Category Archives: Personal Leadership

August 9, 2023 · 7:35 am

On being the Ted Lasso of anything

At a conference recently, several of my colleagues referred to me as “the Ted Lasso” of our institutional discipline. I was taken back at first as I wondered which features of this popular television character they thought I brought to mind (beyond perhaps my slightly too generous mustache). But the more I have thought about what I know was intended as a supreme compliment, the more I have come to embrace it. It is both honorable and at the same time aspirational.

Here I have to add something of a disclaimer. There was a pretty long time between when I watched the first Ted Lasso episode and when – following someone’s recommendation – I give the series another try. I thought the premise was another example of the ridiculous situations that characterize television sitcoms: an American football coach called upon to coach a British football (“soccer”) team with zero knowledge of the game who at the same time appears as the stereotypical caricature of a “good-old-boy” American. And frankly, there have been other moments watching that I have taken a pause on the series because some of the themes and language were a bit too much for my relatively conservative background. We eventually watched all three seasons and some episodes more than once. (The dart game may rank among my favorite of any television scene I have ever watched, S1E8.)

Still as I consider what Ted Lasso represents – especially through the filter of analyses like the Steve Cuss Podcasts and his approach to systems theory (Managing Leadership Anxiety: Yours and Theirs) – I embrace the metaphoric compliment and in specific have contemplated several aspects of the Ted Lasso character that I hope my colleagues intended in likening me to him. (These are grouped in an outline from Paul of Tarsus in a letter from prison to his “team” in Philippi). Continue reading →

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June 29, 2023 · 7:10 am

Perspective on a “speed limit” birthday

There are speed limit birthdays throughout life. They are times for us to take our foot off the gas, check the speedometer, maybe pump the brakes a little and make sure we’re still going the direction we intended. (We may also look around and make sure someone didn’t notice that we weren’t going too fast!)

This month I hit one of those speed limit birthdays. As I thought about this point on the journey, I found myself with a list of things I wish I could reach back and tell my younger self at similar, significant mile-per-hour moments. Here is a short list of some of what I wish I could say:

1973 – 15 years old.
High school -> college

  • Don’t be in such a hurry to get to medical school. Life is more than the next rung on the ladder. (It is going to take you most of your life to figure this out.)
  • You don’t need everyone to like you. Some just won’t. And it’s OK.
  • When your Dad tells you that he doesn’t care what you do as long as you’re the best at whatever it is, he doesn’t mean you have to be better than everyone else. He just means for you to be the best you can be. (It will take you most of your life to figure this out, too.)
  • You are going to take a lot of decades trying to lose the sense that you continually have to please your mother. She is already proud of you. You might as well get started on working that through.
  • And be nice to that cute girl you met in American History class. You are going to spend the rest of your life with her.

Continue reading →

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November 8, 2021 · 6:43 am

The Bat-Phone and Leader Presence

Recently I had the opportunity to speak to the mother of an infant hospitalized with respiratory illness in a hospital in another state. She was the daughter of a friend of a relative but it was a joy to speak to her, talk through some of her concerns and reassure her that from what she was telling me, she was in good hands. (Her baby did well!)

In the course of the conversation, I remembered that I knew a senior physician at the hospital and I send him a quick text. By the time I caught up with him a little while later, he had already been to the patient’s room. He missed the baby’s mother but left his card with his cell-phone number in case she needed anything.

His generous gesture reminded me of the “Bat-Phone” we instituted when I was a hospital CEO (Commander) a decade or so ago. I am relatively sure that I stole the idea from Quint Studer or another of the quality and patient experience gurus to whom we owe so much of the great things we were able to do at that facility while we were shaping a “Culture of Excellence.” We shared the Bat-Phone cell phone number with all of our staff, our hospitalized and ambulatory patients – probably thousands of people. I carried the phone with me every day. It was a visible symbol of our efforts to be accessible to our staff and patients. In addition to the phone number, we also had a link on our public and internal websites where people could reach out to the CEO by email directly. Continue reading →

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September 9, 2021 · 9:14 pm

Imperatives of Leadership: A Pandemic Response

“We few, we happy few, we band of brothers…”

The name of this website was inspired by an article on leadership based on two books by Sandhurst military historian John Keegan. The Face of Battle was his 1976 analysis of major battles in history including Agincourt (October 27, 1415). His 1987 book The Mask of Command highlighted styles of military leadership through history and concluded with five of what Keegan considered to be the “Imperatives of Leadership:” kinship, prescription, sanction, action, and example. The 1998 article examined Shakespeare’s speech by Henry at Agincourt (Henry V, Act 4, Scene 3) as an example of Keegan’s leadership imperatives.

