What's Important Now?

“Please don’t let me die!”

Those were the first and only words he said to me. The young man lying on the sidewalk had been shot multiple times in both legs, an arm, and his abdomen. He didn’t look good.?

Seconds earlier, I had run down the street to the dead-end, the first police officer to arrive on scene. The thick summer air still held the smell of gunpowder. Apart from the distant sirens of additional responding officers, everything was quiet. Questions exploded in my mind: Where is the shooter? Where are my responding officers? Where was he shot? Who else is hurt? Is this scene safe? What will I do if the shooter comes back? What do I do?

Can I actually help this man??

Perhaps you noticed your own stress level rise slightly while reading those questions. It did for me in that moment.?

I anticipated that this shooting might turn into a homicide case and that hundreds of tasks would need to be carried out in the following minutes, hours, days and weeks. In that moment, I needed to focus on only one thing: saving the young man’s life.?

I knew that a life-threatening gunshot wound to an extremity could be addressed with a tourniquet. I focused on applying one to his upper left leg; a single, simple task. Additional officers began to arrive. One applied a second tourniquet to his right leg. Another focused on coordinating the medical response and evacuation of our victim. Another was tasked with scene security. All of our actions flowed from a strict hierarchy of priority and urgency.

Legendary football coach Lou Holtz famously asked his players a question: “What’s important now?” He loved this question (W.I.N.) and directed his players to ask it themselves 35 times a day. Coach Holtz was a successful leader. His 1988 Notre Dame team went 12-0 and was consensus National Champion. He taught his players to focus on the things that mattered the most in every moment.?

Handling overwhelming situations is commonly accomplished through triage: prioritization by degrees of urgency. Dr. Darria Long Gillespie gives an outstanding TedTalk on this subject, wherein she describes the work of Dr. Robert Sapolsky. His research suggested that those who are unable to differentiate threats from non-threats operate with double the level of stress hormones. Who does their best work under heaping piles of stress? You have to manage it. You can do this through triaging.?

Learning how to prioritize your actions can make you more effective and make better decisions at the right time. This is important also for leaders. How does your team focus when things go wrong? Will you teach them how to work the problem?

There are a number of good decision-making tools:?

• The Eisenhower Matrix (right)
• Vroom-Yetton Jago
• SWOT
• Root Cause Analysis
• Decision Trees.?

These systems work for police officers, trauma surgeons, mission control, teachers, and everyone else.

I’ve also found that it’s helpful to seek the input and advice of others, especially when addressing stressful or dynamic situations. Additional perspectives are important and seeking them supports inclusivity and group ownership.?

Like most things, your ability to make decisions under pressure and triage will improve with practice. “What’s Important Now” can eventually stretch into “What’s Important This Week” or “This Year.”?

We later learned that the young man survived his five gunshot wounds. The surgeons told us that our work in the field had indeed saved his life. Priorities were clear in those first moments. Stop the bleeding, get to the hospital.

Triage. Prioritize, Act

What about you? How do you triage in your day-to-day life? Do you have a go-to decision-making tool? I’d love to hear about how you do it, or a story of success.?

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