Long Live Rock!

As I've mentioned in the past (see "You can't always get what you want..."), when I was in high school, I decided to post a "Quote of the Day" on a small dry erase board on the refrigerator in our family's kitchen.  I planned to only use quotations borrowed from rock-n-roll lyrics.  It worked great for about 3 days, then I quickly started losing momentum, gave up, and stopped.  The first quote that I used was from a Rolling Stones song called, "You can't always get what you want".  I've also wondered in the past whether Mick Jagger, the lead singer for the Rolling Stones was a Stoic philosopher (see "Was Mick Jagger a Stoic?")!  It's not far-fetched at all - Mick Jagger once studied economics at the famous London School of Economics and Political Science, which boasts an acceptance rate of about 8 percent!  

As it turns out, I've learned a lot from rock-n-roll lyrics over the years.  One of my favorite rock-n-roll artists, Bruce Springsteen once said, "The best music is essentially there to provide you something to face the world with."  With "The Boss" in mind, I decided to build upon my earlier posts and talk about some of the most important lessons that I've learned from listening to rock-n-roll:

1. "You can't always get what you want..." by the Rolling Stones:  Let's start with the song I've already mentioned.  There's a lyric in the song's chorus that goes: You can't always get what you want, but if you try sometime, you'll find, you get what you need.  It's a pretty amazing sentiment, if you really think about it outside the context of a rock lyric.  I think that you will find in life that you don't always get what you want.  Things won't always go the way that you hoped.  If you find yourself in that situation, take a pause and reconsider.  Chances are that you will come to realize that things always happen for a reason.  Even if you don't always get what you want, you will find that you will get exactly what you need.  What Mick Jagger is singing is a particular brand of philosophical thinking that encourages us a a sense of acceptance and contentment with what life offers, rather than constantly chasing after unattainable goals.

2. "Against the Wind" by Bob Seger: I've always thought that this is an absolutely amazing song.  There's an incredible lyric at the beginning of the song which may be the most poignant statement about life that I've ever heard in a rock-n-roll song: Wish I didn't know now what I didn't know then.  Here, Seger is lamenting the fact that as we grow older (and wiser), we learn some hard lessons about life that we don't necessarily appreciate when we are younger.  The lessons we learn as we grow older can be painful - the most important lessons in life usually are so.  The Roman general Julius Caesar himself said that "Experience is the best teacher" (he technically said it in Latin, "Ut est rerum omnium magister usus").  It's also been said (by many) that "experience is the hardest teacher, because it gives the test first and the lesson afterward."

3. "Follow Your Heart" by Triumph: The Canadian rock band Triumph was one of my favorite bands growing up.  They were known for their powerful guitar-driven rock songs with lyrics that always seemed to have an inspirational message as opposed to the "sex, drugs, and rock-n-roll" cliché - "Fight the Good Fight" (which was written for one of the band members' aunts who was suffering from cancer), "Lay It On the Line", and "Magic Power" to name just a few.  There's a line in their song "Follow Your Heart" that goes: People say don't ever look behind, happiness is just a state of mind.  The underlying message here is one that I've been posting a lot about recently - we can choose to be happy and optimistic, or we can choose to be unhappy and pessimistic.  It's truly a choice.  It all comes down to how we react to life's difficulties and experiences.

4. "The Grand Illusion" by Styx:  I loved this entire album growing up!  The theme for the entire album (Styx was big on concept albums) was that things aren't always what they seem and that it's a "grand illusion" that success will make you happy (see my post, "Success is not the key to happiness...").  Here's the key line from the title track: So if you think your life is complete confusion, 'cause your neighbors got it made.  Just remember that it's a grand illusion, and deep inside, we're all the same.  Here's another line that is just as powerful (and definitely still appropriate given the adverse impact of social media on trust and happiness in society today): Don't be fooled by the radio/the TV or the magazines/They'll show you photographs of how your life should be/But they're just someone else's fantasy...Just remember that it's all a Grand Illusion/And deep inside we're all the same.

