojan Mice

I remember reading Homer's The Iliad the first time and expecting that the famous Trojan Horse would play a major role in the story.  If you are not familiar with the story, The Iliad tells the story of the 10-year siege of Troy by the Greeks.  The book ends before the war does, so the story of the Trojan Horse doesn't even get mentioned!  As a matter of fact, the story of the Trojan Horse is only briefly mentioned at the beginning of Homer's The Odyssey.  It's actually discussed more in Virgil's epic The AeneidAs the legend goes, the Greeks have grown tired of fighting the Trojans, so they come up with a rather unique plan to win the war.  They construct a giant wooden horse and hide their men inside, while the rest of their army leaves.  The Trojans wake up one morning and find that the Greeks have left.  They see the giant horse and unwittingly bring the horse inside the city walls.  Later that night, the Greek soldiers hidden inside the horse emerge and open the gates, allowing the rest of the Greek army to enter the city and win the battle.

The "Trojan Horse" has become a metaphor for any person, thing, or strategy that is being used to hide the true intent or purpose.  For example, a "Trojan Horse" can be a computer virus ("malware") that gains access to a system by appearing to be harmless initially and ultimately causing significant damage to the system itself.  Well, apparently there is now something called a "Trojan Mouse" that describes how organizations "run small, light, nimble experiments - tests not to win wars, but rather to quickly infiltrate new territory, attack new problems, and inform future tactics."  They include small, limited change initiatives that are designed to build capacity, learn, and inform subsequent organization-wide transformational change initiatives.

As Harold Jarche describes them, "Trojan mice are small, well focused changes, which are introduced on an ongoing basis in an inconspicuous way."  The power and utility of conducting these small, limited, and focused "tests of change" is that they limit and diversify the risks involved with larger, more sweeping changes.  

Jackie Mahendra of the Stanford Social Innovation Review says that "unless we're willing to experiment, we can't expect big breakthroughs.  One way to do that - to make risk more approachable - is to run small tests.  To build something that isn't necessarily grand, but rather light, lean, and quick - experiments that we can send off nimbly through the gates and learn from, regardless of what returns.  A Trojan Mouse instead of a Trojan Horse."

Those of us who focus on continuous quality improvement will certainly recognize and appreciate this metaphor of using "Trojan Mice" to initiate transformational organizational change.  We probably just didn't recognize that we were using "Trojan Mice"!  Whether we call them "Trojan Mice" or "PDSA (Plan-Do-Study-Act) ramps", the concept is to start small, learn, and progressively increase the size and scope of the change efforts to continuously improve the entire organization.  

Monday, July 11, 2022

"Starve your distractions"

I remember being taught to "feed a cold, starve a fever" when I was young.  I'm not sure where that adage came from, but it is a medical myth.  A better recommendation (and most certainly not a myth) is to "Feed your focus, starve your distractions."  In other words - prioritize!  Our priorities are those things in our personal and professional lives that are very important and must be dealt with before other things.  Our distractions are the things that keep us from focusing on what is important (our priorities).

The leadership and management consultant John Maxwell wrote a book called The 21 Irrefutable Laws of Leadership with the admonition, "Follow them and people will follow you."  Number 17 on the list is his "Law of Priorities."  Maxwell writes, "When we are busy, we naturally believe that we are achieving.  But busyness does not equal productivity."

I've recently posted about setting priorities (see "Eat that frog!"), but I didn't necessarily offer any advice on how best to do that.  I thought Maxwell's method was perfect.  Simply stated, he recommends setting your priorities (personal, professional, or both) based upon how you would answer the following questions, which he call's "The Three R's":

1. "What is required of me?"  How much time and effort is going to be required for me to complete this task?  Do I have the time and resources necessary to complete it?

2. "What gives me the greatest return?"  What is the return on my investment of time and energy?  Is this particular task going to help me achieve my personal and/or professional goals?

3. "What brings me the greatest reward?" Importantly, does my involvement with this project fit with my personal mission, vision, and values?

Importantly, these three questions are designed to be answered in the above order.  Maxwell also mentions a version of the well-known Pareto Principle (commonly known as the 80/20 rule).  Applied in this context, 20% of what you prioritize will yield 80% of your productivity (assuming that you focus your time, attention, and energy on the 20%).  

