1 WHY LEADING IS PRICELESS

While many authors and speakers have researched, written, or lectured about leading in times of crisis, I have lived it—not just during 9/11, but many times before and after. Leading teams through some of the most visible and dramatic crises of our times is a brand I have been uniquely privileged to experience. The roster includes:

• Leading all health and safety efforts of the National Football League (NFL) Players Association (NFLPA—the NFL players’ union) for more than 22 years.
• Leading as incident commander of the response to the first bioterrorism attack on US soil—the inhalational anthrax attack of the nation’s capital in October 2001.
• Leading the NFL concussion crisis, changing the culture of head injury throughout all contact sports, as well as personally writing the entire NFL concussion protocol, despite significant resistance from the world’s most powerful sports organization.
• Leading the NFLPA response to the COVID-19 crisis from 2020 to 2022, crafting negotiated solutions and protocols that resulted in the ability to successfully complete two of the NFL’s most exciting and successful seasons, despite the challenges of a worldwide pandemic, lockdowns, vaccination hesitancy, and more.
• Leading the medical response to the DC sniper domestic terror attacks as medical director for Fairfax County Police Special Operations and Helicopter Unit.
• Leading the DNA analysis during the Duke lacrosse hoax, which resulted in dismissal of the case and the North Carolina attorney general declaring the players “innocent” in 2007.
• Leading a mobile emergency team deployment to Ukraine, sponsored by the NFLPA and Team Rubicon, caring for more than 350 internally displaced persons during the current war and training over 1,700 Ukrainian doctors, nurses, and paramedics.
• Leading the NFLPA’s 2013 demand for all NFL teams to create Emergency Action Plans (EAPs), which directly resulted in the highly successful and internationally visible result when Buffalo Bills player Damar Hamlin collapsed on the playing field after going into cardiac arrest during a January 2023 game.

Maybe it’s no surprise that my friends began to refer to me as “The Master of Disaster,” a sobriquet that turned out to be prophetically accurate—time and time again. At the considerable risk of hubris, it is something about which I came to take a certain pride, because it is always an honor to lead a team of dedicated people in service of helping others.

I have been honored to give many speeches at national and international meetings and corporations over the years, including several times as the warm-up act for the great coach Lou Holtz. He makes it a habit to attend the speech just before his, both out of respect and to tie his speech to the one before—a very kind and generous habit.

After my speech on leading in times of crisis, during which I had mentioned many of my most challenging experiences, Coach Holtz began what proved to be a very moving speech. He turned his attention to me, sitting in the first row, and said, “Doctor, planes crashing into the Pentagon, the first bioterrorism attack in history, players with head trauma . . . has it ever occurred to you that you might be bad luck?!”

Perhaps as the Master of Disaster I was bad luck, but it has been my privilege to serve others in those roles in my career. I was uniquely ready and able to step up and lead.

Those experiences and many more taught me an invaluable lesson:

Leadership Is Worthless . . . But Leading Is Priceless

Why Is That True?

Leadership is worthless . . . because it’s a noun, the things you say—just words. But leading is priceless . . . because it’s a verb, the things you do—actions, not just words.

However, leading is not only a verb, but a verb in the active voice. Everyone, at every level and in every job, organization, profession, and family, is actively leading through the things they do in these turbulent times of cataclysmic change, which is the fundamental nature of the world in which we live. They are leading themselves, families, friends, and the teams in which they work.

Don’t wait to be summoned to a national or world stage to lead. You are already doing it. Don’t focus on “future leaders”—lead today and every day. By focusing on “leadership,” we have been focusing on the wrong question. To Kierkegaard’s point, the most important question, but the one least often asked, is:

How will I lead myself and my team today?

My experience has also taught me a corollary lesson, learned from Frances Hesselbein, former CEO of Girl Scouts of the USA who was one of the world’s great experts and practitioners on the art and science of leading:

Leadership is a matter of how to be, not how to do it .2

You must replace the wistful, passive word “Someday . . .” with the declarative, active word “Today!”

So, you might ask, how can you move from “Someday” to “Today?”

First, don’t aspire to be a leader, because you already are and you always have been. People have been treating leadership as a “someday” aspiration when it is a “today” reality we all face. This simple epiphany is essential to leading in the active voice.

