July 2010

A part of this newsletter is about unexpected experiences.  One of those occurred this past Saturday, when Arleah and I took a boat trip up the Flathead River with our friends, Deb and Jere Newell.  The Newells live on Flathead Lake and asked us to join them in exploring the river, which connects Glacier National Park with the lake.  They had not been up the river this year and we had never seen it from a boat, in all the years we have lived in Montana.

     

Deb had briefly mentioned something about the “cars” on the river, but it didn’t mean much at the time, so we didn’t pay much attention to it.  As we made our way up the river, we were primarily paying attention to the homes along its banks, and an occasional log feature created by nature.  Then, seemingly out of nowhere, we came upon our first sighting of the “cars.”  Placed along the bank of the river was a montage of rusted out cars from past decades.  Most looked like they were from the 40’s and 50’s.  They were stripped of anything useful or valuable, although a few had shiny chrome bumpers glistening in the sunlight, and one had the insulation from the roof hanging down like a torn shroud.

What struck us was that these cars were not simply abandoned and strewn around the ground like a mini junkyard.  They had been purposefully placed along the bank, most of them half in and half out of the water, hugging the shoreline and each other.  Occasionally, there was one positioned on top of the others, like a painter would do who couldn’t resist that last brushstroke that would complete the picture.

As we pulled in close to one of these “installations,” (there were a few along the river), Deb pointed out a number of cars that had completely slipped into the water and were lying on their sides.  They were eerily visible thru the crystal clear water of the river, and I couldn’t help feeling like I was in the presence of a kind of shrine. 

I know that it may sound strange, but I felt like I had come upon a cemetery and these cars were strange and story-filled grave markers.  One of the cars sitting on top of the others was a big, bulbous Hudson.  We had one of those when I was a child; and my father was so very proud of it.  I think that his practice had finally taken hold, and that Hudson was a message to the world – this first generation American had made it.

As I scanned the row of half-submerged cars and peered down at the sunken hulks, I couldn’t help but think of how many family picnics were launched from those cars; how many trips to grandma and grandpa were taken; and how many children were conceived in those back seats.  Maybe I’m just getting old, but I hope that no government agency or environmentalist hauls those memories away.

I had an interesting experience a few weeks ago at the Salt Lake City airport (where I’m a de facto resident).  I was sitting in Delta’s Crown Room, in between flights, when I couldn’t help but overhear a cell phone conversation taking place a few feet from me. (I’ve given up feeling like I’m eavesdropping, or feeling embarrassed for people.  Cell phones have removed all shame from telephonic communication.  I’m just glad we haven’t figured out how to do colonoscopies over the phone.)  The fellow I found myself listening to, was quite agitated.  And the theme of his agitation revolved around being discouraged and prevented from dealing with people he worked with, in a direct, open, and honest manner.  At one point, he literally said – “If I can’t tell people the truth, then I can’t get my job done.”  There were a number of variations of this theme, and it was obvious that someone on the other end of the conversation was discouraging him from being straight with people, and encouraging him to be more “tactful” (i.e. dishonest).  He was quite frustrated and was getting more and more distressed.  I don’t know how things turned out, since I had to leave and catch my connecting flight.

This fellow’s dilemma was particularly meaningful for me, since I had just left a consulting engagement in which I was asked to assess and give feedback to three relatively new sales professionals.  I had done this, initially, after meeting with them for a few minutes.  I told the first individual that she struck me immediately as arrogant, distant, and uninterested in anyone other than herself.  I told the second person that she radiated distress and that she had a painfully polite smile that never modulated its shape.

And I told the third person, that he had an ingratiating, professional persona, almost charming, but unreal and artificial.  At first blush (no pun intended), the two women did not take the feedback well.  The young man said he was fine with the feedback, but I had no doubt that if I had told him that he was slated for the gas chamber within the hour, he would have considered it an interesting experience.

I take no pleasure in telling people things that upset them.  I do it for two reasons.  First, I care about people and their growth and development.  Second, I have a life-long commitment to the truth.  Most discussions about the truth revolve around grand and glorious corporate mission statements, or pious recitations of eternal clichés.  Few of them connect the truth with feedback to people about who they are and how they impact others. 