5. "Stairway to Heaven" by Led Zeppelin: This song is one of the all-time classics and probably has one of the greatest guitar solos of all time (definitely when performed live, but even the studio version's solo is great)!  There's a powerful line in the middle of the song that goes: Yes, there are two paths you can go by, but in the long run, there's still time to change the road you're on.  In other words, throughout life we will be faced with choices.  The important thing to remember is that if we make the wrong choice, it's never too late to correct course and choose the alternative route.  

There are definitely more lessons from rock-n-roll that I've shared in the past (see in particular "And the world will live as one..." and "Give me something to believe in!").  And there are some that I hope to share in the future.  Art is powerful in that regard.  U2's guitarist, The Edge, said, "You see, rock and roll isn't a career or hobby - it's a life force. It's something very essential."

The Marshall Plan

One of my favorite scenes from one of my favorite movies ("Saving Private Ryan") involves one of my favorite leaders, General George C. Marshall.  It's the scene where General Marshall first learns that Private Ryan's three brothers have been killed and orders a rescue mission to bring Private Ryan back home.  During the scene, General Marshall pulls out and reads a letter, which is the famous "Letter to Mrs. Bixby" written by President Abraham Lincoln in response to a similar situation that had occurred during the American Civil War (see also my post "Courage, Honor, and Commitment").  I've never found out if the scene actually occurred as Hollywood showed it, but it is a very powerful and emotional scene nevertheless.  

General Marshall was one of only five U.S. Army generals to have been awarded the rank of "General of the Army" ( a five-star general) during World War II (the others were Douglas MacArthur, Dwight D. Eisenhower, Henry H. Arnold, and Omar N. Bradley).  He served as the Army's Chief of Staff under Presidents Franklin D. Roosevelt and Harry Truman, and he later served as Secretary of State and Secretary of Defense under President Truman.  British Prime Minister Winston Churchill called General Marshall the "organizer of victory" in World War II and wrote:

During my long and close association with successive American administrations, there are few men whose qualities of mind and character have impressed me so deeply as those of Gen. Marshall. He is a great American, but he is more than that. In war he was as wise and understanding in counsel as he was resolute in action. In peace he was the architect who planned the restoration of our battered European economy and, at the same time, labored tirelessly to establish a system of Western defense. He has always fought victoriously against defeatism, discouragement and disillusion. Succeeding generations must not be allowed to forget his achievements and his example

As Secretary of State, General Marshall was an early advocate for an American commitment to Europe's post-war recovery.  He was the architect of the Marshall Plan, which provided over $13 billion in foreign aid to Western European countries (roughly $135 billion in today's dollars).  In recognition of that work, General Marshall was awarded the Nobel Peace Prize in 1953, the only Army general ever to receive the honor.

Prior to all of this, however, while serving as aide-de-camp to General John J. Pershing (Pershing was the Commander of the American Expeditionary Force during World War I), then Major Marshall wrote a letter to General John Mallory, dated November 5, 1920, in which he outlined the four qualities necessary to be a successful leader during combat.  What's important to emphasize is that these same four qualities aren't specific to war-time leadership - they are fundamental aspects of leadership in general.  To this end, two of the qualities overlap with what Warren Buffett looks for in a potential leader.  

Marshall writes, "To be a highly successful leader in war, four things are essential, assuming that you possess good common sense, have studied your profession and are physically strong."  

1. Optimism:  A leader should be "cheerful and optimistic."  Marshall's belief here is aligned with several other, more contemporary, views of what qualities are necessary for leaders, including my own (see my most recent posts, "All shall be well", "Hope is not a strategy...or is it?", "Two words - wait and hope", and "Leaders are dealers in hope..." on this topic).  What's important to remember is that hope is optimism with action.  In other words, hope goes beyond simply believing things will turn out well (which is, in essence, optimism).  Hope goes one step beyond and involves actively envisioning a path and taking steps to achieve desired outcomes.  As leaders, it is our job to restore and provide hope - we do that by taking action.

