How to lead out of lockdown — business resuscitation lessons from a palliative care doctor

If you are leading an organisation out of lockdown and into an uncertain future, you should read Rachel Clarke’s book Dear Life: A Doctor’s Story of Love and Loss. If you only have 10 minutes, then read her article in the Guardian.[1]

Here’s why.

Resuscitate your business with the focus and belief of an A&E crash team

Clarke recounts the story of three-year old Gemma, dragged from a canal by her parents, unconscious and not breathing. Not able to restart her heart, the girl was whisked away from the tragic scene by the paramedics. Clarke paints the picture of the crash team who were silently waiting for her in A&E: “with a grace and efficiency akin to a choreography, a team of professionals who had been as disparate as atoms, dispersed across the hospital, were poised around an empty bed, waiting as one to swing into action.”

Too inexperienced to help, Clarke watched helplessly as each member of the crash team was quietly given their unique role in working on the lifeless body. Unless the crash team restarted the tiny heart, she realised, in her shock, that the little girl was as good as dead.

20 minutes passed and the resuscitation was “going nowhere.” Yet despite the seeming futility of all the activity, she describes the conviction and desire of this group of medical professionals saying, “the collective will in this bay for the child to live, to survive, was so strong as to be almost palpable. A forcefield of longing around the bed.”

And when with pairs of disbelieving eyes, the chaotic scrawl of the ECG trace started tracking a normal rhythm, they realised the girls’ “stunned, battered, fibrillating heart had somehow started to beat again….a resurrection had occurred.” Gemma had been resuscitated and brought back to life.

We are not resuscitating children. But we are charged with resuscitating our businesses. Like the crash team there is no space to have a moment’s dip in concentration, not a second of lapse in focus. We too need to take on the task of resuscitating our business, acting like professionals with “ruthless dispassion”, both fully human and fully ruthless in doing everything we can to maximise the chance of saving this life — our business.

And only after that total focus then, can we join with the crash team in the shared elation of success in doing our job as leaders.

Take the unknown out of the worst scenario for people

You can imagine that Clarke’s life as a palliative care doctor has brought her into contact with many people in extremis. She tells the story from early in her career, of a patient, Simon, a policeman in his 60’s, with a recent, devastating diagnosis of thyroid cancer. His treatment had been effective, but only served to shrink his tumour, perhaps enabling him to reach his goal of getting to see his grandson’s 6th birthday.

Simon’s treatment left him on oxygen and struggling to breathe. The result was a rasping breath, a struggle for air that made him feel he was in danger of dying at any moment.

Clarke on the other hand realised that, although Simon’s demise might not be far away, it was panic at that moment that was causing this man’s struggle, not his illness. The unknown. He had never faced this situation before and had no idea how his story would end. And as she administered a tiny dose of fast acting sedative to take the edge off the panic, she asked him “Would you like me explain what I think is happening?”

How often do we ask that question to our managers and our employees? In the midst of the unknown unknowns of Coronavirus and exiting lockdown, we don’t have any certain answers. Rather than bury our heads in the sand and imagine that employees don’t realise that our business may fold, may require them to work less or that they may lose their job, why not ask “Would you like me to explain what I think is happening?”

I am sure the answer will be “yes.”

As leader know those liminal moments, when what we do next shapes the course of events. Clarke explains, as a doctor,

There are moments in medicine when what you say next feels as pregnant with risk as a surgeon’s first incision. The right words, used wisely, can bridge the airiest expanse between you and your patient but, if misjudged, may blow trust to pieces. In scarcely a month, cancer had snatched from this man of action and authority his health, his future, his strength and his fearlessness. And today, perhaps worse than all of that, his daughter had witnessed him writhing in fear.

What you say next to your company may determine whether they join you in the fight to resuscitate your company, or whether they will struggle to look you in the eye ever again. Whether they trust you or whether they walk away.

Clarke’s experience told her that this patient was afraid to ask if he would ever leave the hospice and if he would die imminently. In her bravery she confronted this gently and head-on, “One of the things I’ve noticed working here, Simon, is how often patients feel unable to ask about the thing they’re most preoccupied with, which is what it’s actually going to be like when they die — and I wonder whether this is something you’d like to talk about?”

Leading a business, we are unlikely to be literally faced with an employee who is going to die soon, but you will be faced with potentially thousands of our employees who will feel like this is a death — of their livelihood, their expectations, their friendships, their potential. Yet, like Clarke, we can help employees to face into the things that are unsaid, their fears. We have the opportunity to look them in the eye, to engage in their humanity, to understand what matters to them more than anything. In courage we can respond to their questions and ask “Would you like me to explain what I think is happening?”

Acknowledge that leading well hurts

The final lesson Clarke imparts is short. It stems from her deep understanding of what is left in life as she grieved her own father’s death. Returning to work after his funeral she acknowledged that she emerged “a different doctor.”

The business that comes out of lockdown might also be different to the one that went into lockdown. The process of resuscitation is demanding. Some things may never return to how they once were. But amongst the ruthless and difficult decisions we have to make, nothing should stop us from caring about the business and the people who work there.

Clarke puts it poignantly, “I understand that from the inside out, grief, like love, is non-negotiable, and that the only way to avoid the pain is to opt out of ever loving.”

Resuscitating a business coming out of lockdown is hard. Painfully hard. It hurts. Businesses are made up of real, feeling human beings. We all have some incredibly difficult decisions to make over the coming weeks and months.

Acknowledge that this hurts. Lean in. For if it didn’t hurt, we wouldn’t also get to taste the sweet delight that stems from working together to breathe life back into our people, our business and all the things we are trying to do.

[1] https://www.theguardian.com/books/2020/jan/18/all-that-is-good-in-human-nature-is-here-rachel-clarke-on-life-and-death-at-her-nhs-hospice

Originally published at https://www.linkedin.com.

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Psychologist helping women lead unapologetic lives www.becoming.international https://www.linkedin.com/in/alisonmaitland001/

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Alison Maitland

Alison Maitland

Psychologist helping women lead unapologetic lives www.becoming.international https://www.linkedin.com/in/alisonmaitland001/

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