Monday, September 12, 2011

9/11 and Doctors

On the 10 year anniversary of 9/11, I woke up to tributes, memories, and stories playing on every television channel.  The poignant accounts inspired me to write the following letter to our 15,000 Doctors for America members. 


9/11/2011

Dear Anna,

As we sat down this morning to watch the 9/11 tributes, we, like so many of you, were touched repeatedly by accounts of heroism and stories of loss.

One civilian tells the account of heading toward the collapsing towers, feeling he had to do something to help people who were trapped. "You forget what you're supposed to do, what you're taught to do in school," he said. "And you do what's right."

Inspired by such heroes, our country has carried the memories of those we lost, and we continue to seek healing.

As physicians, we are no strangers to the search for healing. Our commitment and our calling to heal is the foundation stone that has remained constant in our work over generations. So deeply ingrained is this ethic that it compels us every day to look past differences in culture, politics, religion, and philosophy and to join hands with fellow physicians, nurses, administrators, pharmacists, and thousands of others in the name of a higher cause.

As one Doctors for America member put it: “No matter how much of a difference of opinion you have with other people at work, you can nearly always get them to come together around what's best for patients."

On a day like today, it's hard to escape the idea that the world needs more healing. It's hard not to wonder what the world might be like if we were able to cultivate more of the "People First" principle in our relationships, in business, and in our politics. While that may seem like reaching for too much, the fact that millions of health professionals around the world have made this our credo and our practice gives us a reason to believe that it can happen.

When thousands of Manhattan residents fled south on the morning of 9/11 looking for an escape from the growing inferno behind them, they were greeted by the unforgiving waters of the Hudson which offered no path to safety. The panicked crowd continued to grow until the US Coast Guard made a key decision: they issued a radio call to every civilian ship in the area asking them to join in an unprecedented citizen rescue mission.

The response was overwhelming. Within minutes, the Hudson was covered with scores of boats streaking toward the southern tip of Manhattan. They pierced through the dense cloud of dust and debris and brought soot-covered people on board, offered them water, and ferried them to safety. In 9 hours, over 500,000 people were rescued. The 9/11 Boat Lift became the largest boat rescue in the history of the world.

The 9/11 Boat Lift was powered by ordinary people. They were never trained in emergency response. Many of them would never have described themselves as heroes, but as one of the boat responders said, "I believe everyone has a hero in them. You've got to look in. It's in there."

Such responders had every reason to flee for safety themselves. The choice they made compels us to ask why they didn't.

Vincent Ardolino, the captain of the Amberjack, said his wife thought he was a maniac for wanting to take his boat toward Manhattan. But he knew that he had to go. "Never go through life saying you should have," he said later reflecting on the decision. "If you want to do something, you do it."

Today, the airwaves and our hearts are filled with sacred memories. In the days ahead, as we ask ourselves what we can do to fix our politics, mend our economy, and make the world a safer place for everyone, we keep the stories of the 9/11 heroes and victims in our thoughts. Stories that reaffirm that above everything else, it is our common humanity that makes us one people.

As individuals who have dedicated their lives to the healing of humanity, few are more equipped to take this message forward than you.


Thank you for all you do.

Wishing you, your loved ones, and your communities peace,
Vivek, Alice, Carol, Chris, Evan, Mona, and the rest of the Doctors for America Team

Values Penetration Index

A few minutes ago, I, along with millions of others, received an email from the CEO of Borders bookstores announcing the end of their 40 year enterprise. I don’t know much about what caused the company to fold, but something struck me in CEO Mike Edward’s email:


“I feel privileged to have had the opportunity to lead Borders and play a role in the true and noble cause of expanding access to books and promoting the joy of reading.”


I was moved by this simple but profound mission. It felt important, like it was about increasing happiness in the world. It felt larger than profits and market share. And I felt all of this despite not being able to remember the last time I went to a Borders and having no real loyalty to the store.


I wonder what it would be like to work at Borders if you felt that was your mission: to promote the joy of reading. What if your job first and foremost - whether you were in sales, customer service, shipping, accounting, or janitorial services - was to bring more happiness into people’s lives through the experience of books? What if you knew that this was the express mission of every single person in the company and you were reminded of this in a million small ways every day? What if at your holiday parties, staff meetings, and individual reviews, this was the goal that was discussed and strategized first? That feels pretty powerful and quite unifying. I could imagine it being a lot of fun too.


A lot of companies have compelling missions and values. The real question is do these missions and values percolate down to the employees and influence their actions and experiences? Or are they merely pithy claims which remain confined to web sites and employee handbooks?