2. Energy:  As General Marshall writes, "When evening comes and all are exhausted, hungry, and possible dispirited...you must put aside any thought of personal fatigue and display marked energy in looking after the comfort of your organization, inspecting your lines and preparing for tomorrow."  Leadership is hard (see my post, "No Easy Victories"), but it is our job as leaders to never show that our will, our resolve, and our commitment to the cause is flagging.  As I've mentioned in the past, leaders are always on stage.  The individuals in the organization will look to their leaders first for any signs of quitting or giving up.  

3. Loyalty:  General Marshall admonishes General Mallory, "Make a point of extreme loyalty, in thought and deed, to your chiefs personally..."  I do believe it is important for leaders to be loyal to their organizations and their teams.  One of my former mentors, the head of our Division of Critical Care Medicine, used to say that he would never ask the other members of the Division to do something that he was not willing to do himself.  That's always stuck with me, and it is certainly something that I try to practice to this day.  

4. Determination: What General Marshall calls determination, I like to call grit.  He again admonishes General Mallory, "The more alarming and disquieting the reports received or the conditions viewed in battle, the more determined must be your attitude."  Persistence.  Resilience.  Grit.  Determination.  These are the qualities that help leaders persevere through the challenges that come with leadership.

Incidentally, Warren Buffett said that he looks for three qualities in a leader - integrity, energy, and intelligence.  General Marshall assumed that leaders must have common sense, be physically fit, and know their craft.  So, he certainly would have agreed with Warren Buffett that leaders should be intelligent.  They should study their profession and continuously learn and develop their knowledge and skills.  Buffett also agrees with General Marshall that leaders should have energy.  

I've mentioned an online video by Simon Sinek in the past called "Trust and Performance" (see my posts, "Do the Cleveland Browns have a trust issue?" and "Attitude > Talent").  Sinek talks about how the U.S. Navy SEALS select the members of their elite group, SEAL Team Six - they select individuals who perform well (of course), but the weigh trust and integrity higher than performance.  In other words, they would choose a SEAL with "high-trust" and "medium-performance" over another SEAL with "high-performance" but "medium-trust".  In other words, they look for individuals who are loyal to their teams, their organization, and the mission.  I think the Navy SEALS would agree with both General Marshall and Warren Buffett.

A life with meaning and purpose...

When I think of all the books that I've read throughout my lifetime, there are a few that stand out as having an enormous impact on my life for one reason or another.  There are others that I just really enjoyed.  I would have to say that Man's Search for Meaning by Viktor Frankl is one of the most important books that I've ever read.  I can measure the impact that it's made on how I've come to view the world in which we live by the sheer number of posts that I've written about it.  Frankl was an Austrian neurologist, psychologist, philosopher, and Holocaust survivor.  He developed an entire philosophy and form of psychotherapy called "Logotherapy" (literally meaning "healing through meaning") based largely upon his Holocaust concentration camp experience, first at Auschwitz and later at Bergen-Belsen.  Frankl talks about the three fundamental tenets of "Logotherapy" in his book.  First, life has meaning, even under the most miserable of circumstances; second, our main motivation in life is to find meaning in life itself; and third, we are free to find meaning in who we are, what we do, and what we experience.  If you are searching for that elusive "one thing" that captures the essence of what it is to live with purpose and meaning, these questions are a great place to start.

Studies have consistently shown that psychological well-being is a key determinant for living the good life.  Individuals with positive well-being live longer and suffer fewer health problems compared to those without positive well-being.  Frank Martela and colleagues recently published a study ("Which predicts longevity better: Satisfaction with life or purpose in life?") that compared "satisfaction with life" (subjectively determined using a validated measure) and "purpose in life" (again, using a validated measure) and mortality.  Having a purpose in life was a much better predictor of living a longer life than simply being satisfied with life.  In other words, having a sense of purpose not only makes us happy, it helps us to live longer lives with fewer health problems!

