!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!
