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On the Other Hand

2018; Wolters Kluwer; Volume: 40; Issue: 18 Linguagem: Inglês

10.1097/01.cot.0000546341.44669.be

1548-4688

Brian J. Bolwell,

Advances in Oncology and Radiotherapy

leadership; oncology: leadership; oncologySometimes I have an odd connection with a movie that reminds me of elements of leadership. I recently saw Molly's Game, a movie about a woman who is an elite athlete, has a severe injury that derails her athletic career, and winds up running high-stakes poker games. She ultimately gets arrested, and the feds put extreme pressure on her to tell them about her contacts. It's a dilemma for her; if she gives up on keeping her information confidential, she will be spared jail time. Alternatively, she knows that whatever information she has might destroy lives, including spouses and kids of her contacts. She feels she has a moral obligation to keep her word and her loyalty to those who trust her. The pressure to reveal her information is intense, but she never caves. In her mind, the only thing she has left is her word, and her ability to do the right thing (defined by her and her criteria for the “right thing”). So, she remains quiet, at significant personal cost. I have watched it several times as I'm want to do. For me, the entire movie boils down to doing the right thing, even with the risk of significant negative personal consequences. It led me to one of my favorite leadership books, The World's Most Powerful Leadership Principle: How to Become a Servant Leader, by James Hunter. Hunter says that leadership is all about character, and “character is our moral maturity and commitment to doing the right thing regardless of personal cost.” Additional fundamental principles about leadership include supporting your team by removing obstacles and addressing political challenges that might be in the way, freely giving credit to others, delegating tasks and being patient about achieving long-term results, the necessity of self-awareness, and the goal of self-improvement. Every last one of these is important. What is not written in leadership books, however, is the potential downside of practicing these core leadership principles. Let's start with giving credit to others. This is a fundamental part of leadership—it's not about you, it's about the team. A few weeks ago, we had our largest fundraising event of the year. It's our fifth year of the event, taking place over a weekend, and we are lucky to have a great team leading it. My input into the event is not robust, but I try to add guidance as needed and always give public speeches that most think are pretty darn good. It's important that I am involved and in attendance. This year, our event was spectacular. At its conclusion, the sponsors sent around a congratulatory email to all involved in running the event. I thanked our primary team and said they deserved all the credit. Which is true. The challenge is that after about 10 subsequent emails, it became obvious that these outside sponsors believed that I had nothing whatsoever to do with the event. Hmmmmm. The speech was really good... yes, the team did all the work, and deserve all the credit but just be ready when those outside of the inner circle think that your involvement was minimal or nonexistent. You have to be ok if people think that you're uninvolved, even if you are. Another key leadership principle is to delegate. In the short term, it may take longer for tasks to be executed, but in the long term it's worth it because you will be developing leaders and building your leadership bench. Fair enough. The challenge, of course, is when you need to execute results immediately. All the positive karma of delegation flies out the window when a deadline is missed. Consequences pour down on you. What's wrong with you? Are you ill? Are you looking at other jobs? Why are you so disengaged? You are forced with the decision to do it yourself or wait for the other person to get it done. Maybe you can do the task together but beware the downside of delegation if you're responsible for a deadline that could be missed. Then there is the issue of removing obstacles for your team. Fighting the battles that need to be fought. I believe that this is essential for a leader to do this—to support the team, to have their back. The risk is that you may become the character “Rescuer” in the Karpman Drama Triangle—a social model of how people sometimes play one of three rolls in a conflict. The roles are the Victim (who feels oppressed and helpless); the Persecutor (the villain; in this case, whoever is creating the obstacles for your team); and the Rescuer (who unwittingly enables the Victim to fail and keeps the Victim dependent.) The Rescuer also can use the Victim as a vehicle to advocate for their own personal issues. Beware of falling in to the role of Rescuer. It's a role that I have sometimes foolishly adopted, usually with negative results. People can think you are simply combative, or nuts. It's important that you are aware of this risk as you embark on a quest to advocate for your team. Usually they can manage things just fine on their own, especially if you have people with grit on your team (Oncology Times 2017;39(13):16,39). If you do decide to enter into conflict on their behalf, make sure that your advocacy is about objective team-related issues, and not personal ones. Finally, one of my favorite leadership principles is the importance of self-improvement and self-reflection. I recently re-read parts of The 5 Levels of Leadership by John Maxwell. He quotes Wayne Schmidt who said, “no amount of personal competency can compensate for personal insecurity.” He emphasizes the importance of self-reflection and how important it is to continue to learn, both about the world and to keep learning about yourself. So, I do this a lot. I think a lot about all the mistakes I make during the day. I think about how I could have handled a situation better. I keep reading books about leadership. I keep reflecting. Unfortunately, there is real risk that you become too self-reflective and decide that what you really need is intense therapy with a shrink. Self-awareness and reflection DO have limits. Sometimes you are better off just moving on. Sometimes it's just better to get on an elliptical machine and listen to music. Going back to Molly's Game, there is really no downside to trying to do the right thing. The worst-case scenario is that you will have to deal with professional (or personal) negative consequences. But even if you do, you should have the inner satisfaction of knowing that your actions were based on your inner value system and that, if you had it to do over, you would still do the same thing. Molly could live with herself because she held on to her integrity. As a leader, that should be what we all strive for—acting with integrity. Leadership is hard but extremely rewarding. It is essential to keep fundamental leadership principles in mind as you navigate the waters of leadership, which are often turbulent. Just be aware that you may need to amend your personal budget to pay for your weekly sessions with Joe or Jane the psychologist. BRIAN J. BOLWELL, MD, FACP, is Chairman of the Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner School of Medicine. Cleveland Clinic is a top 10 cancer hospital according to U.S. News & World Report.Brian J. Bolwell, MD, FACP: Brian J. Bolwell, MD, FACPStraight Talk: Today's Cancer Centers