In the early spring of 2020 as the COVID pandemic gained momentum, US Army Colonel (Retired) Dr. Jim Ficke and I were asked at the behest of the Governor to stand up a field hospital in the Baltimore Convention Center with a number of leaders from Johns Hopkins Medicine, the University of Maryland Medical Center and the Maryland Department of Health.

Fifteen months later the team concluded inpatient operations after providing care for 1,495 inpatients with COVID. Along the way (and often with short notice) we added missions including a mass COVID testing capability and later numerous community sites that have performed more than 110,000 tests to date. Monoclonal antibody infusions were added in the autumn of 2020 and more than 2,300 have been provided since. And finally, when vaccines became available,  a large-scale vaccination center was opened that has provided more than 122,000 vaccinations since February 2021. The Baltimore Convention Center Field Hospital (BCCFH) is almost certainly the longest continually operating convention center COVID hospital in the nation, and probably the only one where the same team also provided ambulatory infusion treatment, large scale COVID testing and vaccination.

In retrospect, Keegan’s imperatives of leadership were the standard as we established and operated the hospital. In many ways, they were key elements of its success. Continue reading →

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March 31, 2019 · 2:17 pm

Fifth Anniversary

The grand essentials of happiness are something to do, something to love and something to hope for.  Thomas Chalmers

Five years ago today we retired from the Army.

I say “we” because it was a journey for all of us: my wife who as a young girl decided she never wanted to marry a soldier or a doctor, my children who without complaint endured the range of challenges and sometimes the trauma of the moves and military life as well as having a dad who was not around as much as he wishes he could have been, and for our extended family whose children and grandchildren spent more than a decade six time zones away from them. I had to visit three different floral shops to find 30 red roses for my wife that day; one for every year we served together as a family.

We were fortunate right away to be offered a full-time faculty position in pediatrics at the F. Edward Hébert School of Medicine of the Uniformed Services University in Bethesda by my life-long mentor, CAPT (Retired) Ildy Katona. Dr. Katona is a clinician and researcher whom I met as a young resident three decades earlier. We were blessed to be spared the angst of deciding “What’s next?” I treasure my academic appointment in Pediatrics and Military and Emergency Medicine at “American’s Medical School” to this day.

A year after retirement my wife noticed a position listed on an Internet jobs-board at the University of Maryland Medical Center in Baltimore where my daughter, son-in-law and granddaughter lived. I applied, and six months later started work for the medical center as an executive in population health. I wasn’t exactly sure what population health even was, but sensed that what we had experienced in our integrated military health care system began to approach it. It’s safe to say that the definition continues to evolve as the state and national healthcare landscape changes.

In West Baltimore we have found Chalmer’s grand essentials. This is the steepest professional learning curve I have ever been on. The “something to do” provides lessons in leadership and life (including failure) on an almost daily basis. It is a new role, a new “rank,” new organizational culture and system, a new model of healthcare finance and delivery and a new patient population. My wife would say the same thing about her position as a school social worker.

We love the work. (Well most of the time.) But mostly, we love the people we have met. They have welcomed us into their church, their neighborhood, their community, city and civic organizations. After what seemed like a lifetime of working for and serving with service members, we have found new friends and colleagues. They are our “something to love.”

As I have written here before, working in Sierra Leone in the winter of 2014 was a “red pill moment” for me when Dr. Paul Farmer challenged us to consider that the mortality of Ebola was due at least in part to health care disparity. The uprising in Baltimore after the death of Freddie Gray happened two months after I returned. Our nation’s attention was (too briefly) turned towards the stark examples of health care disparity in both rural and urban America. There are few better examples of this in the United States than our city, where disparity and inequity were engineered by what can only be called racist laws and practices in the late nineteenth and early twentieth centuries.

But we have “something to hope for.” I tell people routinely that we have not been here long enough not to be optimistic. I meet men and women almost weekly who have dedicated their lives to righting these wrongs and advocating for those who have been oppressed and dispossessed. Our medical systems are awakening to the idea that health is more than the absence of disease and that health care includes things we have historically ignored: employment, housing, food security, transportation, education and literacy. I see it in the eyes of the medical students, residents, nurses and other professionals at our medical center and across the city. They get it. There is hope.

My mother taught me as a boy that there was a difference between joy and happiness. She told me that happiness is a transient feeling, but that “Joy is a decision.” Joy is the decision to view the past honestly but without regret, the present with openness and zeal, and the future with hope.

Chalmer’s grand essentials of happiness are really then the grand essentials of joy: something to do, to love and to hope for.