  

Both Western and Eastern philosophical traditions suggest that finding your purpose in life is one of the keys to a happy life.  For example, Buddha said, "Your purpose in life is to find your purpose and give your whole heart and soul to it."  Viktor Frankl said, "Don’t aim at success—the more you aim at it and make it a target, the more you are going to miss it. For success, like happiness, cannot be pursued; it must ensue, and it only does so as the unintended side-effect of one’s personal dedication to a cause greater than oneself, or as the by-product of one’s surrender to a person other than oneself."  

Another one of my favorite authors, Mark Twain, said that "The two most important days in your life are the day you are born and the day you find out why."  As it turns out, finding your personal "why" is perhaps one of the most important things that you can do in life.  It is the key that unlocks both our happiness and our success.  Finding one's purpose is a highly personal journey, but thankfully there's been a lot of great articles that can certainly help pave the road and make the journey a little easier.  Stay tuned for a summary of the articles that I've found most helpful in my next post.

The third place no more?

I just read that McDonald's just overtook Starbucks' near decade-long run as the world's most valuable restaurant brand.  According to a report by the global marketing consultant firm Brand Finance, McDonald's brand value rose 7 percent in 2025 to US$40 billion, while Starbucks brand value declined 36 percent to US$38 billion.  Jason Aten, writing for Inc. magazine (see "McDonald's just got big news in its decades-long battle with Starbucks"), McDonald's has been playing the long game by investing heavily in its McCafé brand by improving the quality of its coffee and adding free WiFi.  He writes, "In doing so, McDonald's made a bold move: it started positioning itself as a viable third place."

Let's go back in time to talk about what Aten meant when he referred to McDonald's as a third place.  Several years ago, I happened to be speaking at the Risky Business Patient Safety Conference in London at the same time that my sister and her family were touring England.  We decided to meet up and see some of the sights together.  We had a fantastic time!  There's even a picture somewhere of all of us recreating the Beatles' famous Abbey Road album cover.  We had planned to meet at a specific location (I can't remember the exact location), and we had to travel separately via the Tube in order to meet ("Mind the Gap").  Apparently my youngest nephew was just a little too late jumping on to the train at the last minute, and so the rest of my sister's family inadvertently left him at the station and went on without him.  He was already in high school at this point, but his mobile phone didn't have an international plan.  He went to a Starbucks close by and used the free WiFi there to text my sister and find out where they could meet.  Very resourceful!

Starbucks used to be a place to hang out and work while enjoying a great cup of coffee.  The company actually encouraged customers to come and spend free time in their stores and had done so almost from the beginning.  There's a well-known story of how former CEO Howard Schultz wanted to re-create the ambience and experience of a European coffeehouse.  Starbucks was originally founded in 1971 by Gerald Baldwin, Gordon Bowker, and Ziev Siegl, primarily as a small coffee shop in Seattle's Pike Place Market.  The store specialized in selling whole arabica coffee beans to a niche market.  Schultz joined the marketing team in 1982, and during a business trip to Europe, he became fascinated with Italy's coffee culture, particularly the important role that neighborhood espresso bars played in the everyday lives of the individuals living there.  When Schultz returned to Seattle, he was excited to recreate the same environment at Starbucks.  The small company set up an espresso bar in downtown Seattle, which would serve as the prototype for what Schultz envisioned was the future of the company.  

Schultz described his vision, saying, "The idea was to create a chain of coffeehouses that would become America's third place.  At the time, most Americans had two places in their lives - home and work.  But I believed that people needed another place, a place where they could go to relax and enjoy others, or just be by themselves.  I envisioned a place that would be separate from home or work, a place that would mean different things to different people."

The three founders didn't want to become a restaurant business, so Schultz left the company to start his own company, Il Giornale (apparently the Italian word for newspaper).  His coffee shop quickly became popular, and to close the circle, Schultz eventually purchased Starbucks from its original founders.  Over the next several years, he built Starbucks into what it is today - a global brand developed around the concept of a third place.  

