Chapter 1
The Journey to Leadership
The potential to lead can be evident early in oneās life.
In the beginning, there was high school and the incredibly complex, confusing, exciting, and sometimes depressing time called adolescence. By sophomore year, I was involved in many clubs and activities, and had joined the crew team, which was a truly enjoyable experience. It was exhilarating to be in the middle of the Hudson River, rowing in almost perfect synchronization with seven other guys to the rhythmic pounding of the coxswain on the side of the boat.
The enjoyment was short-lived, however. Halfway through the season, I quit the team after an unpleasant incident that had nothing to do with my rowing abilities.
After practice one day, I was riding with my teammates back into town. We came to a stop behind a line of cars at a red light, and in the car in front of us was a lovely little Black girl looking out of the back window. She flashed a big smile and waved ā just a friendly wave to the car behind her.
Our driverās response was, āTurn around, you little Black bastard.ā He had forgotten I was sitting in the back seat of the car ā the only Black crew team member. There was absolute silence, and all the other occupants avoided eye contact with me. When I was able to regain my composure, I asked to be let out at the next corner. I never returned to the crew team. Looking back, I deeply regret running away from an issue that I would encounter numerous times throughout my life. I now consider this as a failure to lead as a person of color in an all-white sport. Neither coaches nor teammates encouraged me to stay.
The episode served as an early lesson in assessing the boundaries of relationships with others. The fact that I was a member of a team, participated in club activities, or worked on school projects did not validate me as socially acceptable in some school activities or social events outside of school. Fortunately, this did not deter me from making friends and establishing relationships. When I was growing up, I never heard my mother use the word āhateā or see her harbor ill feelings toward anyone. I have subsequently realized that those who internalize hatred of another must live with it 24 hours a day and can be consumed by it. Thus, I was able to press on, choosing compassion over hatred, respect over rejection.
Throughout high school, I enjoyed positive relationships with classmates from diverse backgrounds and participated in a broad spectrum of school activities. These relationships apparently were positive and meaningful to my classmates and peers as well, as I was elected president of the junior class. How it happened was somewhat of a mystery to me. I was certainly not the smartest nor best-looking. I donāt remember having a specific platform of witty slogans or appealing but ludicrous promises I could never have delivered. I do remember speaking directly to as many of my classmates as possible, offering a handshake and a smile, and pledging to do the best job possible as class president.
I proceeded through the year with great enthusiasm, basking in the glow that came with the honor and recognition of being a leader. My self-esteem took a nosedive after the Junior Prom. My date and I had not been invited to a single after-party. Our walk home was quiet and sobering, reminding me that how people view you in one context of your life is not necessarily how they see you in other settings.
In my senior year, I was prepared to run for president of the Student Government Organization. However, the school administrators informed me that I was ineligible to run for any office because I had failed typing. I have yet to understand how typing is a measure of my academic or leadership capabilities, but I believed that racism may have been the primary reason I was not allowed to run for the position. I was allowed, however, to participate in Government Officials City Day. Student leaders were selected to spend the day with key leaders of our city government. I was Corporation Council (the lead lawyer for the city) for a day.
Back at school, things were looking up.
For example, I was elected co-captain of the varsity football team. Although I was certainly not the fastest, biggest, or strongest player, I played both defense and offense and always gave everything I had.
I had been a āred shirt freshman,ā meaning the coaches thought my playing skills were good enough to move me up to the varsity team. During the last game of the season, I actually got in the game as a defensive end and made a couple of tackles, so by my senior year, I had been around longer than most of my varsity teammates.
As team captain, I led the team in warm-up exercises before each practice and game. I also set the bar for how the game should be played. I gave all I had every minute, in every game, while constantly pushing my teammates to do the same. I tried to lead by example.
Unfortunately, we had a losing record my senior year ā not the way I wanted to end my athletic career. Did I fail as a leader? Perhaps. But I learned that sometimes your best is not good enough. I also learned that good people with good intentions might not be sufficient to successfully execute the job they are in.
