8 Leadership Lessons I Learned in Surgery

This is the first piece of writing I have done since November 18 when I presented the back of my hand for the IV start. But I began writing it in my head the instant I emerged from La La Land, to discover myself already muttering something about politics (my worst case scenario come true: talking smack about current events when I’m not in full command of my wits and others nearby are holding the sharps, lines, tubing, straps and machines that go beeeeeeeeeeep). Hopefully this piece makes more sense now that I have had a few days to shake the anesthesia from my system and get on with the business of thinking clearly.

Here’s the briefest of backgrounds, just to set the stage. Two years ago, Nick Vincent (a client then and dear friend now) watched me hobble across the reception area of his North Carolina headquarters building. And he kindly said, “You’ve got to get that fixed.” For years up until that point, the pain in my hip would reliably go away if I just knocked out the chocolate and lost a little bit of weight. But that wasn’t working anymore. Instead of just going to the doctor already, my smarter-than-doctors strategy was to continue to beat myself up for my lack of diet discipline, compounding the debilitating pain in my hip with totally elective agony.

I’m still so in love with the overall experience that if someone were to say to me, “You need the other hip done,” my answer would be a cheerful, “Okay.” How’s that for a happy response to the standard customer satisfaction survey question, “How likely are you to come back?”

Being the expert that I am in all things I know absolutely nothing about, I knew that the most obvious solution – find an orthopedic surgeon, go to the hospital, replace the part – was the least attractive solution. And so I spent the next two years, thousands of dollars, and thousands of miles, trying everything but doing it right the first time.

One of the reasons I resisted (setting aside the blood, needles, and paperwork part)? My deep and broad knowledge about employee engagement, culture, years of watching NBC’s ER, and all those times I spotted nurses on strike in front of my nearest city hospital as I was driving by on my way to Carl’s Jr for a Super Star with cheese. New Mexico, where I live, isn’t high on many national quality-of-life lists, except for per capita DWI rates. I brought with me on this adventure of finding relief a really bad attitude about almost everything local, based on nothing more than presumption and elitist snark. So extreme healthcare interventions struck me as being higher quality elsewhere. I traveled as far away as Columbia, SC, and West Palm Beach, FL, in search of a solution, only to return unimproved to my little New Mexico house in the desert after a series of bizarre failed attempts.

Eventually, all things came together at the same time I caught some Ring video of myself galumphing on my front porch, even though I had, by then, lost a lot of weight. I resolved that enough is enough. And I joined the global cadre of “hippies,” who along their own journeys of delay and denial also eventually decided enough is enough. And, like me, all around the world, on November 18, answered the question, “Which hand do you want to use for the IV?” This would be the first of about five needle sticks for me that day – which was actually the worst part of the whole experience when you get right down to it. The other aspects of the day were other people’s job descriptions. My only performance expectation was just to hold still. And not look.

So why is this turning out to be an article on leadership – other than the fact that I’m just an employee engagement geek and can’t help myself? Because I was paying attention to the goings on of the day in the gleaming, brand new hospital in a small town one hour north of Santa Fe.

At every point in the entire process, I discovered a chain of passionate professionals cheerfully doing what they do best, easing a patient along this magic carpet ride toward one day feeling better and restoring hope for a pain-free future of just being able to walk across a room without wincing.

There were a couple of missteps, which I’ll also tell you about. But here it is, almost two weeks out from my Big Day. I’m still so in love with the overall experience that if someone were to say to me, “You need the other hip done,” my answer would be a cheerful, “Okay.” How’s that for a happy response to the standard customer satisfaction survey question, “How likely are you to come back?”  

There are gallons of lessons to be drawn from the surgical experience. So I thought I’d have a little fun here and lay a few of them out for you (I mean, it’s either writing this piece or doing PT):

An often-overlooked leader role is to manage transitions – not simply keep focused on objectives.

