"I am the master of my fate..."

It’s been a busy week working in the hospital this week, so I decided to post one of my favorite poems. It’s by the English writer, William Ernest Henley and it's called "Invictus" (recited by the actor, Morgan Freeman here).  Henley suffered from tuberculosis that invaded his bone, requiring amputation of his left leg below the knee at the age of 12 years (incidentally, one of Henley's close friends was the author Robert Louis Stevenson, who wrote Treasure Island - the character of Long John Silver was inspired in part by Henley).  Nelson Mandela is said to have recited the poem to his fellow prisoners while he was a incarcerated at Robben Island prison (depicted in the movie, Invictus, starring Morgan Freeman and Matt Damon, about the 1995 Rugby World Cup, Nelson Mandela, and the rugby player Francois Pienaar):

Out of the night that covers me,
Black as the pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.

Beyond this place of wrath and tears
Looms but the Horror of the shade,
And yet the menace of the years
Finds, and shall find me, unafraid.

It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate:
I am the captain of my soul.

I think the poem speaks for itself.

"Apes alone weak...Apes together strong!"

I'm probably dating myself here, but I am old enough to remember when the "Planet of the Apes" science fiction media franchise first started with the 1968 film starring Charlton Heston, Roddy McDowell, and Kim Hunter.  Okay, technically, I was too young to see the movie when it was first released, but I remember seeing a lot of the sequels that aired from 1970 to 1973, the live action television series, which aired in 1974, and the animated series which aired in 1975.  I also remember all the action figures, lunch boxes, and other toys that were associated with the movies.  I really enjoyed Tim Burton's 2001 remake, "Planet of the Apes", and I've seen at least a couple of the films in the most recent reboot.  There are a lot of commercials out right now about the latest installment, "Kingdom of the Planet of the Apes", due to be released in a couple of weeks.

I never realized, however, that the entire media franchise started with a 1963 novel by the French writer Pierre Boulle.  Boulle also wrote the 1952 book The Bridge Over the River Kwai, which was made into a superb 1957 movie "The Bridge On the River Kwai" starring William Holden and Alec Guinness.  I actually read his Planet of the Apes novel a month or so ago while at the beach.  I have to say that it was excellent, even if the original movie didn't exactly follow the storyline (although I have to say that the movie mostly stayed true to the novel with a similar, though slightly different, plot twist at the end).  There are a surprising number of lessons about leadership in both of Pierre Boulle's novels (and the movies based on them - see my previous post, "The Bridge Over the River Kwai Syndrome" for more on that novel and movie), which I guess is not too surprising given that Boulle was a French soldier and spy during World War II.

As it turns out, I am not alone in seeing the potential for leadership lessons in the "Planet of the Apes" media franchise.  See, for example, Leroy Ford's Medium post "20 Leadership Lessons from Planet of the Apes" or Joel Eisenberg's Medium post "The Caesar Legacy: Politics and Leadership From Julius to Apes" for just two examples.  Certainly there are a number of political themes in the series as well, as noted by Eisenberg in his post.  I am also fascinated by how different leaders use power and politics to their advantage in the book and movies - not all powerful leaders are dictators, again as eloquently demonstrated in the movies.  I am also deeply interested in the different ways that members of a group interact.  I am reminded of several recent books on this topic, including Blueprint: The Evolutionary Origins of a Good Society by the American sociologist and physician Nicholas Christakis (which I read during the same beach vacation and discussed in a previous post), Groupthink: Psychological Studies of Policy Decisions and Fiascoes by the psychologist Irving Janis, who first coined the term and described the concept of "groupthink", and lastly the excellent book, appropriately enough for the present discussion, Chimpanzee Politics by the scientist Frans de Waal.  

I've always believed (and stated on a number of occasions) that leaders can learn a lot about leadership by reading about other leaders throughout the course of history.  The "Planet of the Apes" media franchise reminds me that we can also learn a lot about leadership through reading fiction or even through watching movies!  It's a lesson that I need to remind myself again from time to time, and it was actually the point of my second ever blog post, "What can we learn about leadership from a movie?"  The answer to that question is, a lot more than you think!

Pavlov's Dog

There's a better than average chance that most of you have heard about Pavlov's Dog.  If you happened to take an Introduction to Psychology class at any point in your life, it's almost a certainty that you've heard about Pavlov and his dog.  Pavlov, in this case, was a Russian physiologist (his full name was Ivan Pavlov) who is perhaps best known for his experiments that led to the concept known as "Classical Conditioning", even though he won the 1904 Nobel Prize in Physiology or Medicine for his work studying digestion.  

Apparently it all happened by accident.  Basically, while conducting experiments that would eventually lead to his Nobel Prize, he noticed that dogs started to salivate whenever his assistants walked into the laboratory.  He was interested in the role of the salivary gland in digestion, and his research team would bring different edible and non-edible items into the lab to see how much saliva would be produced and if there were any differences in its chemical composition.  Soon, the dogs would begin to salivate even before they were presented with food.  Pavlov realized that the dogs had learned to salivate whenever they saw the white lab-coats of his research assistants, which they had come to associate with food.  In other words, they were "conditioned" to respond to the lab assistants by salivating.  He then conducted a series of experiments involving a bell, and eventually "conditioned" his dogs to salivate whenever they heard the sound of a bell. 

