I have been enjoying a leisurely stroll through Leadership In Turbulent Times by Doris Kearns Goodwin. You might think that my fascination with the book is that it is a character study and analysis of performance of four accomplished presidents that draws attention to the deficiencies of the current occupant of the office, but that was not the real attraction of the book, and it was not the writer’s motivation. The book is the result of a five year writing project during which Kearns Goodwin shifted from writing about history to writing about leadership as a subject using the events in the lives of some of our most famous presidents as sources for analysis, instruction and at times psychoanalysis.

 

David Greenberg, a presidential historian who is a professor at Rutgers, reviewed Leadership in Turbulent Times for The New York TImes, and I sensed that he was a little disdainful of her shift in focus, and the idea of using history as the core of a leadership text. Judge for yourself from his words.

 

…in her new book she forsakes the strict confines of biography for the brave new world of leadership studies. A booming field of scholarship — or, traditionalists would say, pseudoscholarship — leadership studies is usually taught in schools of business or public administration, geared toward would-be or midcareer executives and often focused on imparting useful lessons to apply in the workplace.

 

Referring to “pseudoscholarship” and schools of business or public administration in the same sentence seems snarky to me. I guess that I am taking his words to suggest that he prefers a scholarly work that is intentionally written with a style that few people other than grad students would ever want to read, and I am defensive for her although she has enjoyed a success that I would imagine shields her from most critics. I would note that there are 76 pages of references and notes before you get to the Index. I am not sure what clears Professor Greenberg’s bar for real scholarship. Her book sales would suggest that she needs no defense from me.

 

Professor Greenberg also undermined my plans for using the book to connect with our current need for more focused leadership in the healthcare debate which is connected to the considerations about economic inequality, healthcare disparities, the persistent complexity of our system of care that disrupts efficiency and increases costs, and is even connected to our concerns about the environment and global warming. I had noticed that Kearns Goodwin was describing how the four leaders from history approached problem solving and leadership much in the same way that a Jim Collins or a Peter Drucker might write to advise and coach. In the chapters about the big challenges the four presidents faced that put the country in peril she used bold headings to demonstrate how their actions were examples of approaches to specific issues that face a leader. I had planned to list several of the headings and try to show the relevance of her analysis to healthcare leadership. My days of leadership are over, but I still enjoy thinking about leadership as both a natural calling and a learned skill. The headings were Greenberg’s biggest criticism. I have bolded parts of what follows. He continues his attack with words like “self-help,” “bromides,” and “banalities.”

 

“…when Goodwin gets to her section on the four presidents’ emergency leadership, which should be the book’s pièce de résistance, she succumbs to the leadership genre’s vocabulary of self-help bromides and bullet-point banalities. Otherwise bracing accounts of Lincoln guiding the nation through the Civil War and Johnson shepherding the 1964 civil rights bill into law are punctuated by boldfaced, italicized subheads dispensing wisdom like “Anticipate contending viewpoints,” “Shield colleagues from blame,” “Rally support around a strategic target” and “Give stakeholders a chance to shape measures from the start.” These conference-room poster slogans protrude in the text like hurdles obstructing a runner’s path. They interrupt the flow of the stories while unfurling what are fairly self-evident, common-sensical streamers of advice.”

 

Well, I disagree. I liked the conference-room poster slogans.  Here are a few more. I picked three more for each of our four leaders.

 

From Lincoln:

 

  • Acknowledge when failed policies demand a change in direction.

 

  • Gather firsthand information, ask questions.

 

  • Understand the emotional needs of each member of the team.

 

From Teddy Roosevelt:

 

  • Secure a reliable understanding of the facts, causes, and conditions of the situation.

 

  • Use history to provide perspective.

 

  • Be visible. Cultivate public support among those most directly affected by the crisis.

 

From FDR:

 

  • Be open to experiment. Design flexible agencies to deal with new problems.

 

  • Stimulate competition and debate. Encourage creativity.

 

  • Adapt. Be ready to change course quickly when necessary.

 

From LBJ:

 

  • Identify the key to success. Put ego aside.

 

  • Set forth a compelling view of the future.

 

  • Master the power of narrative.

 

Sure, these do sound like conference room poster slogans, but try to imagine Kearns Goodwin’s use of history to show how each one made a difference in an overall effort to steer the country toward calmer water, and away from a history altering disaster and into a better future.  If you can’t do that you definitely should read the book. Next try to apply each “slogan” to your own leadership style, or the style of the leader who determines what happens in the environment where you work. There are two “extra credit questions.” First, how consistent are these “slogans” with Lean management philosophy? Finally, in reference to these “bromides” what do you think about our current national leadership?

