Are you afraid?

Fear – Feeling of anxiety, frightening thought, reverence or worry.  Synonyms include terror, dread, anxiety, horror, distress, fright, panic, alarm, trepidation and apprehension according to the dictionary.

My wife is the strongest and bravest person I know.  Like many women, she had a fibroid tumor.  The tumor was causing increasing hemorrhaging every month.  She barely recovered from the prior month when the cycle would start again and each was worse than the last.  Like so many women, she could not bring herself to face surgery.  In addition to not wanting to scar her perfect, beautiful body, she like most of the rest of us was horrified of the operating room.  Her fear was such that she was practically willing to die rather than submit herself voluntarily to surgery.  Nothing I said or did had any effect on Jo Ann.  She was not going to have surgery as long as she could cling to the hope that the natural process of menopause might ultimately solve her problem.

One morning, I awoke around 5 AM to find Jo Ann gone from our bed.  She was not in the bathroom.  As I got up to see where she was, I found her; on the floor beside our bed in the middle of a large pool of blood.  I was horrified, I thought she was dead.

A few hours later, Jo Ann found herself at Northside Hospital in Atlanta under the care of Dr. Benedict Benigo, Jr., one of the nation’s best gynecological oncology surgeons.  She was told that there was no alternative to surgery as she received blood to strengthen her for what was to come.

The family was allowed to accompany Jo Ann to the pre-OP holding area.  The anxiety of anticipation was building by the minute nearly past the point that a human can bear.  There were prayers and hugs but nothing seemed to be having much effect.  Then Dr. Benigo came to her bedside and what happened next changed my life forever.  He took her hand.  She was trembling with fear.  He asked her if she was afraid.  With a heartbreaking voice that was cracking, she told Dr. Begnio that she was so scared that she did not think she could bear what was coming.  Looking gently into her eyes and squeezing her hand, Dr. Begnio said with confidence and empathy I cannot adequately describe, “I am not afraid.”  He went on to say that he had done this procedure hundreds of times and that everything was going to be OK.

There is no drug that that could have had the effect of his simple, empathetic words, “I am not afraid.”

The surgery was successful, a benign tumor the size of a cantaloupe was removed and Jo Ann recovered to be more vibrant and vivacious than she had been in years.  I emerged from the experience with a totally different view of my work in hospitals.

Years ago, I made a conscious, career and lifestyle choice to go into Interim Executive Services.  I had no idea what I was getting myself into, how I would be changed and what a wild, crazy and fulfilling experience my life would become.  Since then, I became so enamored with my work that I went back to school to obtain a doctorate degree in healthcare administration focused on evidence based leadership. My dissertation, the only one of its type is on Interim Executive Services.

A transition is a scary experience in a healthcare organization.  A senior executive leaves on short notice, then another, then another.  The nightmare this induces seems to go on and on.  I know of cases where multiple leaders left concurrently and I worked in a situation where nine executives departed on the same day.  What is happening?  Why is it happening?  Who is behind the events?  Who is next?  When will it stop?  What is the organization trying to accomplish?  The fear this produces can paralyze an organization.

As an Interim Executive, I do not have a ‘job’ in the traditional sense in the organization.  My role in a transition is to stabilize the situation and help the organization to move forward through assessment, recruitment and on-boarding of new leadership.  I have addressed transitions in my previous blogs.  I have talked about the opportunities they create.  I have addressed the question of what  the leaders in the organization should be doing.  I have addressed the process and course of executive transitions.

In this article, I want to discuss fear.  Fear is a natural reaction to a perceived threat that is not fully understood.  It is a natural human instinct that can have a favorable effect.  I have learned that I am at my best in an environment where there is fear and uncertainty.  Why?  Because I AM NOT AFRAID.  Sometimes, I might be one of a very few or possibly the only member of the leadership team that is not afraid.  Why?  Because I have nothing to lose in the transition.  I am not rooted in the town and I come into an organization as others are exiting.  Actually, I do have some fear.  Voluntary Boards of Directors and most senior executives have little or no experience with transitions.  My fear is based on concern that I will not reach the requirement of need for leadership created by the transition event and the Board’s hope that I can lead a healing of the organization and make it better.  I have seen Interim Executives fail and that is a bigger disappointment to a Board than the event that precipitated the need for the Interim Executive in the first place.  I am human too.  I have a larger fear of failure than most people know or that I let on most of the time.  I am just not afraid of losing a ‘job.’