I won't go into further details - you can read all about "Classical Conditioning" on the Internet or in any introductory psychology textbook (here's a short video reenactment that also explains Pavlov's experiments).  And while you are at it, be sure to read about “Operant Conditioning” too - I always mix them up and I’m sure that I’ve done so again here!

I was recently reminded of Pavlov's experiments by our dog at home.  He likes to chew on sticks and pine cones outside.  He frequently tries to bring these sticks or pine cones inside our house, which of course we would rather not let him do (there's nothing harder to clean-up than a pile of tiny twigs).  I am quite proud of the fact that I can catch him when he comes inside, place my fingers deep inside his mouth, and pull the stick or pine cone out before he starts to chew it.  Of course, after a few times getting caught, he's figured out how to run away and make me chase him.

So, guess what happens now?  He almost always tries to bring in a stick or pine cone from outside, because he thinks it's a lot of fun to have me chase him around our house!  I can see him waiting for me at our back door, and as soon as I open the door, he bends down and picks up a stick that he has hidden underneath his paw.  My wife just rolls her eyes and tells me not to let him inside if he picks up the stick!

I've suddenly realized that I've "conditioned" our dog to pick up a stick every time that he wants to come inside!  Actually, if I think about it, he may actually have "conditioned" me to chase him, because I find myself doing that all the time now, regardless of whether he has a stick in his mouth or not.  Who's Pavlov and who's the dog in this situation?

If “conditioning” really develops this easily, I can now fully appreciate why "change" is so difficult for folks.  Just as important, given the ease with which we are "conditioned" (and regardless of whether that is of the "classical" or "operant" variety), it makes sense that we should be able to establish new habits and behaviors just as easily as it is to hold on to our old ones.  As I've frequently said, leadership often requires being able to lead and manage change.  Managing change is the law of leadership!  It doesn't take much to establish deeply ingrained habits and behaviors.  Don't believe me?  Just remember Pavlov's Dog.

Are you in a "velvet rut"?

There's a saying that a rut is a grave with both ends kicked out.  The American tycoon J. Paul Getty once wrote, "It shouldn’t be very difficult for anyone to resist the temptation to force himself into the pattern of the structured man. One needs only to remember that a groove may be safe – but that, as one wears away at it, the groove becomes first a rut and finally a grave."

Building on a similar theme, I recently came across an older "Daily Stoic" blog post that described something called a "velvet rut".  The "velvet rut" describes the situation in which an individual feels stuck in a comfortable but unfulfilling routine.   It sounds fairly similar to the concept of "quiet quitting" in which individuals just "go through the motions" at work, lacking the motivation to do anything above and beyond the bare minimum necessary to get through their work day.  What separates the two, however, is the fact that individuals in a "velvet rut" are otherwise doing okay, they simply don't feel challenged or inspired in their work.  They are usually content with the work and may even be fairly successful at their job.

If you find yourself in a "velvet rut", perhaps it's time to start looking for what kind of job or work would challenge you, inspire you, or push you out of your comfort zone.  It can be scary to leave a job where you are comfortable, but I suspect that if stay in the "velvet rut" for too long, you may find yourself becoming a "quiet quitter".  Step "into the arena" and be ready to "get your ass kicked".  For as Hunter S. Thompson asked, "Who is the happier man, he who has braved the storm of life and lived or he who has stayed securely on the shore and merely existed."  Lastly, remember Dr. Martin Luther King, Jr's admonishment that "the ultimate measure of a man is not where he stands in moments of convenience and comfort, but where he stands at times of challenge and controversy.”

Look. Listen. Feel.

I just finished completing my online training for the American Heart Association's Pediatric Advanced Life Support (PALS) course, something which I have had to periodically do throughout my career.  Whenever I do take this course, I always think back to the very first time that I learned CPR as a Boy Scout.  We were taught then (and it's still taught now) that whenever you find someone lying unconscious, you should check for the presence of a pulse and determine if they are breathing.  The phrase "Look, Listen, and Feel" summarized exactly how you were supposed to go about doing it.  "Look" for the rise and fall of the chest, indicating that the person is breathing.  "Listen" for air blowing out of the person's mouth and nose.  "Feel" for the presence of a pulse.

I was struck that this "Look, Listen, and Feel" phrase is a great analogy for leadership too!  First, "Look" - there is no better way to check in on your team's wellbeing than to actually go to where they are and ask them how they are doing.  Lean/Six Sigma and the Toyota Production System calls it "Going to the Gemba" ("gemba" is a Japanese word that translates into "the actual place"), though others have called it "management by walking around".  

Once you are at the gemba, the next step is to "Listen" to your team.  Ask them if there is anything that you, as their manager, could be doing to support them better.  Ask them if they have all the resources (including time) to be able to effectively do their jobs.

The third and final step is perhaps the most important.  "Feel" for the members of your team by getting to know them as individuals - what are their strengths, what motivates them the best, what challenges are they experiencing in their professional and personal lives.  In other words, show them that you care about who they are as individuals.  

"Look, Listen, and Feel" is a great way to remember three important aspects of leadership.

Blueprint

A trip to the beach after Easter has become an annual rite of Spring for my wife and I.  It's always a great time to relax, recharge, and rejuvenate after the long, cold Winter.  It's also a great time to catch up on some reading!  This year, I finished a book called Blueprint: The Evolutionary Origins of a Good Society by the American sociologist and physician Nicholas Christakis.  I've mentioned Dr. Christakis and his research a couple of times in the recent past (see "How 'Bout Them Cowboys?", "Happy is contagious", and "Peer Pressure"), and his previous book Connected that he co-wrote with his colleague James Fowler is on my 2024 Leadership Reverie Reading List.  