I have mentioned Cyril Parkinson's eponymous law a few times in the past (see "What does the musical Hamilton have to do with procrastination?" and "The bicycle shed effect").  Basically, Parkinson's Law states that "work expands to fill the time that is available."  Several years ago, after a long day on the internal medicine service as a third-year medical student, my senior resident told me that I should go home for the night.  I responded that I had a few more things to check on before I left.  He replied, "Derek, always remember that the longer you stay, the longer you stay."

As Parkinson recognized, no one is ever likely to have spare time at work.  First of all, I've never been to an organization where there wasn't something that always needed to be worked on or addressed.  Second, we tend to procrastinate - particularly when we think that we have "plenty of time" to finish a project or task.  Lastly, whenever we think we have "plenty of time" to complete a project, we tend to expand the scope of said project, thereby filling the allotted time completely.

How do you overcome Parkinson's Law?  Here is where Maxwell's "3 R's" and "Law of Priorities" become particularly useful.  Asking the "3 R's" in sequence is a particularly useful exercise in this regard.

The 19th century American transcendalist philosopher, Ralph Waldo Emerson admonished, “Guard well your spare moments. They are like uncut diamonds. Discard them and their value will never be known. Improve them and they will become the brightest gems in a useful life.”  Focus on your priorities.

Saturday, July 9, 2022

"The need for change is not an indictment of the past"

I heard an absolutely amazing statement from a business consultant the other day.  He said, "The need for change is not an indictment of past performance."  I have to admit, this statement is absolutely spot on.  I spend a lot of time writing about change, because as leaders, we spend a lot of time managing change.  What we all need to remember, is that the need for change is inevitable.

As I've stated previously (see, for example, "Change is the law of life!", "The law of continuous improvement", or "Survival of the fittest?"), there are three constants in life: death, taxes, and change (my own addition to the famous cliche).  As Jim Collins discovered in his research on organizations that made the leap from Good to Great and were Built to Last, the organizations who do not change with time are the ones who end up failing.

It's a rather simple, yet profound, statement of fact - organizations that fail to change over time are organizations that fail.  In other words, the need for change is not a criticism of how an organization has been led in the past.  What worked for an organization or leader in the past may simply just not work in today's rapidly changing, competitive environment.  

The ancient Roman emperor and Stoic philosopher, Marcus Aurelius said, "Everything's destiny is to change, to be transformed, to perish.  So that new things can be born."  The need for change is not an indictment of the past.  Rather, the need for change is a simple matter of survival.

Thursday, July 7, 2022

"Not every end is the goal"

A few years ago, I was co-leading our hospital's efforts at eliminating central line infections.  There are a lot of small things that physicians and nurses can do to significantly reduce the risk of a central line infection, and we were starting to see some really exciting results.  There was even talk about one day actually having zero central line infections in our hospital!  However, in all of my excitement, I forgot a key point - one of the significant risk factors for getting a central line infection is having a central line!  In other words, getting to zero on our central line infection rate was only half the battle.  Once we got there, we would have to stay at zero!  As long as our patients had central lines, they would be at risk of getting a central line infection.  I didn't know it at the time, but what I was experiencing is something known in psychology as the arrival fallacy!

According to Tal Ben-Shahar (the Harvard psychologist who apparently first coined the term), the arrival fallacy is "the illusion that once we make it, once we attain our goal or reach our destination, we will reach lasting happiness."  We live in a goal-obsessed world (and that's not necessarily a bad thing, in and of itself), and we often assume that when we finally reach our goal - whether that goal is graduating from school and getting our first job, finishing our research project, or even eliminating central line infections in a hospital - things will be great and we will be happy!  

The arrival fallacy has been cited as just one causative factor in the epidemic of burnout among professionals, such as physicians.  Consider that most physicians go to school for 16 years (through high school and college) before they even start medical school.  After four years of medical school, they go on to spend anywhere between 3 to 7 years of post-graduate residency and fellowship training before they are able to practice their specialty independently.  And once they get to that point, many physicians find out that the practice of medicine was far different than they had envisioned.  Many of these physicians are disappointed or even disillusioned - over half of all physicians experience professional burnout and just under half (at least in one survey) would choose their profession if they had a choice to do it all over again.

