Suspension of Disbelief

When we experience a movie, book, or piece of art, part of the onus is to suspend our disbelief in the artificial nature of the medium. But what if the medium is actually more realistic than the original art form? And how do we allow our minds to move beyond our daily constraints of rational thought to become truly creative? I found myself pondering these thoughts as I was sitting in an open air theater the other night in Laguna Beach during a performance of “Pageant of the Masters.”

I’m on the West Coast this week in part as visiting professor at Cedars Sinai. However, given that both of our sons are here, the trip was expanded to include this past weekend where everyone met in Solvang (where the movie “Sideways” filmed.) The ride back to LA paralleled the Pacific Coast Highway, leading to thoughts of motorcycles with the boys, but that’s for a future blog.



On Monday, we went to Orange County to catch up with some old friends. Tickets had been purchased for a show at the Art Center, where classic paintings apparently “come alive.” Although it meant a late return to LA, at least the traffic on the 405 would be light, and I agreed. Prior to the show, which begins at sunset, an open air art gallery was in full swing. I was never a great student of Art History; however, I am always amazed at how an artist can transform disparate colors, textures, and materials into shapes and objects that elicit a visual and emotional response.

The Pageant has been held since 1936. Classic paintings are recreated with real people posed as if they were part of the painting. The entire experience is set to music with a narrator acting as your guide through the gallery. The theme was “Eat, Drink, and Be Merry,” and ranged from Jan Steen, through Larsson, ending with the traditional DaVinci’s “Last Supper.” Even when you watch the actors being posed, it is difficult to believe they aren’t part of the painting, as the lights are dimmed and then reignited. I was mesmerized, and found myself feeling connected with the artist and what they were trying to capture centuries ago. The rational mind quieted and the experiential mind was released.


So it is with our own creativity. When are able to release our overthinking of what is real, we are able to imagine what can be. For a brief time today, suspend your disbelief and dream. ....And if you're really brave, share the dreams with others.

Motivation

“Remove barriers that rob people in management and in engineering of their right to pride in workmanship. This means inter alia,(among other things) abolishment of the annual or merit rating and of management by objective, management by the numbers.” -Edward Deming, father of Total Quality Management

“Happiness is in the taste, and not in the things themselves; we are happy from possessing what we like, not from possessing what others like.” - Francois de La Rochefoucauld 17th century French writer and philosopher


At school, we are currently involved in a year –long study of quality improvement in health care. I have been to the Institute for Healthcare Improvement, to examine opportunities to help drive a transformation of care delivery. As my classmates and I sit at night in the courtyard of the Brookline Marriott, we debate what influences people in their behaviors. As leaders, we need to understand motivation, both of those we lead as well as ourselves. Is it money? Clearly, we all want to be fairly compensated for the work we do, and have the ability to provide for our families. Yet we all have employees who leave for other opportunities, despite offers of increased pay. Is money merely a way to keep score? “This year I received 4%, last year 3%, so I must be doing better.” But we know in our hearts whether our efforts are consistent with our values and abilities. More importantly, we tend to stay in jobs and relationships where we feel valued and respected. Some of the greatest influences of my own sense of self have not been my paycheck, but the connections and accomplishments I was able to achieve with others. And it is even more apparent as I am examining new opportunities professionally as well as anticipating my return to Haiti the second week in September.

Many of you know that I grew up in a working class steel town in Northeastern Ohio and was fortunate enough to attend good colleges and medical school through a combination of scholarships, loans, and work. My initial goals were to be professionally successful and financially self sufficient, to assure that my children could be raised and educated with a degree of security. I judged my success by external markers. It has only been in the last few years that I realized how right Deming was. The sense of purpose engendered by pride in your work and your life eclipses a number. And many of the most successful leaders I know, who motivate themselves and others on pride and mission, at the same time achieve remarkable financial results.


So it is with a sense of pride in the work and joy in the experience that I am looking forward to my return to Milot, as well as the next phase of my professional life. And for all of you, who are at various stages of your own journey, may you focus the light of your energy toward fulfillment.


And if you make a few extra bucks along the way, and enjoy a vacation or other great experience, so much the better.

Days of Cash and Orders of Magnitude

It has been awhile since I updated the blog, and in some ways, I was wondering what new insights might be interesting and enlightening to those of you still following my thoughts. Then, once again, a confluence of disparate experiences provided me a new perspective.


I’ve just returned from my 3 week session in Boston with my colleagues at the Masters in Health Care Management program. We spent a great deal of time on the financial structures of hospitals, endowment portfolios, and concluded with a project analyzing and rating bond proposals. As my team worked through financial statements to determine liquidity, we calculated days of cash on hand. In all the statements, the numbers were expressed in thousands of dollars. A million looked like a thousand and a billion was expressed as a million. Daily operating expenses allocated to thousands of dollars per hospital bed. It is a necessary shift in thinking as you move toward hospital administration –when your previous individual P&L was allocated to the dollar, small changes could make big differences. Now it is time for me to think on a different scale and with an eye toward the system and not the individual.

So when I opened my email the other day, I was pleased to see an update from CRUDEM and Hospital Sacre Coeur. Although the acute earthquake related patient population is drawing down, it became clear that the Hospital needed to expand to serve the population and increase the range of services. As I was leaving in April, a new NICU had been opened and the Haitian medical staff were being trained by CRUDEM volunteers. Lou Snyder, a cardiologist and classmate in Boston, had visited Haiti last month, including HSC. He was extremely impressed with the infrastructure being developed, and hoped to make cardiology services more widely available. The water plant is up and running, and oxygen system coming on line. I was excited to hear of the progress and commitment to continue to grow beyond the current 83 beds.



All this takes money. I have previously noted that on a per dollar basis, HSC provides high value medical care. So do you want to sponsor the Hospital for a full day (and increase balance sheet liquidity?) You can do so through CRUDEM – for only $2342 (that's just a "2" on our big balance sheets.) The Angel of the Day program gives everyone the ability to help the Haitian people and know where your aid is going. There are other fun events locally, including a Taste of Haiti to be held later in September in Boston. You can look on the CRUDEM site – www.crudem.org for more info.

I will be returning to Milot the second week of September. Through some degree of kharma, it will be six months from my initial visit and I look forward to sharing updates on our patients and the recovery of the Haitian people. I am truly grateful for your thoughts and encouragement. Plus, I need some new pictures to share and experiences to add to the blog. For friends and family that haven't yet been able to travel to Haiti, I hope that my words and images reflect the multiple orders of magnitude returned on your investment in time, money, and support.

I'll be blogging more as the time approaches, and certainly during the trip.