According to his website, his research focuses on two main topics (1) the social, mathematical, and biological rules governing how social networks form (“connection”), and (2) the social and biological implications of how they operate to influence thoughts, feelings, and behaviors (“contagion”).  His book Blueprint builds upon his earlier book Connected, focusing primarily on his first research topic - the rules that govern how networks within a society form.  

Christakis adds to the already significant body of research encompassing what has come to be known as the "evolution of cooperation" (a term coined by the scientist Robert Axelrod and which I have also posted about in the past - see, in particular, "Tit for Tat").  This entire field seeks to answer the question, "In a world governed by natural selection and "survival of the fittest", being selfish pays - why then do we cooperate with each other?"

Christakis states, "It's not our brains or brawn that allows us to rule the planet.  It's the human ability to construct societies."  He further suggests that there is a "social suite" that is encoded within our genes and therefore naturally present in all our societies that represents a "blueprint"  for how humans can and do form stable societies.  His "social suite" includes the capacity to have and recognize individual identity, love for partners and offspring, friendship, social networks, and cooperation, preference for one's own group, and social learning and teaching.  He then describes a number of successful societies throughout history and explains how the "social suite" played a major role in determining their success and longevity.  These range from shipwrecked crews (for example, he compares and contrasts two ships that wrecked on the same island - the Grafton and Invercauld - which had incredibly different outcomes, as told by the author Joan Druett in her masterful book Island of the Lost, and he also talks about the fate of the mutineers of the HMS Bounty on Pitcairn Island) to artificial societies that formed as part of a sociological experiment (for example, the Robbers Cave experiment). 

Christakis writes, "Our good deeds are not just the products of Enlightenment values.  They have a deeper and prehistoric origin."  In other words, as mentioned above, the "social suite" is genetically encoded.  In a way, we are predestined to form stable societies, even though at times we do not.  The book is incredibly optimistic and inspiring at the same time.  The book was difficult to read at times (particularly in the middle), but overall I found it to be very interesting and worth a look!

"A science of uncertainty and an art of probability..."

William Osler once said, "Medicine is a science of uncertainty and an art of probability."  I suspect that Dr. Osler, one of history's greatest physicians, would agree that medicine, as both art and science, requires both customization as well as standardization.  Please let me explain.

I've posted about the need for standardization medicine in the past (see, for example, "The History of Standardization - 200 BC to 1945" and, in particular, "HRO: Sensitivity to Operations").  Here is what I had to say about standardization in a very early post from 2016 referring to a common complaint that I hear (still) from a lot of physicians equating "standardization" with "cookbook medicine":

I whole-heartedly agree that "patients are not widgets" and that "we shouldn't practice cookbook medicine."  Standardization, one of the key elements in operational excellence, is NOT "cookbook medicine."  There is simply no justification for why we should not standardize the care of common conditions (e.g. management of diabetic ketoacidosis, acute chest pain, or acute asthma exacerbation) or processes (e.g. care and maintenance of central lines, urinary catheters, surgical time-outs) - these are the kinds of conditions and processes that should be managed the same way, every day, by each and every member of the health care team.  With the care of common conditions, there is some room to maneuver, so to speak.  For example, if a patient deviates from the expected clinical course, then and only then should we deviate from a standardized treatment protocol.  However, there is no reason why we should deviate from standardized protocols for surgical time-outs, shift hand-offs, or maintenance of central lines.

With that in mind, I came across a great argument for standardization from former Marriott Hotels CEO Bill Marriott.  He said, "Mindless conformity and the thoughtful setting of standards should never be confused.  What solid SOPs do is nip common problems in the bud so that staff can focus instead on solving uncommon problems."  It makes such great sense when you think about it.  Why would you want to waste limited brainpower on the tasks that are straightforward, easy, and simple?

A similar analogy applies to leadership in general, specifically in what is known as the contingent theory of leadership, which states that effective leadership is dependent upon the situation at hand.  Rather than using the same leadership style for every situation, apply the best style to the what the situation requires or dictates.  The same concept applies to problem-solving!  I'm thinking in particular about Keith Grint's wicked versus tame problem framework.  Wicked problems require a different kind of approach, while so-called tame problems can be easily solved using common, standard approaches.

Just as important, as Henry Ford said, "If you think of standardization as the best that you know today, but which is to be improved tomorrow; you get somewhere."  In other words, protocols and SOP's can be changed, when there is evidence that suggests a better way of doing things.  High reliability organizations, as learning organizations that emphasize continuous improvement, will always modify or adapt their protocols when necessary.  

Cookbooks are incredibly useful tools in the kitchen!  The same is true for standard operating procedures, care guidelines, and protocols in the hospital.  The important consideration, however, is knowing when to apply them and when to change them.  Maybe that reflects part of the art of medicine?

