Early on in my health care career, a consultant was hired by the system executives to evaluate the management team of which I was the newest member.  After about two days of interacting with the CEO, COO, CFO, VP of Nursing, VP of Human Resources and me, the consultant candidly pulled me aside and said, "Of all of the management teams I have interacted with, this team has the lowest ‘Buzz‘ level I’ve ever encountered."  My response was, "What do you mean?"  To which he replied, "I had to check to see if they even had a heart beat." 

It was about three months after that visit that, one by one, the team began to move on.  In fact, I had a group photo of the seven of us and, one by one, the team began to vanish.  It was like the movie, "Back to the Future," where the faces disappeared from the page until I was the only person left from the team. 

The lesson that I learned was that you need to Buzz to survive.  It’s funny because, as I look over our teams, my personal radar takes me right back to the old Buzz level!

Now, the Buzz that I look for is not a negative, gossipy, whiny, cry baby buzz.  It’s a pumped up, positive, excited, let’s-grow-and-go-and-make-it-happen buzz.

If I want to be depressed, afraid, or to encourage myself to move back to Fayette County to live in an abandoned coke oven, there are absolutely people in the hospital and research institute that, no matter what the day or time, can take me there.

On the other hand, if i want to see a phenomenal future, feel total optimism and get the adrenaline flowing, I can find people here to take me there, too.

Which one are you?

Don’t answer.  Walk up to the mirror and answer this question out loud to yourself.  "How are you doing today?" 

Okay, Buzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz!!!

Let me begin by putting all of my cards on the table. This is not meant to be a sour grapes rant. It’s intended to keep us focused on this short journey through time and space called life. It’s meant to remind us how much nicer it could be if we simply embraced The Golden Rule. No, not the one about "He who has the most gold rules."

As a birthday gift to my retired brother, my present to him was a trip to San Diego to see the Chargers vs.the Steelers. Please, no applause, it was partial payment for a lifetime of IOU’s.

During this four day journey into uncharted waters, we had an opportunity to observe literally thousands of people in every aspect of living. To begin to express the contrasts that we witnessed might be as difficult as differentiating between the management style of Curious George the Monkey compared to General George the Patton.

The one-for-all-and-all-for-myself mentality clearly won out in this climatic paradise known as San Diego. Rudeness, insensitivity and some deeply misplaced anger ruled the day at the game. Passion and sportsmanship were outweighed by alcohol, anger and toxic behavior.

In mixed company with children present, the screaming attendees in our section sounded more like x-rated rappers than passionate fans. Believe me, I’m no goody-two-shoes, but, seriously…it was somewhat NUTS. There were fights, near fights and taunting wishes for fights. There was a point at which, during our walk out of the stadium, we had a genuine feeling of "will we get out of here with our limbs intact?"…and THEY HAD WON THE GAME.

The purpose of this blog is not to bore you with sports information, it is to question the future of our galaxy. Will we fight and scream and kick ourselves into oblivion when there are clearly better choices? It’s like the current contrasts between North Korea and the Amish. What an amazing example they have both presented to us this past week.

It doesn’t have to all be about conservative or liberal politics, religious choices, or one sports team versus another. It can be about humanness. It can be about this journey together on this tiny little planet called Earth and about making that trip with dignity, understanding  and human consciousness.

My very first day in hospital employment was as an administrator.  Granted, only one employee reported to me, but, nevertheless, my title, position and responsibilities all screamed out: white collar, exempt employee.

Administrator: one who administers, one who is "in charge of affairs," one who presides over the dispensation of something, one who looks after and tends to the needs of SOMEBODY.

Can leadership be learned?  Absolutely, yes, but only to a point.  First, you need to get the informational base needed to survive in the area you’re administrating.  Then you may work by assisting another leader.  You might run a smaller department or shop, and, in the process of learning, you discover situational ethics, the art of building cohesive support, accountability, et al.

There are many who believe that genes are imperative in this process, but is is my belief that genes alone won’t do it.  Drive, ambition, work ethic, sacrifice and experience help as well.

As a civilization, we tend to run in packs and continuously choose leaders to take us through each day.  Interestingly enough, the higher up you go as a leader, the less important specific subject knowledge usually becomes. The key, however, seems to be the ability for the leader to articulate a vision, to actually have his followers embrace that vision and to have trusted advisers who will be encouraged to be honest.

You can be given the tools, but it helps to have the spirit behind your efforts.  As former presidential candidate Adlai Stevenson said: "It’s hard to lead a cavalry charge if you think you look funny on a horse."  Self confidence is an important part of leadership.

Another wonderful quote that is key in the leadership business came from Mr. Stevenson’s rival, and the man who defeated him for the presidency of the United States, Dwight D. Eisenhower when he said:  "You do not lead by hitting people over the head – that’s assault, not leadership."

What has happened to leadership in the United States?  It’s been interesting to observe the evolution from liberal to neoconservative.  It has been frightening to absorb the complex bi-ethical embracing of a culture that worships movie, music, and athletic stars who are totally liberal while chastising and destroying anyone with political aspirations who has ever admitted to any slip from perceived perfection.  It became quite disconcerting to me when our country began to require our leaders to be cardboard cutouts in order to qualify for office.  We are human beings, and being led by someone who is not one is only a self-created vision bordering on the delusional.

We are taught to be forgiving, to accept ones brother with his human traits, and to understand that this is a very short journey that gives us a very finite number of years to make a difference in an otherwise confused environment.  As John Quincy Adams said on leadership:  "If your actions inspire others to dream more, learn more, do more and become more, you are a leader."

