!Mo and the medics --- agk's diary 25 March 2022 @ 22:07 --- written on Pinebook Pro at kitchen table to Iranian internet radio while Evy and baby are at the beach --- I wrote a discussion board post for school about my experiences of good leadership. It was full of good memories, so I decided to share some of it. Me as a leader -------------- I build teams, mentor, and help people balance life and work. I'm articulate, rational, logical, and persuasive. I'm not an entrepreneur. I establish processes to rapidly solicit infor- mation on what's happening, bring info into evalu- ative deliberation, and develop consensus on what's to be done. My "crisis parliamentary" approach favors brief frequent huddles that don't distract from the mission. In Haiti after the 2010 earth- quake my team nicknamed me "the chaplain": people I manage expect me to be decisive when necessary and check in with anyone who feels unheard. During the 2010 BP Macondo wellhead blowout/Gulf of Mexico oil spill, I consulted with a Houma Indian community leader and long-time anti-toxics crusader about needs her community might have due to new dumping of toxic oilfield waste in old open-air settling-ponds. I consulted with health workers and public-interest attorneys about what they could provide, then harmonized Clarice's needs assessment with my sense of what could be delivered. We founded a free volunteer-run community health center in the Baptist mission in her town. It saw patients for eight months and assisted with the spill's increased health burden. Regular evaluation and reflection maintained consensus and effective clinic operation, ensuring services matched needs. Mo and the medics ----------------- Mo's an incredible nurse under whose management I worked in tactical and disaster medicine settings for 8 years. I was profoundly motivated by her vision of community healthcare, and her sense of who I could be in a community healthcare system. She moved basic healthcare out of any kind of profit logic, into peoples' homes and local society at no cost to patients. All care her people provid- ed was simultaneously education for patients, families, and local health workers toward greater autonomy and community self-determination. She affirmed values: "We're working ourselves out of a job" is one of her catchphrases. "Be a lazy medic: if we prevent it, you won't have to treat it," is another. She had a sense of the right amount of motivation, and crucially the right timing. I was a day late for a clinic in an isolated part of the southwest- ern US desert with Western Shoshone people. I had trouble getting there and had to walk the last 18 miles in the desert. "I'll chew you a new one to- morrow, Anna," Mo said. "Sit down, you look like shit. Ericka, fill a basin for her to soak her feet." When a week later Mo became a clinic patient with the crippling gastroenteritis we were trying to track to its source, which was tearing through the community, I was paralyzed. I didn't think I could make care decisions autonomously. She managed from her cot: "*Now* is a good time to use your nursing skills, Anna," she said sternly. I realized I knew what to do, because of my training and because we'd been doing it all week. "I hate processing" ------------------- Environments we worked in were often extremely high-intensity, dynamic, and dangerous. There were weeks we made do with 4 hours of sleep a night and saw 120 patients a day out of a tent or a small repurposed mosque or corner store. Planning, prior- ity-setting, decision-making, and evaluating effec- tiveness all needed to be done daily, but when? Mo kept meetings from eating into patient care or rest time by getting these tasks done during down- time without making them feel like work. She took off her shoes in the courtyard and propped them up when work slowed (ie after curfew), and offered hospitality so we paused with her. She remarked on something beautiful or funny, and we relaxed. It felt like we were just letting go of our days, yet essential management tasks got done. I often felt more rested after these informal management sess- ions than from sleep. Mo's an ambassador. She built trust and leadership in populations we served. She intuited and tested power structures, then had informal kitchen-table conversations to build and maintain trust with the powerful while we strengthened the leadership and voice of the least powerful. The least powerful tended to be our patients. We aimed to keep their trust and serve them without alienating or losing support of community leaders. "Health care is an opportunity for nonviolent re- structuring of power relationships in a society," she said. "Pay attention to our impact on power here: do we help concentrate or disperse it? If we concentrate it, we're not improving health, and should not be here." Other leaders and followers I admire ------------------------------------ Erin manages me as a BLS Instructor at work. It's not my primary role, but I love doing it, partly due to her management. When I work with her, owner- ship of work processes is clear, she recognizes and praises my strengths (which makes me feel valued--- remember, self-esteem is not my strong suit!), and she helps with my weak areas, like paperwork. Erin sets up the room before I teach and chases me out if I try to decontaminate the manikins after- wards. Everywhere else I've worked, it's been my job to decontaminate the manikins after I teach. She eliminates barriers to my work effectiveness: she books people for the training, and I can depend on having a course roster ready. She's on-call if I need extra hands in the room, but trusts me. She collects feedback about my performance, and sits in sometimes. She offered recognition by nominating me for employee of the month last year, which I won. Esther worked under my management during the first six weeks of disaster response to Superstorm Sandy. She was an amazing follower. I never had any quest- ion of what she'd done or her capacity to pick up more tasks, thanks to our brief checkins, her quiet participation in meetings with medics in the field, and a great whiteboard system. She finished what she started, and brought special skills, including computer skills that provided a better sense of the situation in the most-affected areas. Her communication was clear and direct, without nonassertive or passive-aggressive responses. She was willing to try new or difficult things within reason, knowing I was there to help her learn and grow into skills and abilities she hadn't yet dev- eloped. She had an independent perspective on what we were doing and how well it was working, and was willing to offer her counsel with good humor. There's no moral to this story, gopher friends, just memories of hard work with good people!