Billy Donovan, who is currently the head coach of the NBA Chicago Bulls, won the 2006 and 2007 NCAA college basketball championship while coaching the University of Florida.  Winning two championships in a row is not very common (only seven schools have accomplished this feat), so you would think that reaching this stellar achievement represented the ultimate pinnacle of success for Coach Donovan.  Quite the contrary - when asked how becoming only the seventh school to win the NCAA tournament two years in a row, Coach Donovan answered, "It doesn't change your life one bit."  He went on to say, "After that experience was over with, I was depressed.  I lost sight of what it's all about."

The 19th century German philosopher Friedrich Nietzsche wrote in his book, The Wanderer and His Shadow, "Not every end is the goal.  The end of a melody is not its goal;' and yet, as long as the melody has not reached its end, it also hasn't reached its goal."  In other words, maybe achievement isn't an end point to be reached.  Maybe it is all about the journey to get there.

Coach Donovan went on to say, "At the end of the day, if it's all about the ring and the trophy, you lose the most valuable thing and it's the group of people and the relationships that are established of people working together to accomplish something they couldn't accomplish on their own."

I am not saying that we shouldn't set goals.  What I am saying, and most experts writing about the arrival fallacy agree, that we shouldn't focus on our professional and personal goals to the exclusion of everything else.  And we should never expect that finally reaching these goals is going to be the one thing that will make us happy and fulfilled.  

Tuesday, July 5, 2022

Leaders adjust the sails

John Maxwell once wrote that, "The pessimist complains about the wind.  The optimist expects it to change.  The leader adjusts the sails."  Leading through turbulent times calls for a healthy balance of what I like to call "realistic optimism."  Leaders who practice "realistic optimism" balance the need to confront the reality of the situation with a plan for how to navigate through the rough waters (to use another metaphor).  I believe that the most successful leaders in these turbulent times are the ones who learn and adapt from so-called high reliability organization, organizations that operate in complex, high-hazard domains for extended periods without experiencing significant disruptions in their operations or catastrophic failures.  To build upon Maxwell's quote above, leaders in high reliability organizations are the ones who adjust the sails.

Dr. Leslie Jurecko is a pediatric hospitalist who currently serves as the Chief Safety, Quality, and Patient Experience Officer at Cleveland Clinic Health System.  In her role there, she is responsible for the development and implementation of one of the nation's premier health systems' enterprise-wide quality and safety strategy.  If there is any health care organization that currently meet the definition of a high reliability organization, it is Cleveland Clinic.  Dr. Jurecko has studied high reliability organizations extensively, and she recently listed 10 leadership mindsets for high reliability organizations.  I would like to list these mindsets here.

1. "Healthcare is a dangerous place to work."  Unfortunately, hospitals and other health care organizations have some of the highest rates of patient harm and employee injuries in the United States.  The late Paul O'Neill, who served as the Chairman and CEO of Alcoa, Chairman of the RAND Corporation, and the U.S. Secretary of Treasury was a strong proponent for workforce safety in health care organizations and believed that physical and psychological safety was a prerequisite for patient safety.  As leaders, we need to recognize that we work in a dangerous industry and commit to keeping our workforce safe, so that they can keep our patients safe.

2. "Complex systems have complex problems and require robust solutions."  One of the five fundamental characteristics of high reliability organizations is "Reluctance to Simplify".  The problems we are experiencing in health care today are complex (see my post on "wicked problems"), and trying to oversimplify their solutions is only going to make things worse.  We should refrain from trying to improve safety, reliability, and efficiency through limited action plans that involve either policy changes or mandatory education and training.  

3. "Patients are part of the solution to your difficult or complex issues."  Some of the best health care organizations have figured out that patients and families are important members of the health care team.  We need to do a better job in bringing patients and families to the table whenever we are trying to solve some of health care's most challenging problems.

4. "Reactivity breeds fear and fear stalls progress."  High reliability leaders establish a culture of psychological safety where our colleagues will feel both empowered and supported to raise concerns about safety and reliability.  Rather than reacting to bad news, these leaders adopt a "growth mindset" to help solve problems and prevent mistakes and errors from becoming safety events in the future.

