THE PLUMBING AND POETRY OF MEDICINE: How Cancer Made Me A Grateful Believer In Both…

There are two essential dimensions of leadership: “plumbing,” i.e., the capacity to apply known techniques effectively, and “poetry,” which draws on a leader’s great actions and identity and pushes him or her to explore unexpected avenues, discover interesting meanings, and approach life with enthusiasm.  ––James March, Stanford Professor Emeritus

Cancer! The word itself hisses, stings and stalks. And when delivered as diagnosis by even a kind stranger’s voice, it also includes a river of emotions, recognized or not. For such challenges, it turns out we need two kinds of help.


The first is timely, skillful action. This help is essential and comes from a logical, linear, objective point of view, known as our plumber’s perspective. The second kind of help is designed for the heart and is just as essential. It comes from a relational, visceral and subjective point of view, known as our poet’s perspective. Let me explain how I know this is true and why it’s so important to understand…


Late on a Friday afternoon, a call came in from the doctor who was covering for my regular, vacationing dermatologist. He had biopsy news from a mole removed from my right shin. I’m not sure if the word “melanoma” occurred in the second or third stanza of our conversation, but it was most certainly the last word I heard clearly. I was besieged by this word that my body had written in secret and was now divulging through the pathologist’s report.


Perhaps the doctor would have unleashed his own poet’s perspective at the first sign of mine. But for me, I could only manage the cool, measured words of the plumber. I remember using the word mitigate in a question that sounded so calm and logical that the doctor came back with the same tone and temperament in his answer. Only later that night, an internet search revealed in me a different more troubling set of emotions and questions. What stage was this cancer? How serious was it? Why had this happened?


That’s when my wife had me wisely promise to cease all further internet searching for the weekend. She also suggested I call the advice nurse at Kaiser on Saturday to calm my mind and plan my actions. So brief had been my logical, reasonable conversation with the doctor the day before that plans for next steps were left in terms of weeks. I needed now to know what could be done in days. With travel plans back east only a week away to scatter my Dad’s ashes, plus the need to support my younger sister who was also working with her own significant diagnosis, I was already stressed.


But what happened over the next five days would be nothing short of magic and would do wonders for my health, heart and emotional resiliency.


It started with a phone call to a Kaiser nurse the next day. Taking my wife’s sage advice, I turned to my own inner-poet. I let the relational, emotional part of me lead. I let my vulnerable self talk to the nurse about the bigger picture of my life including my Dad’s memorial, my sister’s illness and my own anxiety and fear. The nurse was magnificent in her integration of both perspectives. She called first on her inner-plumber to help me think through exactly what linear, logical steps I needed to take over the next days. And then, calling on her inner-poet she showed great empathy and caring. She revealed her own personal story of melanoma.


The skilled integration of these two foundational perspectives reinforced my beliefs about how critical it is for leaders and practitioners in all fields, (perhaps especially medicine) to have awareness and access to both their plumber and poet.


Over the next few days, the conversations would continue. The plumbing and poetry perspectives kept coming, revealing the kind of support I needed even more than I knew. Early that Monday morning, I received a call from my regular dermatologist who had returned from vacation the night before. She called to check in even before her vacation was over. She assured me she was on the case and provided a way to connect with her anytime I needed. Her inner plumber and poet were both integrated and in perfect form.


The same would prove true for the scheduler, the surgeon and the surgical nurse who responded at the perfect moment with a comforting touch on my shoulder as the surgery was underway. And later as I was leaving, she told a story about her own Mother that was so skillful and supportive, that I felt on the verge of both laughter and tears with this brief but kindred connection.


Ultimately, two days after my surgery, sustained by airport wheelchairs and my courageous wife, we made the trip back east to support my sister and participate in the memorial for my Dad. The surgeon in a flash of incredible plumbers skill managed to get my second pathology report to me much faster than expected. It was clean and clear of cancer. It was now confirmed that my melanoma had been found at an early stage, which was a deep relief.


More than ever, I agree with James March, Emeritus Professor at Stanford University when he observed some years ago that,“leadership involves both plumbing as well as poetry.” And surely, given the stakes, there’s no place where skilled leadership is more needed than in the practice of medicine. I know this now from the inside and am deeply grateful for the medical team I was fortunate to experience.


And yes, stress makes things more difficult for us all. Healthcare practitioners and patients alike certainly experience stress, given the environments in which they interact. It makes tapping into both our inner plumber and poet that much harder but also even more necessary.


It’s a wonderful fact of nature that poetry begets poetry. Meaning when one person is able to tap into their poet’s perspective it’s more likely to invite a similar response in others. When it works, my own experience shows this integration makes a huge difference for those served. Just as I have seen what a satisfying and meaningful difference, the balancing and integration of these perspectives makes for those who deliver the services as well.


Look, we need good and skillful doers in this world! Nothing will replace the steady, skilled and confident hand of the able plumber, whether she or he is a surgeon, a leader or any other type of talented professional. But just as needed is the poet’s perspective, with those bold welcoming words, a big-picture understanding and that critical support for the heart.


Our great calling as professionals, leaders, and human beings is to know which perspective is needed, when and in what quantities… and then to give it. For ultimately, without the plumber little gets done. But without the poet… little is worth doing.

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