For over thirty years, I have heard, ad infinitum (and often ad nauseam) about talented people who never reach their potential; about difficult people who no one wants to work with; or about cynical, unhappy people who love to sully silver clouds with black linings.  At this point in my life, I’ve grown tired of the whining and complaining about people who don’t change.  If you want people to change (and I firmly believe that people can change), then tell the truth – the truth about who they are, and how they impact other people.  If you’re not willing to do this, then stop whining and hold your peace.

I will occasionally have clients question the validity of my initial feedback, on the grounds that it’s simply a first impression, and may not be an accurate picture of who a person “really is.”  My response is that they may be absolutely right, but the point they’re making is irrelevant.  You’ve heard the phrase – “You don’t get a second chance to make a first impression.”  Nothing could be truer in our time.  We live in a culture of instantaneity. Twenty-four hour news, email dialogues, overnight stardom.  Who you “really are,” better be apparent to people right away.  Otherwise, the defenses you’ve developed to deal with the world you’ve grown up with, will carry the day.  And those defenses will define you.

The young lady that I gave the feedback to about her arrogance and distancing personae, is actually quite talented and interesting.  After spending some time with her; her humor, articulateness, and warmth create a very different and attractive impression.  (Her unattractive defenses cover her fears and anxiety about being accepted for who she believes she is.)  Unfortunately, most prospects she encounters will be quickly put off by her initial behavior and not experience her engaging side.

The research on connecting quickly with people, is quite sobering and startling.  I have always been intuitively aware of how quickly the process of connecting (or disconnecting) happens, but I recently came across a statistic (courtesy of my friend and colleague, Keith Ferrazzi), that is amazing – “The first eight seconds is the length of time the average human can concentrate on something and not lose focus.”  The study goes on to make the point, that if you effectively connect in these initial eight seconds, you have only an additional 110 seconds to make your case (and your impact).  If you have no idea of how you impact people in those first 118 seconds, you are in for a long, painful and puzzling struggle.

One more point.  Don’t overreact to other people’s overreaction to your feedback.  When you tell people the truth about who they are and how they impact you, they will almost always have a strong reaction.  If they don’t, they have real problems.  When they have their reaction, ask questions about it:  “How do you feel about the feedback I just gave you?”  “Do you feel like it’s accurate?”  “If so, what parts strike you as accurate?”  “If not, what parts strike you as inaccurate?” Don’t try to make people feel better about what you just told them!  It’s the worst, most counter-productive thing you can do.  It removes the fundamental catalyst for change. If you worry about hurting people’s feelings, I have a question for you:  “Would you rather someone have a bad day, or a bad life?”  Think about it.

In all the commentary and discussions about the Obama presidency, I am struck by how little of it talks about Obama, the person, and in particular, Obama’s mixed race background.  He is, in fact, not America’s first black president.  He is America’s first mixed race president.  On the psychological plane, this is no insignificant fact.

    

Personal identity is a complex phenomenon. It is a complicated, often confusing mix of biology, family history, cultural imperatives, psychological gifts and wounds, and core values.  It poses a continual challenge to our attempts to arrive at any kind of clarity – to be able to answer one of life’s fundamental questions:  “Who am I, and what do I believe?”

I have had the privilege of working with a number of very powerful, influential, and impactful individuals in the private sector, as well as in the public arena.  One of the most important things I’ve learned, working with these people, is that huge, colossally important decisions they’ve made, have been driven either by their crystal clear clarity about who they are, or their massive confusion about their identity.  In the best case scenario, these individuals recognize all the varied forces that shaped them; consciously put them aside; draw on their deeply held core values; and do what they know is the right thing.  In the worst case scenarios, other individuals unconsciously and impulsively make profoundly impactful decisions based on being triggered by unresolved issues from their past.

