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Sunday, August 14, 2022

Five Leadership Lessons Learned in Five Decades in Medicine

Plumbers share their best story. A guy makes a late Friday night call for a blocked sink and broken disposer a decade ago. The on-call plumber arrives and the customer asks the repair cost. "I'm a contract worker and it's $225." "That's ridiculous. I'm a dentist and I don't make that kind of money." "Maybe you should have been a plumber..." 

Learn across domains. Car mechanics and plumbers acquire wisdom over a career. Serious study of the game advances your perspective and wisdom. Traffic in specifics. 

Inspire. Dr. Faith Fitzgerald visited Boston City Hospital from San Francisco in 1980 and discussed intravenous drug abuse. She explained types of drug abuse and even tattoos common among drug abusers, such as spider web tats where the forearm meets the upper arm. Capture our players' attention and imagination with what and how we teach. 

Explain cutting as craft with timing, "the ball as a camera," cutting urgently, and the off-ball screener is the second cutter. 

Mentor. Steve Kerr teaches mentors, mindset, and culture. Don't be a know-it-all; be a learn-it-all. Teach players to be curious. 

An early lesson I teach is, "the two best answers in medicine are "I don't know" and "That's a good idea, we should try that."" The smartest person we know has a fractional knowledge of the subject. Medical subspecialty classics like Peripheral Neuropathy are a bazillion pages long on a small area in Neurology.

We were doing a 'hard case' conference in 1985 about a patient with a chest aneurysm. As Chief Resident, I was running it. CAPT Bill Baker prepped me with a preprint of a textbook from Eve Slater, "Dissecting Hematoma of the Aorta." He didn't leave me hanging. "Mentoring is the only shortcut to excellence."


Cultivate a photographic memory for when you need it. 

"Handle it." Whether it was critical illness in the Bethesda Naval ICU or challenging HIV cases in the 1980s, CAPT Tom Walsh expected us to "handle it." Take care of business, whether it's family or academics if you want to play ball. When you're playing, transfer that "handle it" to your skill and will. "Handle it" was his Belichickian "Do your job." 


If you want to become the closer, then practice 'closing' moves during a small part of personal workouts 

"This is how we do it here." Know how and know that differ. It's the Yogi Berra version of, "In theory, there's no difference between theory and practice, but in practice, there is." Seek better ways to teach, drill, study, and execute. Dr. Russ Jeffery explained that you're either committed to teaching or caring for your patients as a private practitioner. And when push comes to shove, you'll abandon the teaching for the patient. When Belichick is asked about other teams or fantasy football, the answer redirects to "I'm only concerned about what it takes for us to win." That includes not only technical and tactical play, but the relationship psychology with players and coaches. 


Broadcaster George Stephanopolous says, "Tell them what you're going to to tell them, tell them, and tell them what you told them." 

"We only have so many silver bullets." Shortly before leaving the Navy I gave a 'Grand Rounds' presentation on sarcoidosis, an inflammatory disease that can affect almost any organ, most commonly the lung. Bill Russell had it. Pat Pazmino a kidney specialist, congratulated me and said, "even the Lone Ranger runs out of silver bullets." 

The time comes to move on. We lose our metaphorical fastball, our edge or motivation. Coaching allows us to share our knowledge, experience, and failures with young people and peers. 


Lagniappe. Constantly rebuilding teams aren't setting expectations high. 

  • What is our success plan?
  • Commit to playing "harder and longer" than opponents.
  • What price are you personally willing to pay? 
Lagniappe 2. "One More" pass creates open looks. 

 Players focused on the scorebook aren't making that 'sacrifice'. 

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