Second, embrace the fact that you are leading and delight in it. Of course, there is both some good news and some bad news here (which is often the same news). The good news is that The Boss doesn’t have what you want—it is already within and among you, personally, in teams, and in families. The bad news is that with the realization that we are leading, we can no longer lay the responsibility (or blame) on The Boss’s desk. If we need to lead better (and we all do to different extents in different situations), then we have it within ourselves and our teams to do so.

Stop blaming The Boss—start leading your life.

Embracing your life as a leader is a commitment to live in the No Blame Zone, that special place where we know we have the answers within and among us—not above us. (And the No Blame Zone includes not blaming ourselves . . .)

Third, inspire every member of your team to lead as well. Leading and inspiring others to lead are inextricably linked—they cannot be separated. Your actions will inspire others to take actions to lead themselves and lead their teams, just as their actions inspire you in equal measure. Choose your actions and words carefully to reflect and inspire others to lead.

I have three key goals for you to pursue as you practice the art of leading:

• Think
• Act
• Innovate

First, think about leading in a radically different way. The current paradigm of leadership is inadequate for the tremendous challenges we face today. It’s essential to lead yourself and your team instead of waiting for your chance to lead.

Second, act on those thoughts within the week, because if you don’t lead through actions within a week, I am sorry to say you probably won’t act on them at all. Not because you are a bad person, but because that is simply human nature, as multiple studies have repeatedly shown.

Don’t put your thoughts on a shelf; put them to work in your life—this week.

Like basketball or lacrosse teams, you are on a shot clock, but your leader shot clock is seven days long, week after week after week.

Third, innovate yourself and your team by changing the system—and yourself. Remember: The way we’re working . . . isn’t working. We live in times of crisis precisely because our challenges are both turbulent and disruptive. But as we will see in some detail, humans crave stability and being settled, even if they are at times unhappy with the ways that they live.

As we’ll discuss later in this book, the speed of innovation occurs not at the speed of intelligence, audacity, genius, or even creativity. Innovation occurs at the speed of trust. It is all our responsibility to innovate, and not that of The Bosses in the C-Suite.

Leading is a constantly renewing process in which we think, act, and innovate to lead others and ourselves.

Leading through multiple national crises led me to the conclusion that there is no true leading except in times of crisis. The crucible of crisis is the place where our actions define our leading.

Captain “Sully” Sullenberger shared a similar insight with me over dinner one evening in Wyoming, when he said, “You aren’t truly a pilot until the engines go silent.”3

“What are you until then?” I asked, wondering what those people flying airliners were actually doing when the engines were working the way they were supposed to.

“You are just a driver,” was his immediate response. “A very experienced and highly trained driver, but still a driver.”

The same is true of leading. You can only truly become a leader once the scatological stuff hits the metaphorical fan, otherwise you are just in charge—a caretaker, a manager. And being in charge but not leading is a horrible place to be.

The COVID-19 pandemic taught us many lessons, not the least of which is that every one of us lives in times of crisis and we will likely continue to do so for the rest of our lives, given the rapid pace of change in which we find ourselves. In the past, an appropriate metaphor for change was navigating the whitewater of Class V rapids in a kayak—exciting, exhilarating, enlightening, and . . . frankly, potentially dangerous.

However, once through the rapids, there were calm, placid stretches of the river where you could not only reflect on successfully navigating the rapids, but also enjoy the flat water and the scenery surrounding it at your own pace before the next set of rapids appeared. (And for those of you who have never kayaked, the paddle is not to propel you down the river—the river does that. It’s to steer, stabilize, change direction, and ultimately, to keep you upright—all decent metaphors for leading . . .)

That was then and this is now. Today, we find ourselves in the perpetual whitewater of change. We shoot from change to change to change, creating the reality that the only constant in life is change. Most people don’t mind change; they mind being changed, which is a far different process that we will learn more about in future chapters. Since leading only occurs in times of crisis, it will be a critical skill for all of us. We should expect crises, change, and innovation to be a constant companion—today, tomorrow, and beyond. World War II general George Marshall got it perfect when he said:

The choice is leading by action or losing by default .4

Too often we lose by default by failing to embrace leading and inspiring others to lead each day. Aristotle was correct when he explained:

We are what we repeatedly do. Excellence, then, is not a virtue, but a habit .5

That’s precisely why leading is a verb—we are what we repeatedly do.