The SAT Problem

Nope, this post is not about what's wrong with the Scholastic Aptitude Test, more commonly known as the SAT!  It's about a specific problem that appeared on the SAT in 1982, in which everyone, including the test writers, answered the problem incorrectly.  The question is shown below:

Okay, what is your answer?  If you answered "B" you are in great company.  If the radius of the smaller circle, Circle A, is 1/3 the radius of the larger circle, Circle B, then it only makes intuitive sense that Circle A will rotate 3 times as it moves around the circumference of Circle B.  Unfortunately, that's not the right answer!  The correct answer is that Circle A will rotate 4 times, which is not even an option listed in the question above - which is why no one answered it correctly, even if you knew the right answer!  Apparently three individuals (out of around 300,000 total exam participants) wrote back to the College Board, the organization that conducts the SAT exam, pointing out the error.  The question had to be thrown out, and the entire exam rescored that year!

Just to prove it to yourself, take a printout of the diagram and cut the diagram into 2 separate circles of different sizes. Place them like the question shows and carefully try to rotate Circle A around Circle B and count the number of revolutions it has done around it. It would be 4, not 3!  Better yet, start with two ordinary quarters, as shown in the video here.  Rotate one quarter around the circumference of the other quarter - but do so slowly, so that you can see how many rotations the quarter completes as it passes around the other one.  As you will see for yourself, the quarter rotates twice as it passes around the other quarter, even thought both quarters are exactly the same size!

What's even crazier (again, watch the video here) is that if you convert the circumference of Circle A in the original problem to a straight line and then rotate Circle B along the straight line, it does so three times!  In other words, there is something about rotating around a circle that changes the number of rotations.  Lastly, try this next one.  If you view the number of rotations of Circle A around Circle B from the perspective of Circle B (i.e. imagine you are standing on the surface of Circle B) or even vice versa, you will note that Circle A rotates just three times instead of four!

The mathematical proof of the answer to this problem, at least as I understand it, is that from start to end, the center of the moving coin (Circle A in the original problem) travels a circular path. The circumference of the stationary coin (Circle B in the original problem) and the path of the center of the moving coin (Circle A) form two concentric circles. The radius of the outer circle is the sum of the two coins' radii.  In other words, the circumference of the path of the moving center of Circle A is equal to 2π multiplied by the radius of Circle A plus the radius of Circle B.  Watch the video here again for a pictorial explanation of this same point (and see also a similar problem known as Aristotle's Wheel Paradox).  

If you really want to be gobsmacked, consider how this coin rotation paradox applies to the number of days it takes for the Earth to rotate around the sun (with day, of course, defined as the rotation of the Earth).  Again, when viewed from an external perspective (i.e. that of a distant observer in outer space), it looks like it actually takes 366.25 days for the Earth to rotate around the sun, instead of what we consider a calendar year as 365.25 days (the former length of time is called a sidereal year).

My point here is to use mathematics to demonstrate one of the defining characteristics of a High Reliability Organization (HRO), the principle of "Reluctance to Simplify".  Leaders in High Reliability Organizations know that the simplest explanation is not always the correct one.  They take the next necessary step to dig deeper into the problem, in order to come up with the right solution (not the wrong one). 

"Slow is smooth and smooth is fast!"

The U.S. Navy SEALS, one of the U.S. military's special warfare units and an example of a High Reliability Organization has a saying that I really like - "Slow is smooth and smooth is fast!"  It makes a lot of sense when you really think about it in depth - slow and deliberate action leads to efficiency, which saves time in the long run (which creates speed)!  When you do things the right way the first time, you avoid making mistakes and having to go back to repeat the same task over again.  

There's a version of this saying that is much older, and I am sure you've heard about it already.  "Haste makes waste."  My sources tell me that this proverb can be traced back to 1542, when it was first noted in the English scholar Nicholas Udall's translation of "Apophthegmes" by Erasmus of Rotterdam (note also that an apophthegm is a concise saying or a short statement).  The version that appeared in this translation is slightly different and one I actually like better.  "More haste, less speed."  

Remember, it's important to take the time to do things carefully and accurately, because rushing through a task often leads to mistakes and errors.  Even when it comes to decision-making, it's wise to remember that thoughtful consideration yields better outcomes.  Instead of rushing to complete a project, it's better to proceed with caution and attention to detail.  As we try to become more efficient in our organizations, it's essential to strike a balance between speed and accuracy.  Haste makes waste.  Slow is smooth and smooth is fast.

Row, Row, Row Your Boat...

It seems like ages since I actually went to see a film in a movie theater.  It's not that I don't enjoy watching movies, it's just so much easier to watch them at home these days.  I do want to see "The Boys in the Boat" based on the book of the same name by Daniel James Brown (which I've written about in a previous post called "Row the Boat").  One of my former CEO's actually purchased copies of the book for the entire senior leadership team, because it provides so many great lessons on leadership.  The story is about the University of Washington rowing team and their quest to compete in the 1936 Summer Olympics in Berlin.  As you probably guessed, the success of a rowing team depends to a great extent on how well the group of eight rowers work together and synchronize how they pull on the oars.

"Row the Boat" has become such a common metaphor for leadership and teamwork, largely because it is perfectly captures the sentiments of what is required for a group or team to succeed.  A few months ago, I came across an article in Harvard Business Review by Peter Bregman ("Execution is a people problem, not a strategy problem").  The article's tagline is "A process for getting the right people aligned."  Bregman writes that "however hard it is to devise a smart strategy, it's ten times harder to get people to execute on that strategy...in other words, your organization's biggest strategic challenge isn't strategic thinking - it's strategic acting."  Strategic acting, or execution, depends upon having everyone in the group acting in alignment with each other, i.e. "rowing the boat in the same direction." 