5. "Stop blaming caregivers for system issues."  Lucian Leape wrote, "The single greatest impediment to error prevention in the medical industry is that we punish people for making mistakes."  High reliability leaders understand that in order to find and fix problems within the system, they have to commit to establishing a culture of psychological safety (see above) and create a "just culture" where people are not punished for making an honest mistake.

6. "Attention is the currency of leadership."  Ronald Heifetz wrote that, "Attention is the currency of leadership. Leadership could be defined as getting people to pay attention to tough problems that they would often rather avoid facing. When you're an authority figure, people are already paying attention to what you do and say. So you can direct attention more easily to a set of key challenges."  By paying attention to what is happening ("Sensitivity to Operations"), high reliability leaders will focus the rest of the organization's attention on finding and fixing problems within the system.

7. "Vulnerability is your superpower as a leader in a high reliability organization."  When a leader acknowledges that he or she is not perfect - when that leader admits to making a mistake - they are helping to build a culture of safety and reliability in the organization.

8. "Ask 'why' five times...then ask again."  Leaders in high reliability organizations "always take the next step" and dig deeper to find the root cause to a problem.  

9. "Stories are great, but stories with data are better."  I like to use anecdotes, stories, and metaphors as a leader to help build a compelling case for change.  Leveraging the power of data can make these anecdotes, stories, and metaphors even more powerful!

10. "Commit to proper change management."  I've talked about change management in a number of recent posts.  As I recently wrote, "Managing change is one of the most important jobs for a leader in any organization.  Managing change is all about managing people.  And managing people is hard."  High reliability leaders are committed to proper change management.

Sunday, July 3, 2022

Charlie Brown and Franz Stigler

Every once in a while, I come across a "feel good" story, and it just seems like I should pass it on.  With all of the turmoil going on in the world, it's great to hear of people who do something extraordinarily good.  I recently learned about one such example that involved an incident during World War II.

United States Air Force 2nd lieutenant Charles "Charlie" Brown was flying a B-17 Flying Fortress (nicknamed "Ye Olde Pub") on a bombing mission in Bremen, Germany on December 20, 1943.  It was actually their first mission with the 527th Bombardment Squadron, 379th Bombardment Group, 9th Air Force.  They were to bomb the Focke-Wulf 190 aircraft production facility in Bremen, which was heavily guarded by over 250 anti-aircraft guns.  Brown and his crew were told that they would encounter hundreds of German fighter planes during the mission and that they would be assigned a spot on the edge of the formation commonly known as "Purple Heart Corner" (due to the fact that the Germans targeted the planes at the edges of the formation).  However, during the flight to Bremen, three bombers had to turn back due to mechanical problems, so "Ye Olde Pub" moved up to the front of the formation.

Shortly after commencing their 10-minute bombing run over Bremen, "Ye Olde Pub" was hit several times by anti-aircraft fire, knocking out at least one engine and heavily damaging a second one.  Brown and his crew were unable to remain in formation, falling behind their colleagues where they were at incredible risk of further attack.  Unfortunately, that is exactly what happened.  Over the next 10 minutes or so, Brown's B-17 was attacked by over a dozen German Messerschmitt Bf 109 and Focke-Wulf Fw 190 fighter planes, resulting in significant damage to the aircraft's oxygen, hydraulic, and electrical systems as well as the loss of a third engine.  Several crew members were wounded, including the tail gunner, who was killed by a direct hit from a cannon shell.  

The crew discussed bailing out of the plane, but they worried that their wounded comrades would not survive the parachute landing.  They pressed on with a B-17 that could barely fly.  At that point, a German fighter ace with 27 total victories named Franz Stigler took off in his Messerschmitt Bf 109 and quickly caught up with Brown's crippled airplane.  

Stigler could easily see the injured and incapacitated crew through the holes in the side of the B-17.  However, he did not open fire.  Stigler remembered the words of one of his commanding officers, who said, "If I ever see or hear of you shooting at a man in a parachute, I will shoot you myself."  Stigler rationalized that a struggling aircraft was the same as a man in a parachute and refused to shoot.  He later said, "To me, it was just like they were in a parachute.  I saw them and I couldn't shoot them down."

Stigler twice tried to convince Brown to land his plane in a German airfield and surrender.  Brown refused both times.  He next tried to convince the American to fly to neutral Sweden, but Brown later stated that he could not understand Stigler, who was mouthing his words.  