We knew them well in our decades of military service.
We are blessed to have found them again in our new home.

Chuck Callahan Henry V 4.3 – Lead from the Front   https://henryv43.wordpress.com/

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June 9, 2018 · 11:05 am

Diversity: Beyond optics to vision.

It was relatively late in my leadership career when the concept of diversity became something we started talking about. (Or perhaps I just wasn’t paying attention before then.) Mandatory diversity training was directed by the organization I was a part of and I don’t remember thinking much of the information. I don’t think I got it.

A few years later in a CEO role I recall a conversation with a younger, African-American member of our staff who became a mentor to me. She was the first to suggest to me the potential role of implicit bias in our employee evaluation process. At first, I pushed back. But I can remember the feelings as her words sank in and I realized she might be right: about our organization and about me. It was a significant emotional moment. I remember where I was standing in my office.

What she said resonated with a concept I had long believed. It was best summarized in an article I stumbled across about an obscure lung disease early in my pulmonology career: “We see only what we look for; we look for only what we know” (Sosman MC, et al. Am J Roentgenol Radium Ther Nucl Med 1957;77:947-1012). We don’t see what we’re not looking for. I think I was beginning to get it.

As the hospital’s senior leader I noticed that most of the faces around our board table looked just like mine; consistent with about 85% of all hospital executives. Our organization and our patients had a very different demographic and I began specifically looking for leadership candidates who did not look like me in race or gender. I had resolved that it was a matter of bad “optics.” At a minimum, a leadership team that doesn’t reflected the diversity of the organization won’t inspire young leaders from different groups to seek positions of responsibility.

But just settling with optics as the reason for diversity also makes the fundamental mistake of assuming that people who look alike are alike. It assumes that all you need to achieve diversity in leadership is to add people who are different than the majority to make the team look good. But you can have bad optics with a team that looks bad or with a team that merely looks good for the sake of appearance. I realize now that I was missing the point about optics.

It was sometime later, perhaps after working in Africa a few times and then settling into a neighborhood where I am the minority that I feel like I am finally beginning to understand.

The lack of diversity in healthcare leadership is a matter of optics.
But it’s not a matter of looking bad. It’s a matter of seeing badly.

A diverse representation of demographic groups and gender at the executive table brings the ability for the entire leadership group to see the issues of the workforce, the patient population and “customers” more clearly and in ways that would be impossible without the range of perspectives.

Diversity is the lens through which the leadership team can look more deeply into the challenges and experiences of a particular group and community (microscopic) and can look farther into the future in envisioning better ways to address the populations’ challenges (telescopic). Inclusion is the willingness and openness of the team to look through all of the different lenses.

I guess I was right about the optics, but was initially wrong about vision. I am still pretty shortsighted at times and I will never say that I completely “understand” or that I get it. That is a conclusion best drawn by others.

But things are becoming clearer.

Chuck Callahan Henry V 4.3 – Lead from the Front      https://henryv43.wordpress.com/

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May 28, 2018 · 8:36 pm

Lead from the front or from the back?

A young colleague asked me recently how a leader reconciles the challenge to “lead from the front” with the recognition that much of the most effective leadership happens “from the back” (a lesson I recognized and attempted to articulate relatively late).

My own leadership journey was shaped as a 22 year old infantry officer. I was inspired by the sign over the door of the Ft. Benning infantry school way back when we were still waiting for Ivan in the Fulda Gap: “Lead, follow or get the hell out of the way.” The school motto is “Follow Me.” With that as background (and the subtitle of this blog site) this tension between back and front struck me as a topic worth considering and provided the chance to write (after an embarrassingly long silence!) And it made me think of Julius Caesar.

“Omnia uno tempore agenda” (“Everything had to be done at once”) is how in his “Gallic Wars,” Julius Caesar described his response to an attack by the Nervii, the fiercest of the Belgic tribes of Northern Gaul in modern day northern France (57 BCE). The attack came at three different points while part of his army was crossing a river and another part was building camp. Caesar describes in characteristic third person “the stress of the moment:”

“Caesar had everything to do at one moment — the flag to raise, as signal of a general call to arms; the trumpet-call to sound; the troops to recall from entrenching; the men to bring in who had gone somewhat farther afield in search of stuff for the ramp; the line to form; the troops to harangue; the signal to give. A great part of these duties was prevented by the shortness of the time and the advance of the enemy…” (II.20).

Caesar details a time of crisis. There was tremendous risk of failure and destruction to his army and to his mission. He describes the chaos that is characteristic of the heat of battle. And he describes “the shortness of time” or “chronos” (“time” in ancient Greek).

