A very privileged, middleclass rant about change

I’m a week into rehab from hip surgery. It laid me low for a few days until I got fed-up. I’m restless at the best of times but this was OTT fidgetiness!

The meds were bad news so I ditched them on day 4 – not because “I can handle the pain” (I can’t) but because I reckon the body knows when you should push and when you’ve pushed it too far. After all, that’s the point of pain – risk mitigation. It’s a warning system.

I’m now on the couch after delivering a webinar we forgot to reschedule in the rush of delivering back-to-back stacked weeks before the op. It was about personal responsibility during change. I’m knackered but fizzing.

And I’m thinking about how surgery and change are similar. Here are some random thoughts:

Symbols, rituals, artefacts all matter.

Two things struck me throughout the 2 days I was in hospital.

Firstly, everybody I came in contact with asked me to confirm I was indeed me. Makes sense – you don’t want to get that wrong when sharp things and drugs are involved. The surgeon chatted with me before the op and asked me to confirm what he was going to do and which leg/hip joint he was going to operate on. Then he took out a purple sharpie and drew a massive arrow on my thigh pointing to my hip. It’s the simplest, yet most effective way to not mess this up AND it gave me some agency. We were in this together ….. nah, that’s bullshit to see if you’re still reading – he was totally in control and I was going to be out to it so I had little agency.

However, by asking me what he was going to be doing was checking my understanding and also handing over some responsibility. There was no coercion, this was my choice. Walking people through change and asking, and then answering, questions is a must. We must also recognise that the timing of asking “do you have any questions?” tends to suits us (the asker who controls the process) and often doesn’t suit the person concerned. Be sure to build recipient thinking and question time into your change process, then double it. This is not consultation; this is human-centred leadership.

The second thing was a red wristband that noted the two things I had a confirmed or suspected allergy too. I liked this and told me there were some safeguards in place and that someone took these seriously. They got these from the 6 page pre-admission form I completed (and messed up) about 10 days before surgery. Going under a general anaesthetic gave me the willies.  This was my first time and having had a procedure on my heart 10yrs ago that required I was ‘awake’ but completely at the mercy of albeit very clever specialists to pump me with adrenaline and set off my heart racing at 240 bpm so they could fry a little piece inside said heart, I didn’t like the thought of what these peeps were going to do during the 3hrs I was asleep and pretty much naked (yes, I’m a closet control freak with trust issues). To think those 3hrs felt like a few seconds is a bit yuck, and why they even bothered with the paper undies ….. that I wasn’t wearing when I woke up? Some things seem a little pointless.

Anyway, my point is – in any change there are some things you don’t mess with. One is providing certainty when you can, and to do this boldly using multiple mediums. When I’m nervous I stop listening and my ADHD and dyslexia go through the roof. Forget about asking me to read and complete a form at the best of times, but on that morning those forms were liquid and everyone’s questions were overwhelming. I told the admitting nurse this and we sorted some easy adjustments I’ve used for years. I suspect people who think/feel/believe they have less agency may have just tried to act normally, as I would have done in years past for fear of not wanting to get in the way of seemingly slick professional processes. Being too scared to ask for time, for a statement to be rephrased or to actually answer truthfully “no, I don’t understand” only adds to patient stress and probably impedes the ability for all those fancy medical professionals to do their job properly. Change is stressful and most of us hide, mask or cover-up how we’re really feeling. When leading change, always ask what people need to feel at ease with the process and where they’re currently at.

Oh yeah, that red wristband not only told me I was important and not to be messed with, but it was also on the side I write with. These little things give you the sense that you matter in an otherwise factory-like process and that they’re thinking about your recovery as well as the actual imminent procedure.

Words matter as much as actions – you’ve got to be uber-transparent in both.

Having said I wasn’t really listening prior to surgery, I sure as hell was afterwards. As a patient you hang off every word your surgeon says to get a glimmer of hope. For me this was about when I can run again. When leading change, people are looking for you to provide hope. Be careful with your words, but not too cautious. Always be truthful.

We have more choice than we think and it’s often around the things we don’t think of.

I have to unlearn and relearn some things; most of all I have to unlearn my old running style and learn to do it differently. This pisses me off because I have a really efficient, relaxed stride that WAS NOT the cause of my injury but IS the barrier to not reinjuring my hip. During change we tend to personalise the cause and effect (why me? What could I have done differently? What does this mean for me?). Sometimes this is healthy; sometimes not. A leader’s role is to provide honest clarity. It’s everyone’s role to action the letting-go of what’s in the way of making progress. I could stay pissed off or I could change the way I run when I get the chance in a few months. That’s my choice. In change we all have choices.

Pride gets in the way of (a) accepting change, and (b) letting people help us.

I had to be pushed in a wheelchair to the plane at Chch Airport, a place I walk through every couple of weeks. I felt tense & embarrassed. I’m more embarrassed now when I think some people permanently don’t have a choice and that was for me, only temporary. I resisted the wheelchair even though the staff saw I was struggling. My need to feel ok and make progress was stronger than my willingness to just let people be kind and do their job (not to mention keep everyone else safe from a drugged-up, crutch-wielding maniac).

Oh, and surgery itself IS NOT change.

Change comes afterwards in the recovery and rehab phases, which is why we need to have a core team/support crew around us. Surgery is a necessary evil, an inconvenience and a time-suck. Sure, it is the start of the repair process but it’s not THE change. All that comes now.

Restructures, realignments, re-whatevers are just organisational surgery and often act as patches.

The change really comes once you’re out of the operating theatre and in the ward, then back home – you never get to go back that place where the pre-op stuff happened, nor is home how it was prior to surgery. Organisations are never the same before and during change (I don’t believe in there being a point of ‘after’ change – it never really ends, nor should it), which is the point right?

We also wait too long to implement change.

In 30yrs of competing in endurance sports, I’ve never been injured …. Until I did …… 5yrs ago. I thought I could run through it, take some time off, manage it with copious physio and several missed diagnoses. I wasted 5 good years of smashing goals thinking my body was a healing machine because nothing had taken me out before, yet all the evidence showed I wasn’t healing. What a dick! We do this with change – hope for the best and persevere. Or we jump to conclusions and initiate change when it’s not needed. Either way, we’re horrifically poor at judging timing, scope, scale and impact – both of change and our abilities to deal with injury … or at least I am!

Finally, change and rehab are individual.

Teams may go through change, but each person experiences their own version of it. This can be vastly different among otherwise similar groups. Likewise, we may get diagnosed with the same injury and require the same procedure, but the experience before, during and well after are unique to the individual. When leading change, don’t assume one-size-fits-all and check-in often. Better still, check-in about how each person wants to be checked-in on, how often, how and to cover-off what specifically? Change is a leader’s prime opportunity to deliver outstanding customer service, and your customers in change are your people.

On the meds front – I reckon there’s a danger in masking pain, especially at work.

1. What are your organisational meds - how do you and your colleagues mask the pain of change in order to get by, be seen to cope, and just ‘get on with it’?
2. What would better look like and would this happen if you stopped taking those painkillers?
3. What organisational ‘wristbands’ do you have in place that give people assurance in times of change – not false hope, but actual assurance?

Feel free to add your ideas of the similarities between surgery and change in the comments. Feel free to also be ridiculous – I need a giggle.

Be good and take care. Now back to Netflix

Take care

Callum