Let me give you some examples.  Bill Clinton is obviously a bright, talented and shrewd politician.  Too bright and too shrewd to intentionally and consciously decide to engage in the numerous boneheaded and self-destructive gambits he got caught in.  If you only had a room temperature I.Q., you wouldn’t decide to have oral sex with a young intern, in the oval office.  So what’s going on here?  Clinton’s childhood is widely known and much written about.  He grew up without a stable male figure; a lonely and unhappy mother; and with demands on him to play a role, as a child, that he was not (and should not have been) capable of playing.  The upshot of this was the evolution of an identity focused around feeling disappointed in, and being habitually disappointing.  This was so ingrained in him, that you could mark your calendar, with great certainty, every six months with the expectation that Clinton would be in the midst of another personal disaster.  He had, seemingly, no control over his propensity to be disappointing.  It dominated his identity.

George Bush’s identity was also dominated by early childhood damage, but with a different permutation than Clinton’s.  Bush grew up in the shadow of indecisiveness and unpredictability from a male figure.  (This probably played a role in his early problems with alcohol.)  Consequently, when he took a position, that was it, for life.  What, in some respects was a strength – his apparent decisiveness – was a critical weakness.  He struggled mightily to re-evaluate decisions, and it was next to impossible for him to admit a mistake and apologize.  His issues with his father and his compensatory rigidity all came together in his decision to invade Iraq.  I have no doubt that the driving force in this decision had more to do with his father’s strategic blunders, than with the national security of the United States.  In essence, he invaded the wrong country.  Sadam Hussein was undoubtedly a madman and a murderous psychopath.  But in terms of global insecurity and national defense, he paled in comparison to the mullahs and lunatics running Iran.

Let’s look at examples of identity being shaped by core values.  In the mid-90’s I had the opportunity to lecture in South Africa at an international conference put on by YPO (the Young Presidents Organization).  What was particularly extraordinary about the conference was the attendance of both Nelson Mandela and F. W. deKlerk, the seventh and last president of apartheid-era South Africa.  The transition to black rule was just beginning, and people at the conference were expecting a firebrand talk from Mandela, and a speech full of mea culpas from deKlerk.  Neither happened. Mandela surprised everyone by not referencing his years of imprisonment and his hatred of apartheid.  He addressed his remarks to his black brothers and sisters and challenged them with an unexpected message.  He said, paraphrasing him – “Don’t expect this [political transition] to be easy, and don’t expect things to be handed to you.  Nobody is going to give you what you’ve been missing, and you’re going to have to work for it.”  The audience was surprised and a bit stunned.

deKlerk’s talk was one of the most forthright and courageous political addresses I have ever witnessed.  He got right to the point.  Apartheid was evil, immoral, and beyond any justification.  And then he galvanized the audience (I paraphrase):  “My followers despise what I am doing [handing over power and calling for elections allowing blacks to vote].  We have one of the most powerful military machines in the world and we could crush any opposition and stay in power perpetually.  But it would be the wrong thing to do.  Ending apartheid is the right thing to do.”  (deKlerk was, at this time under 24hour protection from serious and constant death threats.)

Both Mandela and deKlerk put aside compelling forces from their past, and both came from their core values.  We rarely see this in contemporary politics, business or civic life.  I often say, in my work, that courage is the decision to overcome one’s history.

Barack Obama is very confused about his identity.  And this confusion comes across in his bouncing back and forth in his decision making.  He wants to close Gitmo and extend a hand of friendship to the Muslim world; and he fully supports the pulverizing drone bombing along the Pakistani border.  He wants accountability for educators and opportunity for minority students, and he fails to utter a peep, when the first thing the House does, under his presidency, is kill the voucher program for charter schools in D.C. (populated almost exclusively by poor black students).  There are many more examples involving immigration, fiscal policy, the justice department and on and on.  A lot of people attribute this ambivalence to political pandering and manipulation.  Some of it, is undoubtedly due to those choices. But most of it, I believe comes from his identity confusion.

Before I talk about my time at M.D. Anderson Cancer Center (as a consultant, not a patient), I wanted to make a few comments about a visit with my mother.

Last night Arleah and I went to a family barbecue at my mother’s nursing home.  It is always a sad experience, but last night was especially poignant.  I found myself running the emotional gamut from deep grief to a kind of dark humor.  The best way to convey the experience is thru some random bullet points:

I guess its nature’s irony that I would find myself sitting at a table helping my mother eat.  Here’s a woman who was a professional dancer, appeared in three motion pictures, was a manager at a flagship Saks Fifth Avenue store, who can’t put condiments on her hamburger, without help.