 

I disagree with Professor Greenberg’s sense that the slogans interrupt the story. For me they provided deeper meaning and understanding to stories that I already thought I understood.  The wisdom may be self evident, but the appreciation and practice of those self evident truths is hard to glean from reading the day’s news, or tweets. If I had read this book in 2007, I think I would have done a much better job as a leader.

 

Before I read Greenberg’s review, and while I was reading the book, I read a great review of the work in The Washington Post by Senator Tim Kaine, Hillary Clinton’s running mate. Senator Kaine’s description is gracious and informative. Again the bolding is mine.

 

Her title echoing the truth of the maxim attributed to the Latin writer Publilius Syrus — “anyone can hold the helm when the sea is calm” — Goodwin circles back through her understanding of the four presidents in “Leadership: In Turbulent Times,” trying to extract the basic lessons that enabled each to deal with major crises in their personal lives and in the life of their country. No one is better suited than Goodwin to make the effort, and yet her book makes plain how hard it is to capture the essence of leadership, at least when the question is approached head-on.

 

Kaine’s comment got me thinking. Why are these turbulent times? It seems that not long ago we thought that we were making headway and our biggest challenges were how to maintain and speed up the progress in the economy that we had made since the “Great Recession,” how best to expand and improve the ACA, how to pick up the pace and lead the world in the fight against the looming threat of global warming from the overuse of hydrocarbons, how to gain consensus on the path forward for “dreamers” toward real immigration reform, and how to extract ourselves from our misadventures in the Middle East. Sure, there was a vocal minority that found things that they did not like about each of those ideas, but this is America and we embrace debates about how to solve problems.

 

Our last election brought us a more acute awareness of how turbulent we can make our times, and gave us a leader that has offered us binary choices built on exaggerated self interest and a nostalgic fantasy propagated by widespread nationalistic dualism in every domain of our thought and society. His focus is on what divides us and not what makes us one. He has disdain for those outside the circle, and demands adoration from those inside the walls of his forts. His continuous self promoting rhetoric in Tweets and at large rallies that began before the election, and has continued since, offers the suggestion that the best way to go forward is to enhance our fears and suspicions of one another, and to treat most of the world as our adversaries, or as free loaders. He has done little so far to resolve this new kind of turbulence that rocks us. Indeed, he seems to relish creating division and controversy by seeking the lowest common denominator of civil discourse and charitable human interaction. He is not alone. I doubt that he has said anything that some angry person in some corner of the nation has not already said before, but he has said many things that no living American has ever heard their president say. Some say that he was elected to create turbulent times that match the frustration of those who feel endangered by increasing diversity. He has said that he has come to Washington to drain the swamp, but the pump seems to be working in reverse as the swamp water rises.

 

Senator Kaine goes on to describe the format that is at the heart of the book’s success. He points out that Kearns Goodwin describes four ambitious men who wrestled with their own challenges that prepared them to make progress against deep and resistant problems that threatened our nation. Each was confronted with a problem that was not of their own making. Each had been prepared for the moment by the dual personal challenge of having their ambition blunted earlier in their lives, and by having a significant personal failure or tragedy. All four had a deep appreciation of history, and despite having some of the self promotion that all politicians have, they possessed, and could express, enormous empathy for “the least of these” in our society, and dreamed of the future of America in terms of equality and opportunity for all. Here is Kaine’s useful guide to the book:

 

Goodwin’s effort to turn lessons of the four presidents from her years of scholarship into a book-length essay on leadership traits follows a basic arc. Part I explores the upbringing and emergence of ambition in each leader: the adversity of Lincoln’s boyhood and his self-fashioning into a frontier lawyer and Whig political leader, the privilege and warm family love experienced by the two Roosevelts and their surprising entrance into the hurly-burly world of New York state politics, LBJ’s early fascination with retail politics accompanying his father and grandfather in the Texas Hill Country and his quick rise as an ambitious young New Dealer.

Part II analyzes pivotal experiences of loss or failure each man experienced and how they grew from it: Lincoln’s desultory terms in the Illinois legislature and Congress, and his failure to secure a desired governmental post after he helped Zachary Taylor win the presidency in 1848; the death of Teddy Roosevelt’s young wife and beloved mother on the same day in 1884; FDR being diagnosed with polio in 1921; the young congressman LBJ losing a razor-thin Senate race in 1941.

Finally, Goodwin explores a pivotal period or accomplishment in each president’s term and draws out the keys to his success in negotiating it: Lincoln’s decision to issue the Emancipation Proclamation, Teddy’s handling of a massive nationwide coal strike, FDR’s bold actions in the first 100 days of his presidency to save the American financial system and restore hope to families shellshocked by the economic collapse, LBJ’s dramatic progress to advance civil rights and the social safety net. An epilogue explores how we have come to view these leaders after their deaths.