This I actually learned from a nurse at a neighborhood bar. Leading up to the Big Day, I tended to be, maybe, a little obsessive. And I talked about my worries in places where I would be overheard by strangers. One of those strangers turned out to be an off-duty traveling nurse, trying to enjoy her farm-to-table pumpkin soup, craft beer and new novel at the bar where I happened to have been sitting at the time. Come to find out, she’s a recovery room nurse. Since I love asking people what they like best about their jobs, I turned my focus away from myself for just a second and asked her my favorite question. Her answer: “Holding people’s hands as they come to and reassuring them that everything will be okay.”

Huh. When I got home, I pulled down my copy of William Bridge’s Managing Transitions, and made a mental note to write more about this role in greater depth. Later. But for now, I think it’s enough to just wonder how much wealth we miss with our unrelenting focus on the finish line.

Make sure the support staff knows all the relevant hard words.

The day before my get-acquainted appointment with my ultimate ortho, I got a call from the large health system’s call center. 

“I see you have an appointment with Dr. B tomorrow to discuss hip replacement on your right leg. Is that correct?”

“Yes.” 

“He doesn’t do right legs. He only does left legs.” 

And with that, the appointment was cancelled and more months were wasted while I resumed my search, wondering, “Why does this have to be so hard?”

Months later, my still small voice said, “Give Dr. B another call. Maybe there was a misunderstanding.” Yes, he does both legs. And no. Not a soul could figure out who this call center gremlin was and how she could have possibly had that belief. It wasn’t until I was immediately post-op, walking up and down the corridor with my PT who looks amazingly like Tim Ferriss, and who I will talk about later in this piece, that it dawned on me.

Hip replacement candidates quickly discover that there are essentially two main options for entry – posterior, which is quite literally a pain in the ass and anterior, the golden child of all desirable approaches for almost every possible reason. Understandably, I was on the hunt for an ortho who does anterior. Dr. B doesn’t do anterior by himself – it takes special training and loads of experience. And that note is on his cheat sheet for call center employees to refer to.

Call center employee must have seen the word anterior and thought to herself, “That must be one of those fancy medical ways to say right. I better make that helpful phone call and cancel the appointment.” And so she did.

(For the record: Dr. B works with Dr. J, who is, as it turns out, a rock star in all things anterior.)

No matter who is the most freaked out, leaders always have the power to set the tone for positivity and, even, celebration.

Did I mention that this was my first-ever surgery? My frame of mind in the pre-dawn hours of November 18, without benefit of either coffee or comfort muffin, could have been anyone’s guess. Walking into the hospital, with my little suitcase, the only thing I had going for me – mindset-wise – was the firm self-talk reminder that I am a big girl. Certain behaviors would be expected of me. Running screaming out the glass doors into the still-dark New Mexico November pre-dawn was not an age-appropriate thing to do.

Certain behaviors would be expected of me. Running screaming out the glass doors into the still-dark New Mexico November pre-dawn was not an age-appropriate thing to do.

Then I met Helen, who cheerily greeted me at Same Day Surgery. “Down to your birthday suit, ties in the back,” she instructed with the same smile on her face that, under a different set of circumstances, would have implied warm chocolate chip cookies and milk in my immediate future. “Okay,” I complied. And was rewarded for being a good girl with a warmed blankie, special non-slip sockies for my popsicle toes. And my first stick.

With my change of attire, and being hooked up now, the running outside option was now out of the question. So the only thing to do was to give myself over to the process and focus on the fact that based on all the smiling faces I saw hover over me as I was wheeled to the holding area, I had probably made a good decision. Everyone else seemed to think so.

Everyone has a name; everyone gets to say hello.

In the mandatory joint class I went to a couple of months ago, Yolanda, the fabulously passionate, positive, and excited nurse practitioner, gave us an orientation around what to expect. One of the things she forewarned us about is that during prep time, everyone is going to be super busy, behind face masks, and probably there would be no time for niceties. Fair enough, I thought. I’d rather they just got on with things anyway. 

But as it turned out, I got to meet everyone, face masks off. Even Lawrence, the guy whose job it is to clean my blood and give it back to me in its own special pouch afterward. There were Dr. B; Dr. J; Lawrence; Louise; Chris and Chris, and, I think, Victoria, the recovery room nurse. They all said “Hello, we’re going to do everything possible to make sure your experience is a pleasant one.” 

