Na Na Na Na Na Na Na Na LEADER!

Over the weekend I binge watched Wild Wild Country a documentary on Netflix about the Rashneeshi movement and their effort to build a city in Central Oregon, basically isolated by dozens of miles in either direction. I can't recommend it enough, of course I have a unique element allowing for, perhaps, extra exuberant enthrallment in that I remember this unfolding on the 5 o'clock news, as I grew up in Portland. It was edifying to see the fiasco from both sides; the "free-love, humanistic sannyasins" versus the "ultra-conservative, undereducated white normies" in the nearby town of Antelope, population of 40, at the time. The Rashneeshis were actually Sannysins, followers of Bogwan Shree Rashneesh. They, for most of their time in Oregon, wore all red clothing and were easily identifiable as such.

Cult of personality if there ever was one. Many of his followers spoke about his "presence" and less of his teachings.

This film inspired me to ponder the nature of leadership. Undoubtedly there are untold numbers of humans who have had good ideas, who have had the self-sacrificing nature and altruistic nature that we often say comprises a good leader. I would counter that many of our leaders, from unofficial "leaders" of a small group of friends, to middle-management in any corporate setting, anywhere USA to leaders of industry and those at the highest levels of elected governorship have many discernible attributes, but self-sacrifice and altruism are hardly elements that allows one to climb rank.

Not always is this the case, thankfully. From my perspective, however, I think our culture in the United States has shifted slowly over the decades to espouse and honor results at all costs, and many times, short term gains over long term losses. I could go on and on. I can point my finger at a few specific aspects of our financial system that not only reinforces, but under penalty of law, enforces this dynamic. Of course, if The Citizens United ruling actually made sense, corporations would be interested in their long term viability and not only immediate profits.

I digress.

"Doctor" in latin, translates as "to teach." Not all teachers are leaders, but I argue that most effective leaders, to some degree, are teachers. Perhaps not in an official capacity, but an effective leader needs to educate those in their service to a point where toil is performed with willful duty. You may forgive me for not immediately thinking of a martial structure, where rank and file do as they are told with no questions or concern. This system works when there is punitive action for disobeying orders. It is effective, this is why armed forces and totalitarian regimes adhere to this chain of command. However it is fragile pending loss of punitive measures. It is far better to have willful adherents to your etiology. Whether it be "cubicle troopers" who understand the need for TPS reports (may not like doing them, but they understand their utility and thusly dutifly complete them) or Sannyasins who would willingly die for a man named Bogwan Shree Rashneesh.

I never watched Nurse Jackie when it was airing on Showtime. I remember it was very popular when I was in undergrad. Last night I watched the first episode. Within the first few minutes we learn that doctors are idiots and that (at least Jackie) nurses are the only ones that care for patients well being, much less their medical outcomes. Makes for good TV, if you've never been a doctor, I guess. Not to demean the role nursing has in patient care (I always feel compelled to state that when talking about nurses) but the doctors, at least in the first episode are so careless and cavalier with their medicine, much less their demeanor with patients and other staff that they would not last a week in modern healthcare. At least not in the last century. And why do I bring this up? Because it flies in the face of everything I strive to be as a physician, and overwhelmingly everyone I've ever met in this process -- whether at the end of their career or an aspiring pre-medical student.

So what do I care about leadership? I worry that it stems from a place of ego -- from desiring power. I then remember that just having that worry, the fact that this is a concern of mine is a prognostic factor for a healthy leader. What capacity will this aspiration grow into? I don't know. Simply being a physician thrusts me into the role, like it or not. And there are days where I like it less than others.


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