If a picture is worth a thousand words, Bregman's figure below is worth at least 10,000!  He perfectly captures the "Row the Boat" sentiment here:

He writes, "To deliver stellar results, people need to be hyperaligned and laser-focused on the highest-impact actions that will drive the organization's most important outcomes."  Bregman outlines a series of steps called the "Big Arrow Process":

Define the "Big Arrow"

First, leaders have to define the "Big Arrow" which Bregman defines as the most important thing that a team or organization has to achieve within the next 12 months in order to drive the strategy forward.  He provides a series of questions that if the answer to each is "yes", then the "Big Arrow" is likely the right one:

    1. Will success in the Big Arrow drive the mission of the larger organization?

    2. Is the Big Arrow supporting, and supported by, your primary business goals?

    3. Will achieving it make a statement to the organization about what's most important?

    4. Will it lead to execution of your strategy?

    5. Is is the appropriate stretch?

    6. Are you excited about it? Do you have an emotional connection to it?

Identify the Highest-impact People

Second, leaders have to identify the individuals within their team or organization who are most essential to achieving the goal, i.e. the ones who will have the highest impact on the "Big Arrow".  These are the key influencers and boundary spanners in the organization whose full engagement will be critical to success.  

Determine the Area(s) of Focus

Third, strategy acting or execution needs to be laser-focused.  There will always be competing priorities, but here leaders need to identify which priority will have the largest impact on achieving the team's or organization's objectives.  

Collect and Review Data

Bregman also emphasizes the importance of coaching, and I agree.  However, leaders need to know what to coach their highest-impact people on.  Here measurement of performance towards achieving the "Big Arrow" is important.  Here, leaders can also use data to identify and then remove obstacles to achieving the goals of the team or organization.  

In a survey of 400 global CEO's published in Harvard Business Review by Donald Sull, Rebecca Homkes, and Charles Sull (see "Why Strategy Execution Unravels - and What to Do About It"), the most commonly cited challenge to executing strategy was lack of alignment (40% of respondents), followed closely by failure to coordinate across units (30% of respondents).  In other words, when organizations don't all row the proverbial boat in the same direction, they end up failing to achieve their goals and objectives.  There's no way that the University of Washington team could have (Spoiler Alert) won an Olympic Gold Medal in 1936 without being aligned or coordinating with each other.  The same, of course, is true for any team or organization.

"I am legend"

I've mentioned my love of reading several times in the past, and I've also mentioned (I think) that I mostly read non-fiction books.  However, I have to admit that I also really enjoy reading dystopian fiction.  Perhaps I will give a list of my favorite dystopian fiction stories at some point in the future.  These stories are interesting to me, because (1) they usually are very well written, (2) they generally involve an interesting story, and (3) they frequently reveal a lot about human behavior, both the good and the bad.  We've sort of lived through our own dystopian story these past couple of years with the COVID-19 pandemic, and what is clear to me that times of crisis reveal a great deal about one's character and resilience.  Some individuals fold during times of stress, while others seem to rally and find ways to persevere.  Rather than living through another pandemic, we can learn so much about resilience and perseverance by reading dystopian fiction.

I just finished the novella I Am Legend by Richard Matheson.  The story was written in 1954, and it's been adapted into three movies over the years: The Last Man on Earth (1964), starring Vincent Price, The Omega Man (1971), starring Charlton Heston, and I Am Legend (2007), starring Will Smith.  The novella also apparently was an inspiration for George Romero's classic Night of the Living Dead (1968).  For example, Romero said when talking about the creation of his movie, "I had written a short story, which I basically had ripped off from a Richard Matheson novel called I Am Legend."  The highly acclaimed author Stephen King said, "Books like I Am Legend were an inspiration to me."

The story takes place in 1976 Los Angeles, California after an apocalyptic war and global pandemic (similar to World War I and the 1918 Influenza Pandemic).  Richard Neville is seemingly the "Last Man on Earth" and is left to fend for himself.  The pandemic has killed the rest of the human population and has turned infected survivors into "vampires".  During the day, Neville is free to roam around the city, and every night he barricades himself inside his house and occasionally fights off attacking "vampires" (the vampires seem more like zombies, in my opinion).

It was hard for me to put the book down.  It's very well written, and the story was really interesting.  I think that there are two major difference between the most recent movie version, which I also thoroughly enjoyed, and the book.  First, the book focuses more on how the main character, Richard Matheson, reacts to his forced solitude.  It's a great character study, as we get to see how Neville hits the proverbial rock bottom and then slowly recovers over time to eventually demonstrate incredible resilience.  Second, the book ends with a great plot twist that is very different than the movie.  The book ends with the sentence, "I am legend."  I won't spoil why.  The book is fairly short (about 175 pages in length), and it's a superb story on a subject that is more relevant to me, now that we've been through the COVID-19 pandemic.  I highly recommend it!

"Why is a raven like a writing-desk?"

The stories by English writer Charles Lutwidge Dodgson (you probably know him better as Lewis Carroll) usually involved a lot mathematics, logic, and word play.  He is best known for Alice's Adventures in Wonderland and its sequel, Through the Looking Glass.  I remember reading his poem (which actually comes from Through the Looking Glass) "Jabberwocky" during middle school English and Language Arts, thinking that it was a bunch of nonsense (which, I later realized, was exactly his point in writing it).  