There was a woman across the room, who I thought was looking at me.  She had deep blue, almost black eyes, and pure white hair.  I smiled at her, to acknowledge the eye contact, but got no response at all.  I then realized that she was not looking at me, or anyone else.  She was not even staring off into space.  She was in some private place, all by herself.

There was a woman at the table next to us, who had been served a bowl of soup (or something liquid), instead of the barbeque fare.  She made attempt after attempt to get some in her mouth, but never succeeded. It all ended up in her lap.  I thought, somewhat perversely, that John Cleese and the Monty Python Group would have a field day here.  They could do a senior citizen version of “A Fish Called Wanda.”

At the same table, two residents were locked in a super slow motion battle to unhook their wheelchairs that had gotten fused together when they both tried to leave the dining room at the same time.  There was no upset; no angst; no show of emotion at all.  It was another Monty Python moment.

There was a country western band playing throughout the evening.  Their average age was probably about 80.  They were absolutely terrific.  The fiddle player and the harmonica player were awesome.  And the woman playing the keyboard and singing had an unbelievable voice.  If you closed your eyes and forgot where you were, you would swear that Patsy Kline was in the room.  One gentleman resident, undoubtedly hard of hearing, pulled his wheelchair within inches of the band and lapsed into a kind of catatonic state.  They were absolutely unphased and kept on playing.

Amidst this profound sadness, the staff was flitting around like hummingbirds.  Bringing people things, wiping chins, cleaning tables; seemingly oblivious to the quiet suffering all around them.  We have gotten to know many of the staff, and they care deeply about the residents, and do an amazing job of taking care of them, and truly meeting their needs.  But they have to protect themselves, emotionally; from the stillness, the depression, and the absence of engagement. 

Lastly, the great grandchildren running around was a welcome and stark contrast to the helplessness pervading the room.  They were full of themselves, giggling and shouting, without a care in the world.  They were taking everything for granted, and thank goodness for them.  Life is precious.

And now, for my visit to Anderson.  Last week I spent three days at the M.D. Anderson Cancer Center in Houston.  I had been invited there to deliver a lecture to about 80 of their professional staff that had previously taken part in a number of leadership development programs; and to meet in small groups and one-on-one, with key leaders in the organization.  I received the invitation because of a relationship that had developed with a Neuro-Oncologist who had read one of my books (“Fifth Wave Leadership”), and had been deeply impacted by it.

I had heard about M.D. Anderson for years, and knew it as one of the most prominent and perhaps, preeminent cancer research and treatment centers in the world.  And I have been to a number of research/treatment centers as a professional and thru Arleah’s experience with cancer.  So, I assumed it would be very much like I had seen before.  But I was wrong.

Anderson is of a scope and magnitude that is hard to describe.  It is a mini-city of building after building; research centers, treatment facilities, hotels, restaurants, conference facilities.  It employs nearly 20,000 people (about 3,000 credentialed health care professionals); serves around 75,000 patients a year; and has a budget of nearly three billion dollars.  It is a branch of the University of Texas, and the physicians and doctorate level staff have faculty appointments.  There are 43 distinct departments that all share the mission of wiping out cancer.  What is even more amazing is that Anderson is just one part of the Texas Medical Center, a complex of medical facilities unlike anything else on the planet, employing nearly 80,000 people.

As impressive as this all is, the size, scope, breadth and depth of Anderson, was not what inspired and impacted me the most.  It was the people I met and got to know.  There were two, in particular: Janis Apted, Associate Vice President of Faculty Development, and Dr. Morry Groves, the Neuro-Oncologist who read my book and introduced me to M.D. Anderson.

Janis plays a vital role in making sure that the faculty continues to grow, personally and professionally.  In addition, she has a strong and clear commitment to minimizing the dysfunction inherent in an institution of that size and complexity; particularly one employing a few thousand super-intellectual, narrowly focused specialists.  To say that they work in silos would be the understatement of the century.  You can image the challenge of leading, managing, and developing that population.  You’ve heard of the phrase – “Herding cats.”  This would be better described as herding grizzly bears.