When the senior yearbook was published, I finally had an idea why I was elected president and football captain: I was voted āMost Respected.ā When I looked at the comments my classmates wrote to me, I saw one phrase was repeated many times: āTo a Great Guy.ā
To me, these remarks confirmed that the way I treated them made a difference. They knew I valued them as individuals, regardless of who they were or what activities they enjoyed. Valuing and respecting all people became a major guiding principle of my life.
My years in college were quiescent in terms of leadership development. I was married with a lovely baby daughter, carrying a heavy load of science courses and working small part-time and summers jobs. There was little time for extracurricular activities or social life. After graduating from college, I began a short career as a high school biology teacher. During this time, I underwent further maturation and introspection and developed a new vision of the person I could be.
When the opportunity to become a physician presented itself, I was ready to accept the challenge. My medical education and training would become a critical foundation for my leadership development.
See One, Do One, Teach One
At 2 a.m., the phone in the on-call room jarred me awake. It was the intern (the equivalent of a first-year resident today) to whom I had been assigned for my first clinical rotation, pediatrics. āMeet me in the ER in five minutes, we have an admission,ā he said. I sprang from the bed, splashed some water on my face, swished some mouth wash, grabbed my white jacket and stethoscope, and was off to the ER.
I was a second-year medical student who, after a year and a half of didactic emersion and an introduction on how to diagnose diseases and medical conditions, was now experiencing the real thing. I was to help real people get better. My heart was pounding and my brain was churning with a combination of exhilaration and fear.
Since the dawn of formal medical education, the primary objectives for those aspiring to be in the medical profession have been:
- To understand how the human body works.
- To use that knowledge along with available tools and technology to diagnose, treat, or cure whatever problems were identified.
- To do so with integrity, caring, and compassion, while doing as little harm as possible to the patient.
Teamwork is expected and essential, but little time is spent providing explicit guidelines on how to achieve it. Similarly, little time is spent discussing how to lead such a team as one progresses through the hierarchy of the medical profession: student, intern, resident, attending, department chief. I was not only entering a new profession but also a unique culture.
When we entered the ER, the intern and I were handed the admission papers for a five-month-old infant. The child had been running a fever for nearly five days. The childās mother indicated that she had taken her baby to a local clinic three days earlier, and the child had been diagnosed with a virus. The mother was sent home with Tylenol and instructions to keep the baby well hydrated and return if the baby did not improve. Over the next two days, the childās fever persisted. She grew increasingly irritable, with decreasing appetite and a weak cry. The mother decided to go to the ER rather than the clinic.
The initial assessment did not identify the source of the childās illness; therefore, the child was being admitted for a workup of a fever of unknown origin. We took the child directly to the examination room on the childrenās ward. The intern and nurses knew that a diagnostic workup required urgency and precision. There was much to be done, including a spinal tap (inserting a needle into the base of the spine to extract some of the spinal fluid).
The intern performed a thorough examination on the child to ensure no signs or symptoms not already noted in the ER were present. The resident arrived and immediately took charge. The nurses had assembled the equipment and materials to perform all of the necessary procedures for the workup. The resident turned to the intern and me and said, āSee One, Do One, Teach Oneā as he prepared to perform the spinal tap. It was the first time I heard the phrase that would be repeated throughout my training.
The resident was leading by example ā not only in his explanation of what he was doing in each step of performing the spinal tap and his courtesy toward the nurse who had everything he needed when he needed it, but also in his acceptance of the responsibility of developing the next one who would lead and teach. He recognized the value of everyone in the room ā another lesson carried with me throughout my career.
The spinal tap was completed successfully and the fluid was sent to the lab. The infant was exhausted and somewhat dehydrated, and we still had much to do. We needed to start an IV (intravenous infusion) to provide urgently needed fluids and nutrients and obtain blood culture...