Over the course of my 22 years in the NFL, I have worked with over 10,000 elite athletes. Not one of them has ever talked about leadership, demonstrating leadership, exhibiting leadership, or the principles of leadership. But all of them, in one way or another, have said some variation of the following:

Leading by example

Leading from the front

Leading teams

Leading by being

Leading every snap, all game, all season

They understand the verb “Leading” because it is something they do, a part of who they are, while “leadership” is an abstraction.

For those who fail to understand it, leading can be horrifying, but in fact it is glorifying.

I think we all know that leading matters, but all of us may not know exactly why that is the case. Here are some of the most important reasons why.

First, everyone at every level is a leader, in every action they take. You lead yourself and you lead your team.

Second, every leader is a performance athlete, just like my 2,500 NFL athletes, involved in an endless cycle of performance, rest, and recovery. As a leader, you invest in yourself and you invest in your team.

Third, the work begins within . . .

You might be wondering by now why I keep telling you that every person is a leader. Is it really true? Is everyone really a leader?

I have found in my many years of leading that this is a universal truth, though not as widely understood as it needs to be. Regardless of your position in life, and whether your title is mom, dad, sister, brother, clerk, entrepreneur, business owner, chef, restaurant server, bank president, bank teller, doctor, nurse, and on and on, you are a leader. You are leading your life, your business, your team, your family, your community, and more.

Leading not only has no regard for rank or social status, but it also has a healthy disrespect for titles, ranks, and other such false and arbitrary distinctions. Leading is life’s universal leveler and democratizing force. Perhaps that is precisely why those in power or at the top have benefited from the false distinction that there are bosses and there are hired hands. What term could possibly be more demeaning than hired hand, as if The Boss wants your labor but not your mind?

On February 2, 2020, Super Bowl LIV in Miami’s Hard Rock Stadium featured a close match-up between the National Football Conference Champion San Francisco 49ers and American Football Conference Champion Kansas City Chiefs.

With 7 minutes, 13 seconds left in the 4th quarter, the Chiefs trailed 20–10, and had just had a reception for a 1st down by blisteringly fast wide receiver Tyreek Hill overturned by a San Francisco challenge flag. This resulted in a 3rd down with 15 yards to go from their 35-yard line. Quarterback Patrick Mahomes, playing in his first Super Bowl, was not performing particularly well—so much so that announcer Joe Buck had just said that Patrick needed to play better and that the Chiefs needed some “Mahomes Magic” if they were going to win.

As referee Bill Vinovich reviewed the prior replay, Patrick spoke with Coach Reid and offensive coordinator Eric Bienemy. He asked, “Do we have time to run Wasp?” (By “time,” he meant, did he have enough protection from the offensive line for the play, since Wasp takes a full 4 seconds of protection due to the deep route being run.)

In the huddle that followed, the play call was, “Gun, Trey Right 2–3 Jet Chip Wasp, Y funnel.”

While that string of words might sound incomprehensible to most people, each word in a play call has a specific meaning to a professional football player. It’s not unlike the way that as an emergency physician, my description of a “ventricular tachydysrhythmia with unstable hemodynamics” is completely clear to my team, but not to the average person. Here’s an explanation of the call in detail:

Gun = Shotgun formation, with the QB lined up 5 yards deep

Trey Right = Tight end to the right and three wide receivers are lined up on the left side of the formation

2–3 Jet = Line protection call, with the offensive linemen sliding to the most outside threat for the left tackle and the right guard, right tackle, and running back are on the 2 defensive linemen and linebacker on the right side

Chip = 6 man protection package, with help to both offensive tackles to chip the edge and slow down the defensive ends—this is what will be needed to get the “time” Patrick referenced in his question

Wasp = Slot receiver Tyreek Hill runs a deep post-corner route, starting downfield, then cutting across the middle (post) before cutting sharply back to the outside (corner)

Y funnel = The Y receiver funnels toward the middle of the field, pulling the defensive back with him and clearing open space for the Wasp7

At the snap, Mahomes executed what was in effect a seven-step drop (most quarterbacks only take five). Defensive tackle DeForest Buckner of the 49ers had executed an outside stunt, looping around the left tackle, even with the chip on the defensive end, who had crashed down inside, and was bearing down on Patrick, forcing him to retreat, and just as he was hit 14 yards behind the line of scrimmage, he released the ball in a high arc. Patrick had gotten—barely—his 4 seconds of protection to make the throw, which came off his front foot, not his planted back foot as usual.

