A Story From The Balcony
Leadership! My actions left me questioning my ability. The rationale behind those actions was similar to those of the Colonials in the American Revolution, standing their ground and creating their own rules of engagement with the British. Could they have read, “The Art of War” by Sun Tzu? I don’t know, but on that infamous Thursday when I was ambushed and bludgeoned, the lessons from that book raced through my mind, giving me the strength to strike back. So, now, I stand on the balcony, in control and with new appreciation and understanding for my teammates.
Were my actions adaptive? Did I exercise adaptive leadership? Was I a team player? To understand my behavior and answer those questions, I need to start in the beginning—my first classes at Harvard School of Public Health (HSPH). The importance of common language and culture was immediately clear. The task of tackling “health disparity” gave me the sense that HSPH was a school where social justice was important. In those first few weeks, I learned genes were not the most important determinant of health outcomes but rather socio-environmental factors or more precisely, society.
This realization opened a new world; it was as if I had gained a sixth sense. I gained a sense of awareness, the ability to connect disparate acts revealing patterns of behaviors and recurrent themes. A disconnect existed between the lessons taught in class and the reality of being a Black mid-career student at HSPH. At this great institution, I felt the climate and traditional approaches were contributing factors to the growing health and economic disparities among racial groups and socio-economic status (SES).
One class, “From Theory to Action”, was an illustration of that disconnect. The challenge creating innovative solutions to decrease the epidemic rates of Chlamydia infection in Afro-American teenagers and young adults in Boston. This was an impossible task given the time constraints, our baseline knowledge, and limited access to vital information. In my opinion, we should have analyzed the city’s current programs and their effectiveness. Here was an opportunity to talk not just about health disparities and race, but also to understand the perspectives of those affected. Instead, our impossible project created tension undermining a great opportunity to practice adaptive leadership on all levels and dimensions.
Health disparities are adaptive problems. Their roots are deeply entrenched in race and class, making it almost impossible to recognize our contributing roles in these problems and more importantly, our obligation to do more than discuss these issues. In an article, The Theory Behind the Practice, Jeff Lawrence was quoted, “There is no such thing as a dysfunctional organization, because every organization is perfectly aligned to achieve the results it gets.” This statement challenges HSPH (and all other entities) to stop talking, to start tackling the issues of health disparities. There should be discomfort with increasing recognition of our contributing role in perpetuating these problems. This discomfort should translate into action. That is my definition of “Leadership in Public Health: From Theory to Action.”
HSPH is a classic example of Failure to Listen–unwittingly or not–doing harm, reinforcing stereotypes and quite frankly, speaking from both ends. However, I entered the lower rungs, placing me within arm distance of those making ‘the decisions’–my fantasy and delusion as the story continues, with The Disconnect.