That’s all I’m looking for. . . that’s what we should expect, to dream more, to learn more and to become more. . . to reach our potential to do good, to stop pain and war and suffering when possible, to move humanity even one more inch toward some type of sanity. 

I’m not sure why I wrote this . . . must have been the whole grain Cheerios.

My childhood home was an hour south of Pittsburgh, one of the greatest steel producing centers in the industrialized world.  During those young years, my childhood was interrupted several times a year by adults who were attempting to help prepare us for the worst, the possibility of a nuclear holocaust.

We used to practice hiding under our desks at school and would go into the hallway and cover our heads to protect ourselves from the flying glass.  (If you ever saw the films from the true tests, those desks were not impervious to the Hydrogen Bomb, and the hallway would probably have become a collection of toothpicks, but it was all that we had.)

As a young paper boy, while walking home from my last customer, I can remember looking south toward Pittsburgh and wondering what the fireball and mushroom shaped cloud would look like when the Soviet Premier would finally become so frustrated with our democracy that he would launch the ultimate attack . . . on Pittsburgh.

Imagine my lack of surprise when I moved to Johnstown, PA and discovered that at least one of the Superintendents of a steel mill here had their own personal bomb shelter, or that The Greenbriar had  a special underground shelter for our U.S. Congress.

Thankfully, the need to follow through with this planning never manifested itself as a reality in my life.  My dad, however, was born around the 1918 flu epidemic, and his parents couldn’t get a doctor to come to the house because the doc was very busy.  That disaster did become a reality.

On the other hand, Y2K made plenty of my computer specialists friends a great deal of money.  Except for Cindy, a member of our Y2K team at the hospital, who accidentally leaned against a light switch at midnight, nothing of significance happened, anywhere in the world.

We can only pray that the current flu pandemic, the dirty bomb in New York Harbor and the premature death of our generation’s overweight kids will also not become reality.  We can hope that, like my hydrogen bomb preparations, our time will be invested in worrying about a future that never arrives.

Fortunately, I’ve been trained to worry. It’s been my history.  Most days, if i don’t have some serious degree of anguish, it’s probably either because I’ve slept in or was under some form of anesthesia for a medical examination.

Consequently, at my organization, we are working to protect you from whatever disaster lurks out there.  It’s our job to be prepared.  Steve, our internal co-coordinator for disasters, sent me this e-mail this morning:

The weekend was well spent in Boston, MA.  Even though it was foggy, rainy, and generally miserable here all weekend, we had time with a wonderful group of people representing Planetree at a conference with the Institute for Healthcare Improvement and the Institute for Family-Centered Care.  Nearly 100 professionals and patients were gathered here to discuss the United States healthcare system.  At my table of experts were some wonderful people from Washington, Texas, Arizona, New York and Boston.  The following is an e-mail that I received on Sunday.  I hope Dale doesn’t mind that I’ve included it. It truly says it all about the need for reform.

Dear Nick,

I am Justin’s Mom, who "happened" to be sitting next to you at the conference yesterday. I have experienced a rough 5 years of dealing with a system that, I thought, was meant to comfort and heal. I wanted to thank you for your much needed expressions of compassion. You did some healing yesterday that you may not be aware of.

I was very much impressed by the work that you’re doing, the lives that you’re saving and the example that you’re setting. I am proud of you! Having a forward thinking, multitasking CEO with compassion and sensitivity to lead, will make the difference. I truly believe some people will never get it and need to be replaced by those that do or this whole industry will make a thunderous fall. Having a mother beg for transparency following the unexplained death of her child while in a physician’s (hospitals) care is the highest form of inhumanity imaginable. Yet, the practice of silence is accepted and continues without even looking back at the personal affects of the tragedy. My goal is to say, NO MORE!

Your courage to take the reins and be in charge and lead your organization with a conviction for doing the right thing, fighting the good fight, has to work. When the not knowing became less important than the not caring, a friend from Walter Reed wrote: "We are truly social animals who need to know that someone cares. That is not a weakness; but, as a friend said, "A basic need like eating and breathing.” (I quoted him in my Powerpoint presentation for Yale med residents.)

Most Sincerely,

Dale Ann Micalizzi
Pediatric Patient Safety Advocate
Dale’s Blog at SignalHealth.come
micalizzidag@aol.com

PS Justin played the trumpet too 😉

When I was a kid, I was pressed into service for every fallen soldier’s funeral, every Memorial Day event and every parade. You see, I was the trumpet player who played TAPS, hundreds of times. Sometimes it was for a funeral for an elderly WWI vet. Sometimes for (at that time) a middle-aged WWII vet. The Korean vets were few and far between, but the most meaningful and difficult for me were the newly killed Vietnam vets because they were my brothers. Their birth dates were my birthdate. Their girlfriends were my girlfriends. Their families were my families. I stood by a tree or above the grave site, and many times trembled with my own tears echoing the tears of the loved ones being interred.

The two most difficult times were both lifetime memories. The first was November 24, 1963, alone, in the middle of my high school football game, in the middle of the field, I played solo taps for John F. Kennedy, our president, who at that time was my generation’s personal hero. The man who brought youth, excitement and challenge to our nation.

The second was atop a Bank Building in Indiana, PA where I stood in full uniform as a non-com in the Reserve Officers Training Corps, looking across a sea of 1,000 uniformed soldiers lined up on Philadelphia Avenue, knowing that many of them were waiting to be shipped out to Vietnam. Many of them were my friends, and many did not come home.

I do NOT miss playing TAPS, and wish that the world would stop producing the need for them.