The 49ers were in a 3-deep zone coverage, known as “Cover 3,” which in essence divides the deep coverage into three zones across the field. The cornerback, who had the outside third of the field, stayed with the wide receiver furthest toward the sideline, instead of covering Tyreek Hill, cutting across the middle from the slot. Before Tyreek made his final cut to the outside—turning the safety, who was now covering him, completely around—Patrick had released the ball, knowing precisely where Hill would be.

The ball traveled 57.1 yards in the air, an unbelievable distance yet right on the money. Hill caught it and was wrestled down at the 49ers 20-yard line for a 44-yard gain, turning the game around. The Chiefs went on to score on this and the next two possessions, winning the Super Bowl 31–20. Patrick had gotten the time to run “Wasp.” The Chiefs has gotten their Mahomes Magic!

Why was this such a powerful approach?

First, Coach Reid’s philosophy is a wise but nonintuitive one where, as important as innovation is, the key is the trust in his coaches and players to make suggestions at any time, without any fear of criticism or reprisal. That’s diametrically opposed to “I’m not paying you to think. I’m paying you to run.”

Andy Reid understands that every person on the team is a leader—lead yourself, lead your team!

Second, every team member, like all 2,500 of my NFL players, is involved in a never-ending cycle of performance, rest, and recovery, performance, rest, and recovery. Leading, while essential and universal, isn’t always—or even often—easy. Leading is taxing, requiring energy, focus, and creativity as the challenges loom before us. Leading always involves failure, as we’ll explore in Chapter 4. We must invest in ourselves and invest in our teams to replenish and reinvigorate our skills, preparing us for the next cycle, the next challenge, and the next crisis.

Leading by everyone at all levels, while exhilarating, is also exhausting. Take time to develop your resiliency/adaptive capacity. Invest in yourself, invest in your team . . . it’s a solid foundation both in the NFL and in life. Performance, rest, and recovery is a cycle through which we all go. But too few of us take the time to invest in rest and recovery.

Third, the work begins within. In starting with ourselves, we attain the energy, motivation, will, and tenacity to change the system. To be sure, the system will need to be changed. Dr. Paul Batalden, a healthcare innovator, expressed it well (channeling thoughts of Arthur Jones of Procter & Gamble, who expressed a similar thought earlier):

Every system is perfectly designed to get precisely the results it gets.8

If we are not completely delighted with the results we are obtaining (and no one ever is—at least not for long), then we must change the system, not just the people within the system. Too much of the literature on leadership focuses on exhorting the masses (often using posters and slogans) and getting the hired hands to work at their maximum potential. But to have the energy and tenacity to change the systems in which we live and work, we must first change ourselves.

Which leads to this corollary:

   The work begins within . . . but it turns toward teamwork.

We start by strengthening ourselves, but we turn quickly toward the importance of using that energy and adaptive capacity to build and maintain teams.

During the Russian invasion of Ukraine, our Mobile Emergency Team, Med Team A, comprised Dr. Dave Young and me as emergency physicians, Liane and Summer, our badass nurses, Chris, our flight-trained PA (physician assistant), Steve, our firefighter, Breaux, our team lead and firefighter, as well as Earl, who led logistics for the entire team. These individuals came from all over the country to the war zone of Ukraine, but we were not individuals—we were a driven, passionate, cohesive team, leading our parts of the whole.

In the next chapter, we’ll discuss the importance of leading teams, but we start with ourselves, embracing the fact that we lead all day, every day, in every action. Leading matters because everyone at every level will spend every day of their lives in the crucible of crisis and change. In leading yourself, you lay the foundation for leading your teams. In changing the lives of others, you change your own life. In leading toward possibility, you lead away from deniability and those who constantly crow, “That’ll never work!”

