“My team is not dirty.  All the issues were on their side of the field.  This is a football game, not  a Hallmark Moment.”   Quote from Scott Lago – a Pop Warner football coach in Southbridge,  Massachusetts after a game in which five opposing players all 12 or younger, suffered  concussions.  New York Times

My only grandson, a nine year old, announced that he was going to play football last year.  It made me nervous, but the teams that he played seemed pretty reasonable, and everyone appeared to be fostering a spirit of careful football where little kids were being taught and nurtured.   This year, his second year in the league, he blossomed into a high-speed runner and scored four touchdowns in the first game of the season.    Believe me when I tell you that there was no one cheering more loudly on the sidelines than I was that night.

Several weeks ago, however, my experience totally turned around.  Upon reaching the field, people began to tell me that the team that he was playing only played to win.  None of that made a lot of sense to me until I saw our little guy running with the ball to cross the goal line and a human missile, twenty or more pounds heavier  hit him straight on, helmet to helmet with the force of a predator drone.  It was like watching the NFL but without the $75,000 fine attached.

My heart stopped. I saw my grandson’s head snap back, watched him hit the ground and lay motionless.  Because I was standing only about five yards away from this hit, it left me in a state of complete shock.  Was it possible that someone would train a player to tackle eight and nine year olds like this?  Was it possible that the referee who was not near the incident wouldn’t call a penalty?  Most importantly, however, was it possible that my grandson would not get up or would have a concussion that would negatively impact him for the rest of his life?

Yes, it was all possible, and with the adults from the other side of the field screaming as if each play, each player and each hit would get them a huge raise, or make their lives complete, I had seen clearly before me both the best and the worst of the game.  These little kids, with weight differentials ranging from 20 to 30 or more pounds, are just that, little, and this particular game seemed to have become a blood sport for the adults on the opposite team.

Well, thankfully, he did get up, and he doesn’t appear to have a concussion, but, with four touchdowns from the previous game, he probably had a target on his back, and when I went to his next game, it was with my heart in my throat, and a prayer that saner heads would prevail, and these events will become what they were always intended to be, A GAME, and they did.

As a healthcare professional, I’ve seen too many former NFL stars take their own lives and ran the hospital that actually cared for a local football hero not to be aware of the fact that head injuries are a real potential problem at any age.  This issue is obviously very controversial to people like Coach Lago and those rabid fans that live their lives through the wins of those little kids, kids who just wanted to have some fun.

Interestingly, I’ve been told that coaches are having problems fielding teams in places like Seattle, Washington because the parents who work for Microsoft and Amazon are concerned that concussions could end their children’s’ chances for intellectual advancement.

Maybe we should all spend more time protecting the brains of the teams’ leadership . . . because, if they teach little kids to hit like missiles, they can’t be thinking straight.

Over the last twenty five years, I’ve often felt like a stranger in the heatlhcare world.  Each day I coped with rooms filled with individuals who had finely tuned left brains that were bathed at every opportunity in quantitative information.  This was such a phenomena to me that I became a student and then somewhat of an expert on this topic.  What made them tick?  Why did we see the world in such diametrically opposed ways?

Working in that environment often took me to the precipice of despair as my ideas were dismissed as frivolous, my thought patterns seen as radical and too progressive and my career opportunities stomped on by leaders who, for the most part, saw the world in a very similarly left brained manner.

At each  meeting, a history lesson revolving around previously memorialized numbers was the primary topic of discussion.  Most of the time, these numbers simply raised more and more questions, but, regardless, were seen as the most important part of these sessions.  When ideas were presented regarding impacting these numbers that were not quantitative and linear ideas, the rejections could not come fast enough from the lips of the various levels of leadership.  And when qualitative solutions were added that worked, they were still seen as the first thing to be cut in any budget crises.  (What ever happened to mission?)

Well, as with Karma, sooner or later life throws changes at us, and to many of my former peers, these changes have been incomprehensible, overwhelming and completely stiffling.   Why?  Well, for the first time in my adult life, quantitative is equally as important as qualitative in the world of healthcare.  Think of it.  Your patient goes home from the hospital and in the safety of their own house gets a survey from CMS (Centers for Medicare and Medicaid Services) that asks them, (Are you ready for this?) qualitative questions.   If that isn’t bad enough, depending upon how these questions are answered, your budget could be disrupted horribly, and it won’t be a matter of just lowering the quality of toilet paper to make up the difference.

HCHAPS are making hundreds of my former peers ask questions like, “How much are we going to be cut this year due to poor patient responses?”  More importantly, many of them are finally asking, “How can we change our scores?”

Like I said, it’s Karma.

My formula was relatively easy, but it took a balance of right and left brain to implement it.  You see, no matter what you think, life is emotional, and when we base decisions on emotions, entirely new challenges appear?  “Did your nurses treat you nice?”  “Did you get any sleep?”  “Did your doctor explain things appropriately?”  These types of qualitative questions require a different approach to life and to care . . . it’s “Not just the facts!”

In order to be successful in this new healthcare environment, there is a tremendous need for you and your staff to stop and act like human beings on all levels, to reach out to people, to build relationships, to nurture relationships, to mingle, to care, to be transparent, to pay attention to the root causes of numbers that may evolve from something other than algorithms and more numbers.

It’s time to consider balancing right with left brain; to do exercises that challenge your  creative and humanistic deficiencies; to realize that it is not your full time job to simply react analytically.  We are now in an era of qualitative and quantitative like never before, and if you want to thrive and survive, it is not good enough to have HCHAP scores lower than the average prison hospital.

It is time to look at how you treat your employees . . . do they have HOPE?  Do you ever embrace their ideas and dreams?   It is time to embrace the families with transparency, honesty, openness, and, when appropriate, sympathy.   It is time to wake up and pass out the roses.