Victoria Atkinson White: Proper training is not always enough

Cast members from Grey's Anatomy

Would proper training have been enough to have saved the life of Dr. McDreamy? Photo courtesy of ABC Studios

To adapt in a rapidly changing world, leaders must have skills as well as the wisdom to know when and how to use them, writes a managing director at Leadership Education at Duke Divinity.

Hearts across America broke. Social media exploded. How could it be? The dashing neurosurgeon Dr. Derek “McDreamy” Shepherd on ABC’s hit series “Grey’s Anatomy” was dead.

Broadsided by a truck, McDreamy had been rushed to a hospital that was ill-equipped to handle his traumatic injuries. An argument ensued as the medical team swarmed around him, ordering tests, medications and treatments.

One doctor advocated for a CT scan to check whether McDreamy’s brain was bleeding. Another doctor denied the CT, ordering instead immediate surgery to find and repair the source of abdominal bleeding. Despite the first doctor’s multiple pleas for a scan, McDreamy was rushed to surgery, and ultimately died -- of a brain bleed.

McDreamy narrated the unfolding tragedy, but only those watching the show could hear him; his injuries were so extensive he could not direct his own care. One of the last times viewers heard his voice, he said, “I’m going to die because these people aren’t properly trained.”

In his book “Team of Teams: New Rules of Engagement for a Complex World,” retired U.S. Army Gen. Stanley McChrystal explains the difference between thinking like “a well-oiled machine” -- for which the goal is speed and efficiency -- and what he calls “an adaptable, complex organism, constantly twisting, turning, and learning."

In “Grey’s Anatomy,” both doctors were working toward the same goal: saving the patient. The doctor pushing for abdominal surgery was attacking the known problem: bleeding in the patient’s abdomen. He had a plan: see a problem, fix it, move on to the next problem.

The doctor pushing for the CT scan, on the other hand, was adapting to the patient’s vital signs as well as his responses to pain and stimuli. She was listening to her instincts that she needed more information. Her thinking was more flexible and strategic than her colleague’s.

We tend to think that proper training is the answer to most problems. Get a degree. Earn a certificate. Hone a skill. Apprentice under the experts. Develop a specialty to keep yourself in demand in a quickly changing marketplace.

These are fine steps to take, but McChrystal argues that they are not enough. An effective leader needs to know how to apply skills to changing circumstances.

Consider a story McChrystal tells in his book. In 1978, United Airlines Flight 173 crashed, killing 10 passengers and crew members and seriously injuring 23. The well-trained and experienced pilot knew the plane had a problem with its landing gear; he spent so much time focusing on the manual’s instructions for handling the noncatastrophic malfunction that the plane ran out of fuel and crashed.

“The structure, not the plan, is the strategy,” McChrystal writes.

The pilot tried to follow the manual’s plan for landing a plane with gear issues. In doing so, he ignored the critical structure of the flying experience: you need fuel more than you need landing gear to make it safely to the ground. The plan prescribed a series of steps to execute without question; a structure allows for leaders to adapt and improvise as conditions warrant.

An adaptable structure could have saved the lives on Flight 173. An adaptable structure could have saved McDreamy’s life.

What could an adaptable structure save in your setting?

What would happen if your institution had a “strategic structure” instead of a “strategic plan”? Is your organization a well-oiled machine, with best practices and detailed plans, or a sound structure that allows for adaptability?

The Hebrew prophets expected a Messiah who would have and follow a plan: the Messiah would be a king who would usher in a time of justice and peace and restore the Davidic dynasty (Isaiah 9:6-7).

But then Jesus the Messiah comes, and life happens. A little girl dies. A hemorrhaging woman reaches out and touches his cloak. A blind man begs to see. And 5,000 people need to be fed.

There is little that is speedy or efficient in Jesus’ ministry.

Instead, Jesus is, in McChrystal’s language, “an adaptable, complex organism, constantly twisting, turning, and learning.” He lives and ministers within a structure of love of God and love of neighbor. Everything else can be adapted to meet the quickly changing demands of those around him.

Institutions invest significant time and money into well-worded strategic plans that often sit on shelves, resurfacing only for board meetings or evaluations. But a vibrant institution is both a bearer of tradition and a laboratory of learning. Tradition can provide the strength and perspective a structure needs to adapt and thrive in a constantly changing environment.

The old proverb “Man plans, God laughs” is said with both truth and sarcasm. We like predictability and well-oiled machines. Our plans, however, will get us only so far, until we need to adapt to our quickly changing surroundings.

Jesus’ structure of loving God and loving neighbor allowed for the dead to rise, the sick to be healed, the blind to see and the hungry to feast. The structure Jesus models for us is one at which God laughs -- not with sarcasm -- but with delight and joy in God’s beautifully dynamic and adaptable creation.