But as Wayne Gretzky, one of the greatest leaders in the National Hockey League once said:

You miss 100 percent of the shots you don’t take .9

Take your shot!

(To emphasize the role of teamwork, remember that Gretzky is the leading goal scorer in NHL history at 894 goals . . . but he also had 1,963 assists. And Matt Danowski, my son’s teammate at Duke, was the leading goal scorer in Division I lacrosse history when he graduated at 170 goals . . . but he also had 183 assists. Great leaders may attain glory, but they are even more generous to their teammates.)

My beautiful and brilliant wife, Maureen, and I have three wonderful sons, now grown men. When they were younger, whenever I was in town, I drove them to school in the morning. And when I dropped them off, I always said precisely the same thing to them, which was:

One more step in the journey of discovering where your Deep Joy intersects the world’s deep needs.

I swear I said that to them. They preferred to take the bus! The point is simple, but important. The world’s deep needs are infinite and often impenetrable. You must start with—and stay constant to—your Deep Joy! Everything else is a distraction.

Burnout occurs when we allow the job stressors to disconnect us from our Deep Joy. Reconnecting to our Deep Joy—our True North, our raison d’être—is the core of curing burnout, and the core of leading in times of crisis.

You may also refer to Deep Joy as your passion, and this is a perfectly reasonable formulation as well. In following our Deep Joy or passion, we are constantly reminded (preferably every day in every interaction) of the extent to which those actions are true to the Deep Joy. Sun Tzu understood this as he clearly demonstrated, in his wonderfully terse way in The Art of War:

Every battle is won before it is fought.10

The battle is won by those who know their Deep Joy and stay true to it. To be blunt, this isn’t always easy—in fact, it is never easy at first to say, “While this looks like a great short-term opportunity, I must say ‘No’ because it takes me away from my Deep Joy.” That’s hard, that’s tough. The only thing harder and tougher is to cave in and do the expedient thing . . . and then navigate your way back eventually.

As a physician, part of my Deep Joy has been caring for patients—people from all walks of life—who have taught and given me much more than I could ever give them in return. In my work with health-care systems, I show them a photo of a young female physician jumping for joy and ask them a simple question:

While the photo is of a physician, it could just as easily be anyone doing any job anywhere. Regardless of what kind of work you do, I have a question to ask: Is that you?

Now, let me ask a follow-up question: “Is that you? Going in to work . . . or going home?” Because it is my contention that all of us, no matter where we work or what we do, deserves to feel that way going in to work, not just going home. To do that, we need to reverse the jump, and the first step in doing that is to reconnect to our Deep Joy, which is critical to leading authentically and with intentionality. Leading requires unleashing that jump for joy in all of us.

Here are two ways you can reconnect to your Deep Joy:

First, get a photo of yourself in your formative years. It might be from grade school, junior high, high school, college, your first job, your best job, or the day you were married. Now explain to that young person in the picture what your Deep Joy was. Tell her if and how you have stayed true to that Deep Joy. If not, why not? And if not, how will you navigate your way back to it? (Hint: It starts by leading in every action of every day . . .)

Second, some people prefer to use the magical tool of the written word, using simple declarative sentences. If you’re one of those folks, write a letter . . . to yourself . . . from yourself—the person you have become. Answer the same questions as above. Don’t be surprised if either path becomes a bit emotional—these are matters of the heart, not just the head. And don’t despair. I guarantee there are ways to reconnect with your Deep Joy, which we’ll share together throughout this book. Your journey back to it can be transformational.

And for what it’s worth—and at the considerable risk of hubris—years and even decades after I have given speeches or done consults, people often approach me to say, “Your statement about rediscovering my Deep Joy is the best advice I’ve ever gotten.” So, I believe it just might be worth the effort . . .

With these thoughts concerning leadership and leading, we’ll next turn to why “Leading Alone Is Worthless . . . But Leading Teams Is Priceless.”

• Leadership is worthless . . . because it’s a noun, the things you say—just words.
• But leading is priceless . . . because it’s a verb, the actions you do—not just words.
• Think, act, and innovate—because the way we’re working isn’t working.
• Replace the passive, toxic word “Someday . . .” with the healing word “Today!”
• Everyone is a leader—lead yourself, lead your team—the leader you are looking for . . . is you!