If you’re running a company, a non-profit, a government agency, or a pick up sports team, I think the above questions are critical. What is your Values Penetration Index (VPI) - the degree to which your group’s values are reflected in the day to day experience and actions of your employees and volunteers? The greater the VPI, the higher the happiness quotient among employees and customers. Ultimately, this means better business and better service.


Now, to apply the VPI to myself as an individual: do the values I write about and dream about percolate down to my daily interactions and decisions?

Saturday, July 9, 2011

Finding inspiration over platanos maduros

Last night, I had dinner with a man who is literally building his dreams. Iftikher Mahmood is a Bangladeshi pediatrician who practices medicine in Miami. He’s in his forties, has three children, and is married to a woman he adoringly describes as “my voice.” My first impression when greeting him at the entrance of La Carretta Cuban restaurant in the southwest corner of Miami was that he was that this was a man with quiet fire inside him. He also radiated warmth.

My father introduced me to Iftikher because he thought we’d connect over our shared love of social entrepreneurship. Over a meal of mahi mahi, arroz con pollo, and platanos, Iftikher told me about an effort he has been running for the last 12 years to improve access to good health care for the poor in Bangladesh. “Especially women and children,” he added. Iftikher is trained as a physician, not as a manager, an entrepreneur, or a development expert. Yet, through the sheer force of will, he has built hospitals and clinics that have served tens of thousands of patients, brought health professionals from all over the world to volunteer in his villages, and inspired a growing list of organizations to fund his efforts - including the government of Japan.

Iftikher related the story of his Fistula Program, an effort to help women who have developed pathologic connections between the birth canal and either the bladder or rectum. A distressing condition that causes incontinence and social isolation, these fistulas are most often the result of prolonged, obstructed labor which goes untreated. Not surprisingly, poor women in developing countries are by far the largest group that suffers from this condition. The treatment is surgical repair that costs a few hundred dollars on average. Both the expense and the lack of available services mean that most poor women go untreated. The resulting human cost is high: a lifetime of embarrassment and physical discomfort, social isolation, and related depression.

Iftikher convinced a surgeon from France to perform 15 of fistula correction surgeries in 1 week in his hospital in Bangladesh. By comparison, there were no other hospitals in Bangladesh that were providing this surgery according to Iftikher. He showed me pictures of patients who had been treated in the fistula repair program. The joyful, relieved expressions on their faces spoke volumes.

Iftikher has ambitious plans for the future: expanding the network of clinics and hospitals and bringing in more health professionals to train local care providers. My father is one of the physicians who Iftikher recently recruited to volunteer time in the clinics in 2012.

Halfway through our conversation, as I was flipping through the wirebound program summary he brought along, I saw a donation page requesting $500 for a lifetime membership. I seriously thought about donating on the spot. What’s more is that I found myself working hard to think about people who I could tell about Ifthikar’s projects.

It’s a powerful thing when you feel called to go to bat for someone within 15 minutes of meeting them. Part of it was the amazing results Iftikher has generated. Part of it was his improbable story that took a lofty dream and transformed it into a rapidly evolving reality. He did this not with his management training, personal wealth, or connections (he had none when he began) but with single mind devotion to a vision he held of a better Bangladesh. It was Iftikher’s unqualified, heartfelt commitment that inspired me to want to act and spread the word about his projects. I’m pretty sure that's also what has inspired so many providers and patients to join his cause.

I suppose it’s no surprise that Iftikher’s organization is called The Hope Foundation (www.hopeforbangladesh.org). Hope is what he provides wherever he goes. Hope for a happier, healthier life. Hope for a way to participate in making the world a better place.

As I left dinner feeling hopeful and inspired, I was thinking about how many of us are hungry for more inspiration in our lives. When we sense it in other people, we are drawn to them. When we sense it within ourselves, even for a brief moment, we feel exhilarated and connected to the world, and we ignite a fire in those around us.

I believe there are sources of inspiration around us that we probably overlook each day. When I look for inspiration in my day to day life (not in speeches, conferences, or momentous events), I tend to find it in the people who normally inhabit my life - parents, my sister, my close friends, and my patients. It’s easy to go for days or months without being attuned to the day to day inspirations (I certainly have). But they are there.

Iftikher may have inspired me with his extraordinary efforts to serve the poor. But he also reminded me to look more closely at the day to day, to live life aware of the inspiration around me, and to open myself up to the ideas and feelings it may catalyze.

That’s a lot to get out of dinner. I was so full, I didn’t even have room for dessert.