There's an interesting passage in Alice's Adventures in Wonderland that involves a conversation between Alice and the Mad Hatter (check at the scene from the 1951 full length animated Disney movie here - on a side note, I always thought the Tea Cups ride at Disneyland was perfect fit for the Mad Hatter's Tea Party scene in the book and movie):

Mad Hatter: Why is a raven like a writing-desk?  Have you guessed the riddle yet?

Alice: No, I give it up.  What's the answer?

Mad Hatter: I haven't the slightest idea.

As it turns out, there is no answer to this riddle!  Subsequent writers have attempted to answer this question over the years.  For example, I've heard someone muse that perhaps Edgar Allen Poe used a writing-desk for his famous poem, "The Raven", which is certainly possible considering that Poe first published it in 1845 and Carroll wrote Alice's Adventures in Wonderland in 1865.  I've also heard someone suggest that both writing-desks and ravens have quills!  Yet another individual suggested that both have "outstanding bills" on them!  

Apparently Carroll himself suggested that a raven is like a writing-desk "because it can produce a few notes, though they are very flat" in an updated version of the book.  He continued, "and it is nevar put with the wrong end in front" (note that he misspelled the word never on purpose - nevar is raven spelled backward - but apparently a copy editor corrected the misspelling thinking that it was an inadvertent mistake).

Lewis Carroll loved writing riddles with no answers, and he loved nonsensical writing even more!  His pen name is actually a riddle in and of itself.  He apparently translated his real name, or at least the first and middle names, into Latin form "Carolus Lodovicus", reversed them, and then translated them back into the English Lewis Carroll!

Some have suggested that Lewis Carroll's point was to talk about time.  Note that the entire conversation between the Mad Hatter, the March Hare, and Alice takes place during a never-ending tea (see the entire conversation around the fact that the Mad Hatter's world is stuck at 6 PM) party (note also that the letter "t" is the mathematical symbol for "time").  Alice responded to the Mad Hatter's reply and said, "I think you might do something better withyg the time, than waste it asking riddles that have no answers."  To which the Mad Hatter replied, "If you knew Time as well as I do, you wouldn't talk about wasting it.  It's him."  

Some have suggested that this entire sequence is a reflection on the some of the newer mathematical concepts of that period in history and in particular the Irish mathematician William Rowan Hamilton's theory of pure time.  The fact that the Mad Hatter's riddle is not solveable reflects the difficulty in understanding some of Hamilton's theories about space-time.  

I could end this post with a conversation and reference about the High Reliability Organization principle of "Reluctance to Simplify", but I won't.  I think the point of all of this discussion (both mine and Carroll's) is to remind all of us to always look for the hidden, deeper meaning.  In other words, take the next step and avoid oversimplifying things too much, because you could end up missing something important.  

Believe it or not...

Today is April 1, 2024, and according to my calendar it's April Fool's Day!  I am going to avoid the temptation to post something that is completely untrue and follow it up with the phrase "April Fool's!"  Instead, I wanted to give you my own "Leadership Reverie" version of "Ripley's Believe It or Not" (a popular show from my adolescence that was hosted by legendary actor Jack Palance) and "Strange But True Stories" (a popular series of books from my childhood).  All of these stories have something (even if fairly tangential) to do with leadership (or leaders)!

Winston Churchill was once prescribed "alcoholic spirits" by a physician.

I think I've written about this story in the past (see "Broken like an egg shell or squashed like a gooseberry"), but it's interesting enough to write about it again!  The famous leader was traveling in the United States in order to deliver a series of lectures on the "Pathway of the English-Speaking Peoples" in December of 1931.  He was apparently attempting to generate some additional money to offset some of his financial losses in the stock market, and he was scheduled to deliver one of these lectures at the Brooklyn Academy of Music in New York City on December 14th.  He hailed a cab to go on the night before his lecture to meet a friend.  Both Churchill and his taxi cab driver were confused about the building numbers, and Churchill exited the cab on the wrong side of the street.  He tried to cross the street against the light and was hit by a car traveling at a speed of 30 mph.  The car dragged Churchill several yards before flinging him into the street.  He was quickly taken to a local hospital, where he would spend the next several days.  Churchill's physician, a Dr. Otto Pickhardt, wrote a note for him (see below) prescribing alcoholic beverages "for medicinal purposes only" (remember that the U.S. still had not legalized the sale of alcohol following the passage of the Eighteenth Amendment to the U.S. Constitution in 1919, which wasn't repealed until passage of the Twenty-first Amendment in 1933).  Believe it or not...

David Rice Atchison, U.S. President for a day?

Here's a story that I actually first heard about on "Ripley's Believe It or Not", and I've been interested in the story ever since.  After we heard the story, I remember that my father and I researched this story and figured it all out in the days before the Internet!  David Rice Atchison was a Missouri Democrat who served in the U.S. Senate from 1843 to 1855.  He was popular amongst his colleagues in the Senate, who elected him as president pro tempore (often shortened to president pro tem) on 13 separate occasions.  The president pro tempore of the Senate is the second highest ranking official in the U.S. Senate, after the Vice President of the United States (in case you don't believe, check out Article One, Section Three of the United States Constitution), and presides over the Senate in the Vice President's absence.