To which I was increasingly inclined to respond with: “Okee dokee.”

Teams are efficient. And it’s so tempting to skip the part about introductions and names, especially when the project at hand involves blood, focus, precision timing, and machines that go beep. But while I was lying there, still in holding, watching the movements of a very relaxed, confident, group of people wearing scrubs, everyone had time to stop, paint for me their vision of a successful, even pleasant, experience, and give me their name. What that said to me: They cared about my name too. I wasn’t just “the right hip.”

Treating someone according to what you perceive to be their category kills the charm.

The only awkward moment happened when the nurse anesthetist appeared looking exquisitely self-conscious. In a kind of fluttery way that stops being cute among girls older than 14, he sidled up to the big question: 

“How much do you weigh?”

Me on the inside: “Really? After you guys knock me out, the first item on the agenda is an en plein air Foley catheter insertion, with the entire cast of a Fellini circus movie in attendance, for all I would know. And you’re getting all pearl-clutchy about asking me about my weight?”

Me on the outside, bearing in mind that he was the one who would soon be expertly shuttling me between two worlds, not too early not too late: “Why are you nervous about that question?”

Him: “Well, I know ladies don’t like to be asked about their weight.”

I put him out of his misery by matter-of-factly giving up the digits. I have to say that it feels almost churlish to even bring this moment up. He did a fabulous job, performing a scary femoral nerve procedure deftly, confidently and painlessly. When I woke up later I had none of the side-effects that I had read so much about. So all-in-all, zero complaints. I just hope that someone kind and expert reads this and takes him aside to say, “The ladies in pain aren’t vain about their gain by the time they come to you. They just want you to do what you do so well.”

Everyone wants clarity about their world.

I don’t remember a single moment when I didn’t have my glasses on. From the time they put the little mask over my nose to a split second later when I was in recovery, all toasty warm, muttering away about the headlines, I could see everything around me. I didn’t have to be able to see everything all the time; no, I most certainly did not. But I was able to understand my surroundings always, which is probably especially important when there’s not much personal agency otherwise.

There’s always a personal story behind the paperwork.

In my professional life, I help companies ignite a culture of self-perpetuating passion by helping employees link their personal epic sagas with the organizational meaning of the work they do. So I discovered instantly that I met a kindred spirit in Ben, the Tim Ferriss look-alike physical therapist. He told me later that the first thing he asks patients upon meeting them is, “Tell me something about yourself that I won’t find on the chart.”

Inside the initial hour where he’s considerately tying the back straps of my johnny gown, telling me “down with the bad, up with the good” (which I since remind myself every time I have to decide which leg to lead with as I approach a step), instructing me about form and posture over my walker, like I was a member of the US Ski Team, we’re talking about literature. The next day? The topics are blood pressure, breathing, walking with a flowing motion, and how objectivism empowers capitalism in such a way that supports society’s interests as a whole. I tell him the untold story of the Cuban Missile Crisis, and he tells me about his mother – a fluent French speaker and a physician herself, who opted not to use the French pronunciations of words commonly used in American conversation – because, she told him, it’s obnoxious to be an intellectual show-off.

During our check-out stroll about the room minutes before I was discharged, the word galumphing came up. It’s a great word, one I’ve used for years when snootily criticizing the way other people walk. Karma bides its time. And now I have to humbly own galumphing as my own personal situation. At least for a little while. But not for very long, if PT Ben has any say about it.

By this time my friend Kate, who was there to pick me up and drive my sorry butt back home to sleep off the oxycondone, was sitting on my room’s sofa scrolling through her phone. And I’m doing my click-roll-click-roll walker stroll around the room.

“Where does galumphing come from?” she asks. We both turn to her and say in unison: The Jaberwocky! And with that, the three of us piece together from memory the nonsense lines of one of the best poems ever.  

And, as in uffish thought he stood,

The Jabberwock, with eyes of flame,

Came whiffling through the tulgey wood,

And burbled as it came!

One two! One two! And through and through

The vorpal blade went snicker-snack!

