My grandfather said: “If two people tell you that you are drunk, lie down . . . even if you haven’t had a drink.” I have tried to incorporate the lessons of this old Russian aphorism into my leadership style. First, no matter how much I think I know about something, there are nearly always others who know more. Second, even when I do in fact have superior knowledge, others may have a different perception – and perceptions often matter more than physical reality. As a result, I strive to avoid taking a firm position until I have explored its merits with stakeholders; I am always examining decisions from others’ perspectives and adjusting my inclinations as I develop my own opinion.
Periodically, however, I need to be reminded that I may be “drunk.” When I began overseeing the Office of the Chief Medical Examiner for Massachusetts (the “OCME”) in 2007, a management consultant had determined that the agency was “on the verge of collapse.” It was lacking in leadership, management systems and resources. Like most people, I assumed that the mission of the OCME was the same as on television – using forensic pathology to catch murderers. When I learned that in fact, only 10% of our cases were homicides, I thought I had found the solution to the OCME’s problems: jettison much of the work that was extraneous to my understanding of the core mission.
Before announcing my decision, I spent several days at the OCME. I observed the morning meetings where staff drew on epidemiology to plan the day’s work. I observed an autopsy that mattered to no one except the family members of the deceased. They wanted an explanation as to why their loved one, whom they had previously thought was the picture of health, had dropped dead, and the ME’s believed they deserved that explanation. I tried to help a doctor explain to a grieving mother why her daughter would commit suicide, seemingly without any warning. Finally, I listened as the doctors discussed how to better persuade parents to cut grapes in half before feeding them to toddlers to avoid deaths like that of the child on the autopsy table in front of them. None of these cases involved homicides, yet each was immensely important. I realized my opinion of how to “fix” the OCME was wrong. These doctors guard public health and by explaining death – not simply accepting it as inevitable – they honor the value we place on life. Those tasks are as crucial to our society as solving homicides. So, instead of changing the mission of the OCME, I changed my mission: I dedicated myself to nurturing leadership within the agency, advocating for greater resources and helping build management controls.
We have come a long way at the OCME since 2007: we have a thoughtful and experienced management team who have built systems that make the office work, we have been able to recruit and retain a phenomenal cadre of medical examiners, and the extraordinary staff work every day in very difficult conditions to serve the public. There is work that still remains and some of it is dependent on additional funding but the team at the OCME – and the Commonwealth – have much to be proud of.