I endeavor to bring calm and order to a chaotic situation because I have nothing to lose.  I have but one objective and that is to help the organization get through the transition and on with its life, hopefully better for the experience.  I have found my calling.  Most executives have only one or two organizational transition events in which they are a leader during the course of their career.  I have been through a number of these events.

The ability to manage fear separates mediocre leaders from excellent leaders.   When an event precipitates fear, the Executives that are capable of leading the organization to the next level quickly distinguish themselves from those that cannot.  I discussed a situation that created absolute horror for the participants in a previous article.  It is an amazing phenomena to see the behavior of executives in an organization during a transition.  The difference between those that are paralyzed with fear and those that see and are striving for the opportunity created is palpable.  Some people rise to a challenge while others are frozen when the environment starts demanding more.  Some people relish change and opportunity while others mourn what used to be.  Some people need structure and predictability.  When structure and predictability are disrupted or eliminated, they panic and seize up.  Unfortunately, all too often this places them on the bus that is headed for the transition destination.  Interestingly, this phenomena is not the fault of the organization.  The transition may be induced by the organization but it has no control over how people will react.  The people react as they will forcing the organization to make adjustments because the Board will see to it that service to patients and fulfillment of the mission will continue in spite of personnel turnover.

It is easy for me to to tell you to not be afraid.  I can say from having experience in transitions and having been through more than one as a ‘victim,’ it is not fun.  ‘Still and yet,’ we must press on.  We are charged to make every aspect of our organization better.  It is being demanded by the environment and the patients we serve.  Fear is good.  It gets the adrenaline going.

An interesting aspect of combat is that there is no way to predict how humans will react in a combat situation.  The big he-man is reduced to a blithering idiot frozen in place sobbing for his mother while the meekest of the group steps up and says, “I have had enough of this,” as they demonstrate super-human courage and leadership.  Similarly, organizations cannot predict who their best leaders will be during a transition.  Some people are energized and come to life in an unstable situation and others hunker down.  Excellent leaders make themselves known when the chips are down and their leadership counts.  A moron can run something when it is in good shape and the environment is stable.  The essence of leadership is manifested and tested when it matters.

What kind of leader are you?  You have to acknowledge that fear is normal.  Everyone has fear.  Get over it.  Get up and get going.  Inspire those that are looking to you for clues as to how they should be responding.  If you have fear for your job, the best way to lose it is to fail to step up when the organization needs your leadership.  Fail in this situation and you have voted yourself off the island.  An administrative assistant once told me that the only leader the organization had ever had that was worth a hoot was the CEO that did not need the job, did not want the job and did not care whether the organization kept him or not.  His singular focus was to make the place better and he was comfortable doing the right thing for the organization without regard to his job and letting the chips fall where they would.

One of my favorite quotes is from Dr. Claire Lewicki (Nicole Kidman) in the movie Days of Thunder.  If you have not seen that movie, it is full of excellent principles for living and leading in organizations.  Substitute the word fear for control and see what you think. “Control is an illusion, you infantile egomaniac. Nobody knows what’s gonna happen next: not on a freeway, not in an airplane, not inside our own bodies and certainly not on a racetrack with 40 other infantile egomaniacs.”

“The only thing we have to fear is fear itself,” – FDR

“Letting sleeping dogs lie is for fear of the dogs.” – A friend

“The Lord is with me, I cannot be afraid.  What can man do to me?” – The Bible

“Do one thing every day that scares you.” – Eleanor Rosevelt

Google the words “Fear Quotes.”  That will keep you busy for a while.  There are thousands of concepts for you to contemplate and mediate upon.

Fear is a natural and normal reaction to instability and the unknown.  In order to be a successful leader, you must master this emotion and harness its energy to focus your efforts into being a better and more effective leader.

What is your mantra?  Mine is that, I AM NOT AFRAID.

Please feel free to contact me to discuss any questions or observations you might have about these blogs or interim executive services in general.  As the only practicing Interim Executive that has done a dissertation on Interim Executive Services in healthcare in the US, I might have an idea or two that might be valuable to you.  I can also help with career transitions or career planning.
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This is original work.  This material is copyrighted by me with reproduction prohibited without prior permission.  I note and  provide links to supporting documentation for non-original material.

If you would like to discuss any of this content or ask questions, I may be reached at ras2@me.com. I look forward to engaging in productive discussion with anyone that is a practicing interim executive or a decision maker with experience engaging interim executives in healthcare.

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