Schultz served as Chair and CEO at Starbucks from 1986-2000, 2008-2017, and again as Interim CEO from 2022-2023.  Over the years, Starbucks has occasionally lost its way by de-emphasizing the third place concept.  Schultz famously came out of retirement in 2008 to resurrect the brand and the company by returning to its roots as a third place for people who love coffee.  Schultz famously wrote an open letter to all of the company's partners (what Starbucks calls its employees) in 2018, "Great coffee and our stores will always be catalysts for community.  Now more than ever the world needs places to come together with compassion and with love.  Providing the world with a warm and welcoming third place may just be our most important role and responsibility, today and always."

As it turns out, always doesn't always mean forever.  Over the last several years, Starbucks, under new executive leadership, began to prioritize goals like efficiency and volume over the customer experience.  The legendary (often mythical) third place was de-emphasized.  As B. Joseph Pine II and Louis-Etienne Dubois write in an online article for Harvard Business Review (see "How Starbucks Devalued Its Own Brand"), "Starbucks is in trouble again...Going to Starbucks isn't what it used to be, and the brand itself isn't what it used to mean.  The fundamental problem: Starbucks has been commoditizing itself."

The meteoric rise of Starbucks as a company has been covered in a number of Harvard Business School case studies, articles, and books (see in particular "Starbucks Coffee Company: Transformation and Renewal" by Nancy Koehn and colleagues, as well as Schultz's book, Onward: How Starbucks Fought For Its Life Without Losing Its Soul).  What is remarkable is the fact that prior to Schultz and the third place, coffee met almost every definition of a commodity.  Any business person in their right mind wouldn't have predicted a company built around specialty coffee would become one of the world's best known brands.  The secret recipe for the success of Starbucks really comes down to the third place concept.  As Schultz himself suggested in an open letter on LinkedIn to the company leadership, Starbucks has lost its soul.  Starbucks, as Vetha Varshini Kavya Alam writes on Medium, has become just another coffee shop.  As a result, McDonald's has taken over as the world's most valuable restaurant brand.

Daniel Kline writes (see "Starbucks CEO sounds the alarm on coffee chain's problems") that "Starbucks seems to bounce between two types of CEOs: those who care about coffee and atmosphere and those who worry about efficiency and operations...Laxman Narasimhan and Kevin Johnson, both of whom followed Schultz in the top spot, always seemed more concerned about operations than coffee."  Starbucks' new CEO, Brian Niccol, who was CEO of Chipotle prior to becoming CEO at Starbucks on September 9, 2024, appears to be a hybrid of the two.  He wrote in an open letter shortly after taking over the company, "We're refocusing on what has always set Starbucks apart - a welcoming coffeehouse where people gather, and where we serve the finest coffee, handcrafted by our skilled baristas."

Time will only tell whether Niccol can keep operations smooth and efficient, while at the same time emphasizing the quality of the customer experience.  It's a position (and predicament) that many leaders in health care know all too well!  At least for the moment, however, it seems that Starbucks can no longer claim to be the third place.

Squaring a circle

Once again, I learned a rather interesting bit of trivia about the number π a few weeks after (not before) International Pi Day (see another post from the past, "Pi and Infinite Monkeys" which I posted on September 3, 2023).  March 14th is always a fun day in our house, because my wife is a middle school math teacher!  She always celebrates International Pi Day by having her students bring in either pizza or pie, and there's always a contest to see which student can recite the highest number of digits in π.  While I am confident that almost everyone can remember that π is roughly equal to 3.14, I suspect that many of us forget that (1) π is what is classified as an irrational number (a real number that cannot be expressed as a fraction), (2) the decimal representation of π never ends and never repeats itself (although there are occasional short repeating elements, such as the six consecutive nines that appear starting at the 762nd decimal place, commonly known as Feynman's Point after the brilliant physicist Richard Feynman, (3) π is the ratio of a circle's circumference to its diameter.

What I didn't know is that my home state of Indiana almost passed a law in 1897 to change the value of π to 3.2.    