Janis is perceptive, persistent, courageous, and a straight shooter.  She is not easily dissuaded from her mission, and her commitment to make Anderson the best it can possibly be.  She could easily back off, take a low profile posture, and create and sponsor the usual pre-digested, mind-numbing training that passes, in most institutions, for professional development.  She has chosen not to, and for that, she has my respect and admiration.

Morry Groves is a fascinating individual.  Besides the fact that we share the same first name and both went to graduate school twice (he is an attorney and a physician), he has an out-of-the-box commitment to knowing himself better, and to be a better person in his home life, and in his work with his patients.  He does extraordinary work; he is clearly embraced by his patients; he is respected by his colleagues; and he has not one iota of pretense or arrogance about him.  In addition, he is remarkably trusting of himself and others, and is wide open to feedback about who he is, and how he impacts others.

The high point of my time at Anderson (and the inspiring part of the visit), came during the last afternoon I was there.  Morry had mentioned, in earlier conversations, that if I were interested, he would love to have me come to “clinic” with him.  “Clinic” is when he sees patients, primarily to track their treatment and update them on their status and progress (or lack of such).  He is accompanied, usually, by a resident, or a nurse practitioner, or both.  He reiterated his invitation to join him, and added that he would appreciate feedback on how he related and worked with his patients.

We began that afternoon by going thru the medical history of the four patients we were going to meet with.  (Morry is a specialist in brain tumors.)  I got a crash course in brain cancer and a complete overview of each patient’s diagnosis, treatment history, and prognosis.  And even though I have the requisite credentials, clinical background, and experience with issues of confidentiality, I felt honored by being included as a member of the team working with these patients.  I also got a brief history of the research done on these tumors, and the progress made in prolonging the life of those afflicted.  The gains made don’t, at first blush, seem very great.  But if you’re fighting for your life, another couple of months is a long time.

I was nervous and anxious preparing to meet with the four patients scheduled that afternoon.  In my fifteen years of clinical practice, I had dealt with the death of a few of the people I had worked with; and I certainly had experienced gut-wrenching suffering.  But I had never worked every day with people who were almost certain to die while I was helping them.  That’s the world Morry and his colleagues live in.

The interaction that penetrated to my core, occurred when we met with the third of the four patients.  She had been a teacher; had led a very active lifestyle; and was now, for all intents and purposes, confined to a wheelchair.  Her tumor had wreaked havoc with the left side of her body, and it was not responding to the treatment regimen.  She was accompanied in the consultation room by her daughter (who was taking notes on a laptop), and her husband, who looked drained and exhausted. 

The moment Morry, myself, and a resident entered the room and sat down (after some brief introductions), she began talking about her lack of control over her left side, her inability to walk, and her fears of having a painful death.  She asked Morry some questions about how things were looking, but answered them herself.  She knew it was bad; she knew it was going to kill her; and she knew she didn’t have a lot of time left.  It was gut-wrenching.  No one knew what to say.

Something clicked for me.  I asked her if I could ask her some questions.  She nodded.  I asked her what upset her the most, and she answered that she was so frustrated by not being able to control her own body.  I then asked her to identify the strongest feeling she was having from a list of five – mad, sad, glad, hurt, and afraid.  I no sooner had the words out of my mouth, then she blurted out – “mad,” and broke down into uncontrollable sobbing.  Her grief exploded like a volcano.  Her daughter followed immediately, as did the resident.  The tension in the room dissipated completely, and there was a palpable look of relief in her face.  Life-threatening illness is an incomprehensible loss, and requires constant and explosive grieving – a grieving that frightens everyone.

From that point on, I pretty much took over the consultation (once a therapist, always a therapist).  I talked with the three of them about her need to grieve daily and to create a list of at least ten people who could sit with her and let her grieve (grieving is exhausting for everyone, including the listener).  The consultation ended on as good a note as was possible, and Morry reviewed her meds and made some adjustments.

The impact point came for me, as we were walking back to the staff room.  Morry thanked me for my help and turned to me and said – “We miss 90% of what’s going on with our patients.”  At that point, a strange feeling came over me.  What I felt was – I had just changed people’s lives in a way I had never experienced before.  Perhaps this is what some call a spiritual or religious experience.  Whatever it was, it has changed me.