He left it dead, and with its head

He went galumphing back.

“And hast thou slain the Jabberwock?

Come to my arms, my beamish boy!

O frabjous day! Callooh! Callay!”

He chortled in his joy.

Everyone wants to be special and memorable in some way. And I know that PT Ben has seen many more patients in the days since we said good-bye at the hospital. So I know my place in the grand scheme of things. Still, it makes me smile to think we’ll always have The Jaberwocky. And of all the back-views of johnny gowns he will have seen in his career, it will be mine that springs to mind each time the word galumph comes up in conversation.

Joyful employees are the best talent magnets.

Over the following handful of days I met Mickey, Cody, Jessica, Pablita, Melissa, Leah – all of whom came to give me little pills in little cups, measure the output in the yellow bag hung at the side of my bed, plug my I-phone charger back into the outlet, measure, weigh, record, and respond to my call button in a matter of seconds. I discovered this drive to be the very best patient they had on the floor – their favorite – so I didn’t use the button very often (at least I hope I used it less than everyone else – maybe there’s a leader board in the nurses station somewhere and I was way down the list. If so, I don’t want to know my ranking).

The last person to come breezing into my room was the energetic, athletic, joyful Justin, who pulled the duty of reacquainting me with the lav after the last of my hook-ups were detached and I was free to roam about the room. I was still under strict supervision, of course….I learned the hard way that the bed alarm gets loud enough for someone strong to come running if a patient decides to go rogue and ignore the “call, don’t fall” signs posted all around.

By this time, in the company of all these caring professionals, I had come to the conclusion that we can still keep our humanity and dignity even under conditions involving yellow bags and back flap ties. And so I was basically okay with this young, handsome nurse tech cheerfully and confidently making sure I was securely seated before saying, “I’ll just wait right outside the bathroom door, pull this string when you’re done.”

To turn my attention away from myself, I asked him about him. He was born and raised in this town that most people like me drive through as fast as possible on our way from Santa Fe to Taos. As luck would have it, his professional career preparation coincided with the building and opening of this beautiful, quiet hospital filled with world-class healthcare professionals.

The dreary view of the town’s beige skyline outside my hospital room window reinforced my own ignorant opinion about what prospects there might be in a town such as this one. In my curiosity to learn more about why he would choose to stay in this town, I tried to be as diplomatic as possible (probably failing utterly). In response, he gave me his Instagram account name (jchav58_). Flipping through the photos of this young man’s life, I see a deep and abiding love for all things Northern New Mexico. Rocky Mountain hiking. High desert vistas. Trout fishing. Graduation days. The big pick-up truck his proud brother has finally bought. His grandmother, whose own delight on her face at the first time she went trout fishing in decades is recorded in an IG picture. The infant goddaughter whom Justin is holding on his lap and loves so much. The Christmas carols he plays on his classical guitar. The picture of his mother napping with a gigantic black lab sound asleep next to her.

This is life in Northern New Mexico. This is where new generations of centuries-old, established, local, multi-generational families continue their lives without having to uproot themselves in search of job opportunities elsewhere. Looking at his hometown through his eyes and camera lens, I can now see a landscape filled with love, family, celebration, music, and belonging.

Thousands of tourists blow through this town on their way to Taos for their ski vacation. They don’t look twice at it, except to maybe wonder who might live there and why. Then you meet Justin, who makes you feel just fine about needing maybe just a little bit of watchful help on the loo. And then you see his love for his life on Instagram. And then you might even think that maybe there’s a place for you there too, “I wonder what the job market is like here.”

Now that I’m in transition from stapled patient with my surgeon’s penned initials still visible on my right knee back to functioning observer of passions, trends and patterns, I can see how engaging leadership really is all about managing transitions.

Organized life – business, career, healthcare – is all about reaching through the present toward a better future.

Organized life – business, career, healthcare – is all about reaching through the present toward a better future. And when we remember to bring with us the love, the connection, the community, the traditions that make us who we are, we can transition from judgment to acceptance; ignorance to understanding; control to surrender; fear to confidence; false pride to authentic connection.

It really is going to all be okay.