Since antiquity, mathematicians have tried to solve a problem known as "squaring a circle".  The problem can be stated as follows: Given a circle, construct a square with the same area as the circle using only a compass and straight edge.  Unfortunately, solving the problem has proven to be impossible, which is why "squaring a circle" is now an idiomatic expression used to describe a problem that is impossible to solve.  Here's where the Indiana law comes in.  Back in 1894, an Indiana physician and math enthusiast named Edward J. Goodwin believed that he had discovered a solution for the "squaring the circle" problem.  He was so proud of his proof that he asked his friend, Taylor I. Record to introduce a bill (Bill 246) in the Indiana House of Representatives under the title, "A Bill for an act introducing a new mathematical truth" in 1897.  Bizarrely, if passed, the law would have allowed the state of Indiana to publish his discovery in its textbooks for free, while everyone else would supposedly have to pay royalties to Goodwin.  I'm not sure that's exactly how copyright laws work, but that didn't seem to bother Goodwin or Record.

Interestingly enough, Goodwin's proof only worked if π was equal to 3.2.  The other state representatives in the Indiana House were confused by the topic and whether it was even appropriate for them to vote on such a bill.  One representative referred the bill to the Finance Committee, presumably because the bill involved numbers.  Another representative joked that the bill should go to the Committee on Swamplands, where it would "find a deserved grave."  The bill eventually made its way in the House Education Committee, which approved it and sent it to the General Assembly for a vote.  The Indiana House of Representatives voted by majority to approve the bill on February 6, 1897.

Before the bill went to the Indiana Senate, however, another mathematician caught wind of the bill.  Purdue University's Clarence Abiathar Waldo had apparently stopped by at the Indiana Statehouse in order to request funding for the Indiana Academy of Science.  Instead, he found himself teaching Indiana Senators on the finer points of geometry.  Waldo later recalled in the Proceedings of the Indiana Academy of Science, "A member then showed the writer a copy of the bill just passed and asked him if he would like an introduction to the learned doctor, its author. He declined the courtesy with thanks, remarking that he was acquainted with as many crazy people as he cared to know."

Despite Waldo's impromptu geometry lesson, the bill nearly passed the Senate.  However, the Senate agreed to postpone consideration of the bill indefinitely on February 12, 1897, narrowly avoiding what would assuredly result in widespread ridicule.  Waldo later wrote, "My state did not further this monstrosity, and it was probably the Indiana Academy of Science alone which prevented it.  That one act of protection was worth more to Indiana, jealous of her fair fame as she is, than all she ever contributed or can contribute to the publication of the proceedings of her Academy of Science."

It's an interesting footnote in the history of mathematics.  I wonder why I was never heard about this story when we were taught Indiana State History in grade school?  And even though I am posting this on April Fool's Day, as far as I can tell, the story is absolutely true (Goodwin even published his proof in the prestigious journal, The American Mathematical Monthly under the title "Quadrature of the Circle")!

Happy Doctor's Day 2025!

National Doctor’s Day is celebrated every year on March 30th.  The first Doctor’s Day was observed more than 90 years ago, on March 30, 1933 by the Alliance to the Barrow County Medical Society in Winder, Georgia (a small town located just east of Atlanta).  Members of the Alliance selected the date to honor all physicians on the anniversary of Dr. Crawford W. Long’s first administration of anesthesia in 1842.  Of note, Dr. Long used ether during surgery to remove a tumor from the neck of James Venable.  The first Doctor’s Day was observed by sending cards to all the physicians and their spouses, and a red carnation flower was placed on the graves of deceased doctors.  

Through a series of resolutions in the years that followed, Doctor’s Day was widely celebrated throughout the southern United States, with sponsorship by the Southern Medical Association.  Eventually, a resolution was adopted and approved by both the U.S. House of Representatives and the U.S. Senate on October 30, 1990 and signed by President George H.W. Bush, designating March 30 as “National Doctor’s Day."  The red carnation remains as the symbol of Doctor’s Day.

I can honestly say that if I had the chance to do it all over again, I would still choose medicine as my life's work.  Medicine has been my passion and my calling.  Being a physician has made me a better person, and I am incredibly proud to be a member of this esteemed profession.

