I have had the opportunity to speak to Mike Matthews, Patrick Sweeney (West Point Psychology and authors of Leadership in dangerous situations) and Tom Kolditz (Author of In Extremis Leadership and developer of the WestPoint Leadership Program). I am slowly compiling my notes and going thru their books. One of the most interesting comments was by Tom Kolditz (author of in extremis leadership). It seems that while most teams want to work as a democracy and by committee, when everything crashes they want a leader who is authoritarian, makes decisions based on input, is competent and (most of all) a leader who they trust and will take their circumstances into consideration (ie will not throw them under the bus). So we have to have two hats when we lead: 1. in day to day business we need to be able to work by committee and get everyone's buy in 2. In a crisis- we need to be the authority, the one responsible for rapid decisions. If you read Marcus Luttrell's book Lone survivor, you see this in action when they are suddenly discovered on the mountain. In the end, their commanding office makes a decision, and even though they know it is a death sentence, do not complain any further and back up that decision.
Dan Vargo: Nice summary of what and how we lead. Good topic for an APDS discussion for teaching leadership.
KL: I was thinking the same thing! I have not been to any prior meetings so not sure if similar leadership topics have been covered or not. As surgeons we simply have to be able to flow into the bureaucratic type for every day business (we have to get things done by committee) but that won't work during a crisis and we have to teach staff to be able to adapt and make decisions on the fly (ie how to do that). I have found that while you can take bits and pieces of leadership information from aviation, police, fire service, Coast Guard and the rest of the military, medicine just does not fit any particular mold (unless you take into account the events of the US Airways flight 1549 in 2009. Now that sounded like a scene from an OR catastrophe.