The new blog of F. Nicholas (Nick) Jacobs, FACHE, author of Taking the Hell Out of Healthcare
13 Dec
{Taking a business blogging break this week for a little holiday fun.}
This holiday thing is intense. I was reading the other day that people started really getting into celebrating Christmas around 354 A.D. So, we made it from 354 until about 1954 before things really became so commercial. It took 1600 years for capitalism to take hold, but when it did, WOW! I’m not exactly sure what a Christmas recession looks like in other countries, but in the United States, we seem to still buy everything; we just try to get it on sale.
So, in the spirit of holiday capitalism, I went to the mall today with three of the little kids; the six, four, and almost two year old. We went there to see Santa Claus, or, as their mom called him, “The Big Cheese.” When she called Santa that, there was a three kid pause, and finally, the four year old said, “Cheese?” Who is the “Big Cheese?” “Santa,” her mom said, “Santa Claus is the Big Cheese.” Nina said, “Why is he cheese? I thought he was Santa.” By then mom realized that it was not good to confuse little kids about elves, magical people, and such because it was already confusing enough.

Photo Credit: AP
The day’s plan was simple: get their picture taken with Santa. We needed Annie Sullivan, Helen Keller’s teacher to pull off that miracle. The oldest one with two missing front teeth, played with everything in the garage before agreeing to be strapped into his seat, and the baby somehow flipped the lining of her seat and buried the belt latches. Only the four year old, who was wearing her Christmas dress, sliver dancing shoes, and holiday hair ribbon climbed into her seat and said, “Let’s go see Santa.” Not unlike her three year old cousin, Lucy, who spent hours under the Christmas tree staring mesmerized up into the lights and decorations, Nina was completely into it all.
When we arrived at Santa’s workshop, we watched a string of tiny kids panicking on the ole boy’s lap. The two year old was no different. Nothing helped. Squeaking reindeer toys, binkies and funny faces, were all in vain as she screamed in the arms of this strange, red suited man. After the trauma, we bought their Christmas picture. It had one terrified baby and two older kids looking off into space as if a hypnotic alien was on top of the camera. It could have been a scene from “Transformers 2: Revenge of the Fallen.”
During lunch we discovered that Santa had known exactly what the middle child wanted for Christmas, and that he had even discussed the particulars with her in detail. The magic continued. It was also during this meal that we had a very serious reindeer discussion. The boy’s mother looked at me and said, “Ask your grandson to name the reindeer that pull Santa’s sleigh.” So, I did just that. To which he replied, “Well, Poppa, you see, there’s Dasher and Dancer and Prancer and Vixen, Comet, Cupid, Donner and Blitzen plus Rudolph and Olive.” “Olive?,” I said out loud. “Yes,” he replied strongly, “Olive the other reindeer …used to laugh and call him names.” The absolute truth about the reindeer is that Dunder and Blixem, Dutch words for Thunder and Lightning, had their names changed to Donner and Blitzen several years ago for better song rhyming. (Another list of reindeer names that I saw included: Fireboy, Leroy, Pablo and Clarice, so Olive worked for me.)
In fact, this week I got another E-mail describing a third grader who was reading a story in class when he yelled out, “Mr. Markle, what’s a frickin’ elephant?” The teacher walked quickly over to the student’s desk to assure him that he was incorrect when he saw that the boy was reading a story about an “A-frican elephant.”? He was obviously Hooked on Phonics. So, “Ho, Ho, Ho, Merry Christmas to all and to all a good night.”
9 Aug
Since stepping back from my CEO role, I have had time to reflect upon the toll that a position like that can take on any individual regardless of the thickness of their epidermis. I have come to realize that anyone who is completely in charge of an organization faces many of the same challenges.
As a young man, I had serious delusions about what it would be like to be in the role of President. It was kind of a Superman fantasy: Yes, I would be kind, understanding, and fair. It would be my further commitment to be honest, forthright, and ethical in every way. My obligation would be to the people and the patients at all levels. My motto would be “Truth, justice, and the American way.”
Then the big day came, and my tenure began. It took about an hour to realize that it was now my personal responsibility to do everything necessary to generate all of the money needed to make payroll for the employees. In an area with a disappearing population base, that was an extremely challenging task, and as the Sisters of Mercy used to say, “No money; no mission.”
During the money quest, the issues of loyalty and fairness were always rearing their ugly heads. Could you, in this very self-centered culture, ever really expect people to be loyal no matter what your commitment had been to them? I would minimally try to play the role of a benevolent, servant-leader.
I was the guy who would reach out to people who needed a break and then provide them with that break; sometimes against the conventional wisdom. What did I expect in return from them? Simple loyalty. Time and time again, however, those same people who might never have had the opportunity that they were given would turn on me. It became almost predictable.
It took them a long time to believe that they were capable of doing the job that I had personally selected them to take, but usually as soon as they reached their comfort zone they would begin to turn away. Maybe it is just human nature, but even Mighty Mouse would have been disillusioned by this recurring situation.
The other CEO reality is that fairness is situational and so subject to interpretation that it becomes impossible to please or satisfy everyone. The nature of our new collective employee psyches seems to be one of “If it’s not done directly for me, then it’s not fair.” The list of individuals who were brought to the leadership stage over my 22 years in healthcare was voluminous. Dozens of people were given consideration for their education, salaries, promotions, and advancements, yet if one other person was recognized in a similar way, the hue and cry was often, “It’s not fair.”
So, looking back over two decades of running hospitals, foundations, a research institute, and several other spin-off companies, an appropriate summary for any future leader is to “go with your gut.” With that in mind:
You are not now and will never be a superhero.
You are a human being with human frailties.
You cannot right the world or repair dysfunctional childhoods, marriages, or lifestyles through your benevolence.
However:
You can do what you believe will result in the most good for the most people.
You can respect the fact that your efforts could help to continue payrolls for hundreds or even thousands of families.
You can embrace the fact that the vast majority of your mistakes will not be fatal to anyone, but you also need to learn to cut your losses and deal with the disloyal.
One of my mentors used to pull me aside periodically and say, “Nick, you’re doing a great job, but you need to lighten up. We only pass through here once. So, try to enjoy yourself, my friend.”
Now that was good advice.