NYU School of Medicine Graduation
May 19, 2011
Good morning, ladies and gentlemen.
So you’re "there!" All those sleepless nights…all that angst and self-doubt along the way…and here you are, doctors! I’m incredibly proud of each and every one of you.
Okay, I guess I should confess it I feel especially bonded with this class because we embarked on a major new chapter of our lives at the same time – you as medical students and me as Dean and CEO.
And I’m sure you feel special closeness today to all those who’ve supported you so wholeheartedly along the way--your family…your friends… and your teachers. Let’s take a moment to salute them.
I’d like to spend the next few minutes talking to you about leadership. It’s a topic that seems to inspire a lot of discussion these days— in terms both of how crucial it is to solving problems… and how serious the consequences are when it’s lacking.
There’s a recent book by Elkhonon Goldberg, an NYU faculty member, called The New Executive Brain where, by the way, "executive" is used in the neurological sense of the frontal lobes, not in the boardroom sense. It offers a thought-provoking observation about leadership. Of all the talents individuals can be blessed with, Goldberg says, the ability to inspire and mobilize is, and I quote, "the most mysterious and profound…the one with the greatest impact on the destiny of others."
To the degree that observation is true—and I believe it is— I think it’s fair to say that leadership is an extremely important matter for doctors to think about. Whether the setting is an underserved rural area ....an international humanitarian relief organization…or an academic medical center -- a physician serves—or at least should serve—as a guide for other people.
Let me start by talking about what leadership isn’t.
First of all, leadership is not about power. I guess I feel particularly strongly about this one because people at the Medical Center often seem to assume that because there’s this "Dean & CEO" title after my name, I’m a powerful guy.
Well, if I look at my household, I’m a "power" all right...
… a tertiary power…after my wife and my dog!
No one did a better job of dispelling the myth of power than Dwight David Eisenhower in World War II.
You might expect that someone with a title like "Supreme Commander" would excel at throwing his weight around.
But to defeat Nazi Germany, Eisenhower had to align the efforts of strong-willed generals of different nationalities and sometimes fiery temperaments.
Barking orders at people like that would probably not have yielded resounding success! So guess what metaphor Eisenhower used to talk about leadership?
A piece of string.
"Pull the string, he said, "and it will follow wherever you wish. Push it, and it will go nowhere at all."
Which, of course, is another way of saying that if you try to coerce people, you’ll get resistance…but if you manage to connect with their own aspirations, they’ll respond because they want to.
Second—and you’ll see the connection with the first right away—leadership is not about seeking the limelight.
Leaders do find themselves in the limelight from time to time, but that’s a byproduct of circumstance, not a destination.
If you’ll allow me another example from a profession very different from ours, there’s a book with the fascinating title On The Psychology of Military Incompetence, by Dr. Norman F. Dixon. It draws on a century’s worth of examples, starting with the Crimean War, to demonstrate that "glory-seekers" (and others who—consciously or not— seek prominence to prove something to themselves or someone else)…typically make the worst leaders imaginable.
It’s no coincidence that eminent movie directors rarely feature themselves on the screen, except in cameo roles… or that the most distinguished scientists are, almost without exception, the most generous of mentors. Helping others shine is one of the surest hallmarks of greatness.
So, if leadership isn’t about power and isn’t about glory, what is it about? For a physician, I think the answer has three main parts.
First is respect for others.
I’m not sure that all physicians realize just how palpable respect—or lack of it—actually is. Respect gets transmitted in dozens of small but unmistakable ways. Like how long you keep people waiting. Whether or not you look them in the eye …and really listen. And so on.
Doctors who are dismissive—no matter how competent they may be otherwise—typically leave patients feeling less attended to… than if they were buying a car.
For me, respect is not just about attitude; it’s also about action.
For instance, you can use authority in disrespectful ways—like putting what matters to you personally at the top of the list; or you can apply that same authority to the greater good, expediting things that others need to have done.
Another example is what I call "showing up."
I’m a passionate believer in the power of technology to benefit patients. And, like so many other people, I probably couldn’t function without email, which lets us weigh in at all hours of the day and night, wherever we are.
But email doesn’t convey the look in someone’s eyes…or what their body language is saying…or the difference that a caring person’s presence makes.
For building true bonds with other human beings, and showing them that they matter to you, there’s no substitute for being there.
The second key attribute I think your patients need from you is courage— what Hemingway characterized as "grace under pressure."
When you think about what it really means to put the patient first, you see that right away. It takes courage to fight for them. It takes courage to deliver bad news—and especially to call forth their strength without trivializing what they face. And it takes courage to admit when you don’t know what the answer is.
All doctors encounter situations where there’s a downside to every alternative. Courage in a situation like that involves being honest about the risks… owning up to your own limitations…and counseling the course of action that you believe in your heart to be best.
I’d say (and by the way, this is an observation, not a political statement), that President Obama exhibited just that kind of courage in his decision to raid—rather than bomb—the Bin Laden compound. It took "guts" to choose the option that entailed far greater risk of failure…but also a far greater chance of providing definitive answers… while sparing innocent people.
The third leadership attribute I’d like to explore with you in fact permeates everything else: authenticity.
We’ve all heard people say of someone they admire that he or she is quote-unquote "the real deal."
And everyone around them knows exactly what they mean—as if there’s some kind of internal gyroscope that signals whether someone’s authentic… or just pretending to be. Right?
I’d say authenticity is essentially about being who you are, and allowing others to be who they are.
The best example I can think of is South Africa’s first black President, Nelson Mandela, who had a genius for connecting with people—from statesmen…to rugby players.
Nelson Mandela holds pride of place in history for unique reasons, forged at huge—I’d even say unimaginable— cost to himself.
But what he seems to have taken from his ordeals was a profound sense of shared humanity— and human frailty!...somehow, in the process, de-activating the gene that passes judgment on other people…and attaining an inner calm that others felt and responded to, seemingly almost by osmosis.
Mandela, for me, demonstrates above all that whatever power leadership entails comes from within.
So, ladies and gentlemen, there you have it. Respect…courage…and authenticity.
Whatever your own recipe, I hope you’ll make a lifelong commitment to exercising leadership… remembering that it isn’t about "starring" in anything…it’s about offering the best that is in you to those who need your help.
Congratulations to each and every one of you…and thank you very much.