On March 2, 1849, Vice President George M. Dallas (during the James Polk Presidential administration) took leave of the Senate for the remainder of the session and the Senate elected Atchison as president pro tempore.  Until the adoption of the Twentieth Amendment in 1933, presidential and congressional terms began and ended at noon on March 4.  During the year 1849, March 4th fell on a Sunday.  So, in accordance with the Constitution, President Polk signed the last of the legislation passed by Congress during that session on the morning of March 4th and recorded in his diary, "Thus closed my official term as President."  The Senate, having been in session all night, adjourned shortly thereafter.  President-elect Zachary Taylor preferred not to conduct his inauguration on a Sunday, in observance of the Christian Sabbath, so he was not officially sworn in as the 12th U.S. President until the following day, a Monday.

If Polk ended his Presidency on March 4th and Taylor didn't begin until March 5th, who was the acting President during that interval of time?  Under the Presidential Succession Act of 1792, the Senate president pro tempore immediately followed the vice president in the line of presidential succession.  So, was David Rice Atchison the actual U.S. President during that short period of time?  Most historians and law experts say no, but it is a popular myth that is frequently retold (see a picture below of a plaque in Plattsburg, Missouri recognizing Atchison's one day presidency).  Atchison himself wrote after the fact, "I never for a moment acted as President of the United States."

While this particular issue with the timing of presidential inauguration is unusual, it's not the only time in history that it's happened.  Inauguration day similarly had fallen on a Sunday in 1821, the day on which President James Monroe was to take the oath for a second term. Monroe also chose to delay his oath until March 5th, leading John Quincy Adams to write in his diary that the delay created "a sort of interregnum during which there was no qualified person to act as President." Similarly, after the mild confusion about when Taylor became U.S. President, President Elect Rutherford B. Hayes decided to avoid the confusion altogether and took the oath of office in a private ceremony at the White House on Saturday, March 3, 1877, two days before his public inaugural ceremony.  Technically then, if outgoing president Ulysses S. Grant’s term did not end until March 4, did the United States have two presidents at the same time for one day?  Believe it or not...

Benjamin Franklin lost a chess match to a computer.

A couple of centuries before IBM's Deep Blue (a computer) beat world chess champion Garry Kasparov in a game of chess and before artificial intelligence was even a thing, both Napoleon and Ben Franklin were defeated in a game of chess by a computer known as the "Mechanical Turk".  The "Mechanical Turk", also known as the Automaton Chess Player, was built by Wolfgang von Kempelen in 1770 to impress Empress Maria Theresa of Austria.  The machine consisted of a life-size model of a human head and torso, with a black beard and grey eyes and dressed in Ottoman robes and wearing a turban.  Its left arm held a long smoking pipe, while its right hand lay on the top of a large cabinet, on which appeared a chessboard.  The machine made its debut at Schonbrunn Palace in Vienna in 1770, and it would appear in several exhibition chess matches across Europe for nearly 84 years, famously defeating both Napoleon Bonaparte and Benjamin Franklin.

Here's the twist - it was all a fraud!  Inside the cabinet sat a real person who was actually the one playing chess.  The machine actually consisted of several intricate parts that allowed the person to see his opponent's moves and to work the "robot" to move the different chess pieces into position.  That alone is still impressive, but everything else associated with the "Mechanical Turk" was an elaborate fraud.  Believe it or not...

There was a "Schindler's List" in China too.

The 1993 film Schindler's List was outstanding (so was the book)!  It tells the story of how the German industrialist Oskar Schindler saved more than a thousand mostly Polish–Jewish refugees from the Holocaust by employing them in his factories during World War II.  Steven Spielberg's movie certainly helped popularize the story, but what is not as well known is the story of the Chinese diplomat Feng-Shan Ho.  Feng-Shan Ho worked in Vienna as consul-general during World War II, and during his tenure against orders and at the risk of his own life, issued "perhaps tens of thousands" of visas to Jewish refugees, allowing them to escape Nazi Germany.  It was only after he died in 1997 at the age of 96 years that his story came out, and he was honored by the Commission for the Designation of the Righteous in 2000 with the honor, "Designation of the Righteous Among Nations".

The World of Warcraft has been used to model real pandemics, including the most recent one.

The "Corrupted Blood Incident" (also known as the World of Warcraft Pandemic) took place in 2005.  Apparently, game developers for the World of Warcraft, a massively multiplayer online role-playing game developed by Blizzard Entertainment, accidentally introduced an extremely virulent and highly contagious disease into the game, which spread quickly throughout the game universe and caused a virtual pandemic.  The introduced disease, called "Corrupted Blood", was supposed to be confined to a particular area of the virtual world to be used by the dungeon "boss" Hakkar the Soulflayer as an additional challenge to players.  Once players attacked Hakkar, they were "infected" by the spell, which would slowly decrease their life energy over time.  Surprisingly (at least to the game developers), players unknowingly transmitted the infection to their animal companions, who in turn spread the infection to other players in the game.

Once the spell became known to players, they traveled great distances (virtually, of course) in order to find a safe haven.  Unfortunately, this only caused further spread of the "disease".  Some players tried to help their friends, only to become infected as a result.  Finally, some players intentionally spread the "disease" to other players.  There was a virtual pandemic which very nearly wiped out the entire game!

The response by the game developers will sound familiar.  They instituted quarantine zones and enacted social distancing measures to try to contain the spread of the infection.  Unfortunately, many players resisted and managed to bypass the quarantine measures, causing further spread.  Eventually, Blizzard Entertainment had to institute a hard reset to restore the state of the game to just before the introduction of the "Corrupted Blood".