At one point in the battle, his Twelfth Legion was in trouble, fighting too closely bunched together, and without many of their small unit leaders (centurions) who had been lost to wounds. Caesar describes his own response to the crisis, chaos and the time-pressure of “chronos:”

“He perceived that his men were hard pressed … he likewise perceived that the rest were slackening their efforts … having therefore snatched a shield from one of the soldiers in the rear (for he himself had come without a shield), he advanced to the front of the line, and addressing the centurions by name, and encouraging the rest of the soldiers, he ordered them to carry forward the standards and extend the companies, that they might the more easily use their swords…” (II.25)

This was a time for the leader to lead from the front. Caesar demonstrated character and courage by personally assuming the risk of failure and death. He demonstrated leader competence by recognizing that his troops were leaderless and faltering: “He perceived that all the centurions of the fourth cohort were slain, and the standard- bearer killed, the standard itself lost… He likewise perceived that the rest were slackening their efforts, and that some, deserted by those in the rear, were retiring from the battle and avoiding the weapons” (II.25).

Caesar recognized the context of the fight with the loss of the leaders, also seeing that they were crowded together in the forest, and “That the affair was at a crisis, and that there was not any reserve which could be brought up” (II.25). And he recognized the critical importance of communication. He called to his centurions “by name;” relying on efforts he had made to know his men personally prior to the battle (having perhaps abandoned the too convenient excuse, “I’m sorry I’m just not good with names”). He called out and encouraged the rest of the soldiers. He knew exactly what they needed to hear.

Crisis, chaos and “chronos” are three occasions when a leader should lead from the front.

Caesar also identified at least two occasions when it is appropriate even in the midst of urgency to lead from the back.

“The stress of the moment was relieved by two things: the knowledge and experience of the troops — for their training in previous battles enabled them to appoint for themselves what was proper to be done as readily as others could have shown them — and the fact that Caesar had forbidden the several lieutenant-generals to leave the entrenching and their proper legions until the camp was fortified. These generals, seeing the nearness and the speed of the enemy, waited no more for a command from Caesar, but took on their own account what steps seemed to them proper” (II.20).

The Roman legions were well trained and well led by commanders that Caesar trusted; who applied their own initiative and creativity to the situation and did “on their own account what steps to them seemed proper.” Even in crisis and chaos, leaders need to lead from the back when they know that their organizations are well trained and that they are led by men and women whom they trust. The temptation to micromanage a project or its architect and to take credit for its success are ways that a leader can move “to the front” when it would be best for him or her to step back and let the group or emerging leader shine.

The use of Caesar’s writing about his imperial exploits is not meant to justify the geo-political drive to conquest any more than it would be to use the example of corporate raids or take-overs motivated by greed. But leaders with any experience know that it only takes a single organizational misstep and social media post or market fluctuation to suddenly create a time-pressed, chaotic, crisis.

It is nice to be able to write your own history. (Is this account the ancient equivalent of a modern-day CEO memoir?) Caesar concludes with what we would hope to realize from our own leadership efforts: “On his arrival, as hope was brought to the soldiers and their courage restored, while everyone for his own part, in the sight of his general, desired to exert his utmost energy, the impetuosity of the enemy was a little checked” (II.25).

The enemy’s impetuosity was “A little checked;” at least for a day.

Tomorrow will be another opportunity to find the balance between leading from the front and from the back.

Chuck Callahan Henry V 4.3 – Lead from the Front https://henryv43.wordpress.com/

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February 11, 2018 · 9:45 pm

Play like you have nothing to lose.

“How many of you have ever worked for a bad leader?”
(Every time I ask the question almost everyone raises a hand.)

“What made him or her a bad leader?” I usually ask. You hear a number of different responses. Occasionally someone will talk about a truly toxic leader. But most of the time the common answer is more like this:
“They only cared about themselves.”

“And how long did it take you to figure that out?”
“About five minutes,” I have heard more than once.

I wondered today whether the common problem with these self-concerned leaders is the inability to play like they had nothing to lose.

Frankly, as leaders we always have something to lose. When we make the hard call, stand by our people, serve as “poop-umbrellas” absorbing or deflecting the “stuff” that sometimes rains from on high we run the risk of everything from taking heat to losing our job or reputation. Which brings me to the events of the past couple weeks.

I confess I have had to resist joining the throngs who have written about the recent Eagles Super Bowl victory, especially as a fan for almost half a century; onephiladelphia_eagles_logo_4008 who remembers clearly the many “almost made its” and “there’s always next years” that have become the stock jargon of Philly fans. But indulge me as I can’t help but think that there is a leadership lesson in their victory this year.