 

Since Professor Greenberg has disdain for Kearns Goodwin’s construction of her chapters with headings that sound like slogans, let me give you a few excerpts from her writing that were particularly meaningful for me as we look at the future of healthcare reform and hope for improvement in our version of “turbulent times.”

 

We still need to do many of the things that Teddy Roosevelt suggested over a hundred years ago. Even then he sensed deep division in the country. She writes:

 

…he warned, the country would eventually be “sundered by those dreadful lines of division” that set “the haves” and the “have nots” against one another…

 

He proposed a universal national service program to mobilize young men and women from different backgrounds “to work in a spirit of brotherhood for the common good.” Long before, he had predicted that the “rock of class hatred” was “the greatest and most dangerous rock in the course of any republic,” that disaster would follow when two sections, or two classes are so cut off from each other that neither appreciates the other’s passions, prejudices, and, indeed, point of view.”

 

As we now survey the deepening abyss between red and blue states and all of the other dualistic ins and outs that define us in our multiple identities, the apprehension and warning of those words seem freshly appropriate. All four of Kearns Goodwin’s  leaders were seeking to solve social problems, and all shared the dream of an inclusive and diverse nation. Of the many words of wisdom from the speeches and letters that she quoted, I found myself strangely drawn to a man that once I did not like ot trust, Lyndon Johnson.  In the 60s I underappreciated his legislative leadership in civil rights and the potential power of the Great Society although I benefited, and perhaps you did also, from some of the loans and scholarships that the HIgher Education Act of 1965 produced. Like most of the young people around me in medical school, I was blaming him for the horrors of Vietnam.  In hindsight, nobody was better at domestic policy and worse at foreign policy than LBJ. His dream of a Great Society was interrupted by the nightmare of Vietnam. Kearns Goodwin was close to him in those years and gives a balanced view of what he achieved in the first year and a half of his presidency and what he lost in the last three and a half years. My favorite quote from the book remains central to our current challenges of inequality at every level, and the connection of that inequality to the healthcare disparities that plague us now.

 

Johnson announced and explained the Great Society in a speech that he gave at the commencement of the University of Michigan. She writes:

 

“Johnson chose…the place where John Kennedy had called for a Peace Corps to lay out his own expansive picture of a future in which every person would share in the progress of the country. By building on the strengths of prosperity rather than on the necessities of Depression, the Great Society would exceed the New Deal. “For a century we labored to settle and subue a continent,” Johnson told the graduates.” “For half a century we called on unbounded invention and untiring industry to create an order of plenty for all of our people. The challenge of the next half century is whether we have the wisdom to use that wealth to enrich and elevate our national life.”

 

It makes me sad to realize that that challenge was delivered to my generation, and that we failed to live up to the opportunities that we have had even after the horror and distraction of Vietnam was over. Kearns Goodwin relates from personal experience gained on long walks with Johnson how troubled he was by the fact that Vietnam undermined the bold start to the Great Society and its vision of economic equality. His last speech was delivered at the Johnson Library not long before he died at age 64 following what was at least a third heart attack. The occasion was a Civil Rights symposium that had drawn many of the leaders of the Civil Rights era of the 50s and 60s together to make plans for the future. Kearns Goodwin writes:

 

While admitting that civil rights had not always been his priority, he had come to believe that “the essence of government” lay in ensuring “the dignity and innate integrity in life for every individual”—”regardless of color, creed, ancestry, sex, or age.” ... “ I don’t want this symposium to come here and spend two days talking about what we have done, the progress has been much too small. We haven’t done nearly enough. I’m kind of ashamed of myself that I had six years and could not do more than I did.”

 

The plight of “being Black in a White society,” he argued remained the chief unaddressed problem of our nation. “Until we address unequal history, we can not address unequal opportunity.” …It must be our goal to assure that all Americans play by the same rules and all Americans play against the same odds. “And if our efforts continue…and if our will is strong, and if our hearts are right, and if courage remains our constant companion, then I am confident, then, my fellow, Americans, I am confident that we shall overcome!”

 

As we approach the election of 2020 we will hear a lot about the problems that make our times turbulent. We will hear ideas that will need to be understood because some will be good and some will be ill conceived. Healthcare will be center stage. It is already. What we need to also consider, as much as the issues, will be the character and leadership qualities of the person we chose to guide us. I would suggest that the four presidents Doris Kearns Goodwin discusses make good templates against which to consider those offering themselves and a message of hope as our servant leader in the continuing turbulence that our focus on self interest has produced. As we look for national leaders that match the template, we should also focus on elevating the leaders in healthcare who fit the mold. We can do better in both areas.