Last year I found myself on the hotseat as a leader, being scrutinized and needing to come up with solutions to a major problem. My role at the time included directorship of a multi-organ transplant program at a large academic medical center. A routine certification survey conducted by the Centers for Medicare Services (CMS) revealed an immediate need to make a significant programmatic adjustment due to recent federal rule changes.
Our liver transplant program had operated in consortium with the Veterans Administration for some 23 years. The actual surgical procedures were all performed at the VA facility. The new rules along with the fact that the VA, though ironically a federal program but not Medicare approved, required that all non-veterans have their surgeries performed at the academic medical center.
CMS required immediate action be taken and allowed only 72 days to move the program, a task better suited to a six- to eight-month timeframe.
I was pressed to the extreme of my professional role, under political pressure, with a difficult task to pull off. It was time to take a deep breath.
The timing was serendipitous. I had just begun the six-month Courage & Renewal Academy for Leaders, where I would discover tools and peer support to help me through this difficult challenge. Often we are unaware of these moments, but sometimes we receive the gift of noticing them as they happen.
It was an incredibly complex component of our program to move. It involved operating room systems, retooling lab services and blood banking, training ICU staff, forming a new surgical team, and essentially bringing a total team of 85 people together to make it all happen. At the same time, my immediate VP resigned and an interim VP was named, someone on assignment with limited University system knowledge. Despite the challenging landscape, we successfully made the move within 60 days. Six liver transplants were then performed in sequence without incident.
All these events were the work at hand, but the most important reality that emerged was the simultaneous focus of my inward journey.
The Courage & Renewal Touchstones figured prominently, particularly using silence, being open, listening, and speaking my truth. The peer-circle calls in between the Academy retreats were rich, affording the unique opportunity to explore, reflect, and to grow in “listening.” I appreciated the intentionality of the process and how quickly community developed.
By embracing the Courage & Renewal leadership practices, I was able to establish clearer understandings and enhanced relationships which became essential to the extreme teamwork underway to ensure a successful move for the liver transplant program. It allowed me to find my voice and to help others find theirs.
In courage work, we say “one stands in the gap holding the inherent tensions between realities and potentialities.” And this is exactly where I found myself.
The six months in the Courage & Renewal Academy for Leaders was the most useful, meaningful professional development I’ve experienced in a long time.
When we were asked to write up our projects for the concluding retreat of the Academy for Leaders, I had writer’s block. Then came the spontaneous image of a Maine lobster buoy. I kept hearing the words, “buoy up, buoy down.” Exactly what a buoy does in reality. This became the symbology of the current events in my life. The circles of trust opened the doors.
In holding the tensions around the events of work, or the tensions of maintaining a contemplative practice in the midst of the world swimming around me, the notion of keeping the buoy visible and afloat is an apt metaphor.
When the buoy is submerged, truths are obscured. The practice must become a letting go to allow the tether to untangle, removing the snags that hold the buoy down and create imbalance. In letting go, or simply becoming aware of the snag, the buoy in its buoyancy re-emerges, continuing its role, pointing the way to true self. The snags and the submerging of the buoy are essential to ongoing understanding and awakening. The reality of the snag and the awakening go hand in hand no matter what.
A year later, Courage & Renewal practices remain an extension of some long held practices around silence and mindfulness. Key word being practice. There is no finish line so to speak, just practice.
As I continue to embody this unfolding in my own leadership and life, I am drawn to John O’Donohue’s words:
I would love to live
Like a river flows,
Carried by the surprise
Of its own unfolding.