Who goes for it on fourth and goal from the one yard-line just before the half with a trick play that they’ve never run before; throwing to a guy who hasn’t caught a pass in a game since high school? What coach listens to the players on the field and takes a gamble that if it had failed and they ultimately lost the game would have been the play every pundit would point to as the moment of supreme mistake, ultimate error, the deadly “momentum changer” that doomed the game to defeat.

But even after watching and re-watching the clip and listening to the recorded dialogue, I don’t get any sense that there was a fear of taking heat, losing job or reputation as the decision was made.

They seemed to be playing as though they had nothing to lose.

It’s easy to understand why a leader might do otherwise. A politician works hard to get elected and becomes motivated to remain in office. A healthcare administrator works her whole life to become a hospital CEO. An officer begins the journey to general as an ROTC cadet. A teacher gets his masters then doctorate with the hope to one day become a principal and then the day finally comes. The next in line for corporate CEO is competing with scores of others. A coach or player is finally in the Super Bowl…

I wonder sometimes whether the fear we take counsel of is ultimately the fear of loss to self. And whether we can too quickly allow that fear to keep us from taking the risks we must to achieve organizational success. Certainly, there is much at stake. But Teddy Roosevelt has advice for every leader who is willing to get into the arena:

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” (April 23, 1910)

This week the credit belongs to a team of leaders who played as though they had nothing to lose and won.

Next week the same opportunity may be ours.

Chuck Callahan Henry V 4.3 – Lead from the Front      https://henryv43.wordpress.com/

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January 1, 2018 · 2:05 am

On Having Knight Vision

The Holy Grail seems at times a more reasonable quest.

The standard for behavior and rhetoric has become intolerance and abuse. New allegations of harassment and assault are so numbingly common in the continuous news cycle that we can’t remember which actor, which athlete, which politician provided the last denial or tears of reptilian remorse. No one is entitled to their own opinion nor do we “agree to disagree” (whatever that meant anyway). People who see things differently are “idiots” treated with a level of disdain we used to reserve to trot out seasonally for the fans of rival sports teams.

“A man never hurts a woman” my mother scolded after I beaned my big sister in the head with a stone thrown carelessly over my shoulder in her direction. “Walk her to the door!” my dad hissed as I sat passively in the back seat of the station wagon while my date made her way up the sidewalk after a ride home from a high school band party. Offer your seat. Hold the door. Don’t be unkind. Offer it up. Think of others. Do your best.

It seems like a vision from a different world.
But perhaps these days it’s a world worth remembering; one worth fighting for again.

My mother gave me the gift of knight vision.
Not the ability to see in the dark but the desire to push against it. Continue reading →

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July 4, 2017 · 10:24 am

Learning Leadership in the City

Ten TwelveOn a clear, breezy summer Saturday morning in the Sandtown-Winchester neighborhood of Baltimore, 10:12 Sports Director Jeff Thompson speaks to a young player about character in the context of a flag-football game. In the background, the Ravens and the Bengals play the fifth game of their season.

In this neighborhood, 60% children live below the poverty level, 80% of households with children under 18 are female-headed, unemployment is 17% and a quarter of kids never finish high school. The field where the young men play is half a mile from the scene of the uprising and violence surrounding the death of Freddie Gray in 2015.

This is the neighborhood where Jeff Thompson and his volunteers work with young men teaching the fundamentals of character and leadership from a Christian perspective. The lessons are framed against the backdrop of a flag-football league that also employees local youth on weekends as referees, linesmen, and statisticians.

Character is the foundation of almost any leadership model. The ability to “lead self” is crucial before one can attempt to apply almost any other leader competency. There’s much that a developing leader can read about the importance of character and no shortage of books on the subject. But no book can teach what we learn from credible mentors who serve as examples and who listen to understand.

Albert Schweitzer said, “Example is not the main thing in influencing others, it is the only thing.” Leadership guru Michael Useem took that same idea one step further: “Leadership is best learned from example and best communicated through example.”

Still a relative newcomer to Baltimore, I have joined the search for the magic, missing ingredients that once applied will cure the city’s woes. I know already that there isn’t any single thing. But on this Saturday morning these young men – in the context of a community who loves and cares for them and who holds them accountable for their actions – were experiencing the closest thing I have found to a foundational first step.

“Leadership is character in motion” (Les Csorba).

For these young men on any given Saturday there is more in motion than the football and the players on the field.

Chuck Callahan Henry V 4.3 – Lead from the Front      https://henryv43.wordpress.com/

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