The Centers for Disease Control and Prevention heard about the incident and asked Blizzard Entertainment if they could use the data from the game to learn more about pandemic epidemiology.  There have been a number of research publications using the "Corrupted Blood Incident" as a model for disease spread and containment, some of which were used to help public health officials with the recent COVID-19 pandemic.  Believe it or not...

There is an offshore platform that claims to be its own country.

The Principality of Sealand claims to be its own country (although no one else recognizes its independence) and is located on a World War II era offshore platform (technically what is called a Maunsell Fort) called Roughs Tower located 12 kilometers off the coast of Suffolk, England (see picture below).  The family and associates of Paddy Roy Bates occupied and claimed the decommissioned Roughs Tower in 1967.  Bates had apparently seized Roughs Tower from a group of pirate radio broadcasters that same year with the intention of setting up his own station there.  They repelled incursions from several rival pirate radio stations, as well as the British Royal Navy.  While they still occupy the platform and claim to be their own sovereign nation (and have their own flag (see below) - one of which was placed on the summit of Mount Everest by mountaineer Kenton Cool, seal, website, monarch, and sports teams), since 1987, when the United Kingdom extended its territorial waters to 12 nautical miles, the platform has been in British territory.  Believe it or not...

The oldest "closed" terrarium may outlive its owner.

In 1960, David Latimer decided to grow a sealed glass bottle terrarium.  He placed a quarter pint of compost and water inside a ten-gallon glass bottle, added some spiderwort seeds, sealed the top of the bottle shut, and placed the now "closed" terrarium in a corner of one of the rooms in his house where it would receive sufficient sunlight.  He last watered the terrarium in 1972, and the terrarium hasn't been opened since!  The ecosystem inside the terrarium is perfectly balanced.  Believe it or not...

The Republic of Vermont?

If I asked you to name the original Thirteen Colonies from early American history, could you do so without cheating?  Vermont was one of the original colonies, correct?  Actually - nope.  Vermont was the 14th stated to be admitted into the Union and the first state that wasn't a colony.  Vermont actually was an independent republic prior to becoming the 14th state, called simply the Vermont Republic, which existed from January 15, 1777 to March 4, 1791.  Notably, the Vermont Republic, similar to the Principality of Sealand above (but for completely different reasons) was never formally recognized by any country, including the United States of America.  The history of Vermont was obviously closely tied with that of the Thirteen Colonies and the early United States, and in fact, several Vermonters fought for the Americans in the Revolutionary War, most notably Ethan Allen and the Green Mountain Boys.  Believe it or not...

 

The CEO of Segway Inc. died while riding a Segway.

Several years ago, our family took a tour around the city on a Segway.  I was surprised to find out how hard they were to ride, but once I got the hang of it, it was a lot of fun.  In one of the incredible twists of irony, Jimi Heselden, an English entrepreneur who purchased Segway Inc in 2009, died while riding his Segway near a cliff in 2010.  It's just another reminder about the need to always think about safety!  Believe it or not...

Happy Doctor's Day 2024

National Doctor’s Day is celebrated every year on March 30th.  We usually have a special luncheon for our physicians on Doctor's Day (or on the Friday before, if Doctor's Day falls on the weekend, as it does this year).  It's not the most convenient time of year for a celebration, as this week usually falls in the middle of Spring Break for a lot of our physicians.  Regardless, it's important to celebrate our physicians and everything that they do for our organization.

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 have never been more proud to be a member of this great profession.  We've all had a difficult past few years with everything that has been going on in our world.  Regardless, physicians have been at the forefront leading societal change during one of the most difficult periods in our nation's history.  Importantly, our influence is due in large measure to the trust and respect that society has for our profession.  

It's important that we continue to earn that trust and respect from other members and professions in society.  There have been a number of studies and articles on the so-called "disruptive physician" in the past few years.  Ultimately, health care organizations promote the behavior that they tolerate, and I am proud to say that in my experience, "disruptive physicians" are incredibly rare.  

There have also been a number of studies and articles on the increase in physician burnout in the past few years.  Certainly, the trend in burnout has only further increased since the COVID-19 pandemic.  Health care organizations should continue to focus on addressing the system and local factors that contribute to burnout.  Unfortunately, I do think that some of the issues that we face as a society are also contributing to burnout in all professions, including the medical profession.  We need more partnership with organizations outside of medicine to help us address these issues which are so important to our workforce.

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!

Leadership is not about solving problems???

The late Colin Powell, retired General who served as the 12th Chairman, Joint Chiefs of Staff from 1989 to 1993 and Secretary of State from 2001 to 2005 said, "Leadership is solving problems. The day soldiers stop bringing you their problems is the day you have stopped leading them."  It's a great quote that emphasizes that leaders need to build psychological safety within their teams so that they will feel as though they can speak up with ideas, questions, concerns, or even acknowledge their mistakes.  The Harvard Business School professor Amy Edmondson has written extensively about psychological safety, including The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth and most recently, Right Kind of Wrong: The Science of Failing Well (both are superb).

I recently came across a LinkedIn post by Robert Shumate who made a slight correction to Colin Powell's quote.  He said, "Leadership is mentoring others to solve problems.  The day those you lead come to you to solve their problems is the day you've failed leading them."  After thinking about this some more, I realized just how profound this slight change in the original quote is for leaders today.  Leaders have to create "fearless organizations", but they also have to both train and empower their teams to solve problems on their own!  After all, this is exactly what High Reliability Organizations do with the fundamental principle of "Deference to Expertise".