Beyond belief, Stigler moved his Bf 109 in close formation near the B-17's left wing, so that German anti-aircraft guns wouldn't shoot at them.  He escorted the B-17 until they reached the coast, and Stigler departed with a salute.

Brown eventually managed to cross the North Sea and land his plane at RAF Seething Air Force Base in England.  During the postflight debrief, Brown informed his commanding officer what had happened.  His commanding officer told him not to repeat the story to the rest of the squadron, as they were afraid that it would build a positive sentiment about the German fighter pilots, potentially placing them at risk if they falsely expected similar help provided by Stigler.  Brown said, "Someone decided you can't be human and be flying in a German cockpit."  Stigler was too afraid of relaying the incident to his commanding officer.  Remarkably, everyone in Brown's crew survived their injuries, with the exception of the tail gunner.

Both Stigler and Brown would serve until the end of the war.  Brown returned to his home in West Virginia and served in the Air Force until 1965, at which point he became a Foreign Service Officer for the U.S. Department of State.  Stigler would later move to Canada and become a successful businessman.

Brown spoke at a combat pilot reunion in 1986.  He told the story about Stigler's escort and salute, and then decided that he would like to find the unknown German pilot.  After four years of searching without success, Stigler responded to Brown's story in a combat pilot association newsletter.  They spoke over the telephone and later met in person.  They became close friends, staying in contact from 1990 to 2008, when both died within several months of each other.

What an incredible story!  Just when you begin to doubt human nature, a story comes along of incredible kindness and compassion.  The Charlie Brown and Franz Stigler story was later recorded in a 2012 biographical novel by Adam Makos called A Higher Call.

Friday, July 1, 2022

"It's all good!"

My wife and I recently moved into an older home that we absolutely love.  However, as with any major life transition, not everything has worked out perfectly.  We've uncovered a few problems (the latest involving our cable and internet, which can't seem to work consistently), and we've probably spent more money on some things that we weren't necessarily expecting to have to purchase.  We've both learned to shrug off everything, look at each other, and say, "It's all good!"

As I thought about this more, I came to the realization (very quickly) that this is exactly what Stoic philosophy is all about (see one of my older posts, "To be a Stoic in today's world - part 1")!  Contrary to popular belief, Stoicism is not at all about being emotionless.  Rather, Stoicism is about the pursuit of self-mastery, perseverance, and wisdom.  The name of this branch of philosophy actually comes from the Greek Stoa Poikile, meaning Painted Porch, a place located on the north side of the Ancient Agora of Athens where these philosophers gathered and taught their students.  The founder of Stoicism was the ancient Greek philosopher Zeno of Citium (not to be confused with Zeno of Elea who is most famous for Zeno's Paradoxes), but other famous Stoic philosophers included Seneca the Younger, Musonius Rufus, Marcus Aurelius, and Epictetus.  

One of my favorite Stoic lessons can be summarized with a famous quote from Epictetus.  He said, "To make the best of what is in our power, and take the rest as it occurs."  What is in our power?  Again, according to Epictetus, "Some things are in our control and others not.  Things in our control are opinion, pursuit, desire, aversion, and, in a word, whatever are our own actions.  Things not in our control are body, property, reputation, command, and, in one word, whatever are not our own actions."  

In other words, you should only worry about what you can control, not about what you can't control.  The things that are not under your control will happen regardless of how you react.  I am reminded of the famous Serenity Prayer written by Reinhold Nebuhr in the early 1930's (and now most famous for being used by Alcoholics Anonymous and similar organizations):

God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.

I am not saying that there are not challenges or problems that you will face in your daily professional and personal life.  It's not exactly like Disney's song from The Lion KingHakuna matata, a Swahili phrase meaning "no worries" or "no problems."  But it's similar.  The important point to remember is that we will encounter challenges and problems throughout our lives.  The key is that we accept that there are some problems we just can't control.  Once we accept that these are things that are beyond our control, why worry about them so much?

Those of us working in health care have been through a lot these past couple of years.  It goes without saying that there is still a lot of turmoil going on in our world - both the one in which we live every day (health care) as well as the one outside it.  Stoic philosophy - particularly the concept that we should worry about things that are under our own locus of control and not everything else - has helped me get through these last two years.   Perhaps we could all use a little Stoicism in our lives.