To all Doctor's - thank you for what you do, each and every day!

"No Easy Victories"

I was reading a Harvard Business Review article ("How to Stay Optimistic (When Everything is Awful)") just last week that referenced another article written many, many years ago by former Secretary of Health, Education, and Welfare (under President Lyndon Johnson) John W. Gardner.  The article, "No Easy Victories" was published in the journal American Statistician on February 1, 1968 and is based on a speech that Gardner gave at the American Statistical Association's annual meeting in December, 1967.

Gardner made several points about leadership in general that I thought were worth repeating here.  They fall into the following high level points:

1. It's lonely when you are in the arena.

Gardner opens (after a few introductory comments about how he came to be speaking at the American Statistical Association's meeting) with the following statements:

I cannot speak with assurance, only with concern.  I constantly marvel at the number of people outside the arena of action who know precisely how to solve our problems, and the number of people in the heat of action who lack that superhuman clarity.  

I think that Gardner provides a key point on leadership here.  First, as I've stated many, many times, leadership can be lonely (see my posts, "Reflections on leadership", "12 O'Clock High", "It's lonely at the top", and most recently, "Fortress of Solitude").  It's lonely because: (1) as a leader, you are always "on stage" in that everything you say or do can be scrutinized, questioned, evaluated, or criticized; (2) the expectations for leaders oftentimes far exceed what they can deliver; and (3) almost everyone believes that he or she could do a better job leading.  I am reminded of Theodore Roosevelt's "In the Arena" speech or Brene Brown's speech "Why your critics aren't the ones who count".  As William Shakespeare said, "Uneasy is the head that wears a crown".

2. Leaders have to make difficult choices.

Gardner talks about some of the difficulties that leaders encounter.  Foremost among these is the job of making rational choices when resources are limited (and he offers the qualification that resources "will always be limited relative to expectations").  He said:

Forced choices are of course not the only consequence of a limit on resources.  We can have our cake and eat at least some of it if we can get a higher yield from the dollars, talent, and institutional strength available to us...somewhere up the line hard decisions will be necessarily made.

As a leader, you will have to make difficult decisions at times, some of which will be unpopular.  It's important that leaders make decisions that advance the organization's mission and vision, as well as ones that are consistent with the organization's core values. 

3. Expectations oftentimes do not match reality.

I mentioned above that one of the reasons leadership can be lonely is that the expectations for leaders oftentimes far exceed what they can deliver.  The same is true for organizations.  Gardner said that most of the individuals today believe that their institutions can accomplish "just about anything".  Moreover, when these same institutions fall far short of those expectations, the natural tendency is to blame "the people who love power or money more than they love mankind".  He suggested that this mismatch between expectations and reality has created some of the mistrust and cynicism that we are seeing today in the workforce:

The modern belief that man's institutions can accomplish just about anything he wants, when he wants it, leads to certain characteristic contemporary phenomena.  One is the bitterness and anger toward our institutions that occur when high hopes turn sour...cynicism is continually fed and renewed by the rage of people who expected too much in the first place and got too little in the end.

4. Leaders will have to lead their organizations through change.

Gardner said:

Even excellent institutions run by excellent human beings are inherently sluggish, not hungry for innovation, not quick to respond to human need, not eager to re-shape themselves to meet the challenges of the times...We are going to have to do a far more imaginative and aggressive job of renewing, redesigning, revitalizing our institutions if we are to meet the requirements of today.

I am struck by how much of what was true in 1967 is still true today.  Some of the challenges that leaders faced back then are faced by the leaders still today.  However, Gardner's message is one of hope and optimism.  He ended his speech with the following statement:

The fight for a better world is a long one, a recognition that retains high hopes but immunizes against childish collapse or destructive rage in the face of disappointment...We face the gravest difficulties in the days ahead.  But if we could bring to bear on our toughest problems all of the talent and resources of this Nation we could accomplish some things that would leave an indelible mark on the history books.