Executive Perspective

Lessons From Room 411

by Paul D. Houston

I think it was John Lennon who said life is what happens while you are busy making other plans. We all have had those moments when our reality confronts our intentions. Reality always wins.

About a year ago I was looking to the next day and all I had to do. Big plans, busy, busy. But that night I had a major tummy ache. Earlier episodes had been diagnosed as “acid reflux.” But the pain would double me over and didn’t seem to bear any relationship to the acid reflux others had described to me. Besides that, the medication I had been given didn’t seem to help and the attacks were becoming more frequent and severe.

On my way to work I decided to stop by the doctor’s office and see what could be done. I had gotten no sleep the night before and the pain had been quite memorable. A medical assistant saw me since my problems didn’t seem to warrant a real doctor. Thank goodness for youth. In about 15 seconds he found I had a fever and abdominal pain and pointed out that is never a good combination. About 15 seconds more and he concluded my problem wasn’t acid reflux but a gall bladder issue. The next thing I knew I was driving myself to the emergency room, instead of my office, and the following day I had major surgery to remove an infected gall bladder that had the biggest stone the surgeon had ever seen. Life is what happens while you are busy making other plans.

Mulling Systems
That started a week-long odyssey through the medical system that I found as enlightening as it was frustrating. Several of the lessons reinforced my commitment to systems thinking.

As my digestive system shut down, it created pressure on the diaphragm and I couldn’t breathe properly. This led to a case of pneumonia. The shortage of oxygen created a shortage of enriched blood to my system. I had a severe potassium shortage, which it turns out endangers the heart. So I just laid in that hospital bed and watched one system within me pull another system down, which pulled another down.

Those of you who know me will not be surprised to know that naturally my thoughts turned to song. It was the one about how one bone is connected to another bone and so on. All my bones and systems were interconnected and when one started to fail it caused others to fail.

Fortunately, the medical staff wasn’t about to let that happen so I had more tubes in me than a ’60s television set and over time they got the digestive system back up, which took the pressure off the respiratory system allowing me to fight off the pneumonia, which got more oxygen to my system and the systems started to pull each other up.

Systems thinking is really an understanding that things are connected in an organic way. Sadly, our current reform efforts ignore this reality. And sadly, many good school leaders fail in their mission because they are trying to fix the pieces instead of healing the whole.

Hierarchical Talk
But back to Arlington Hospital. As I observed the staff, I discovered on the one hand they had a system for everything. If you had a test scheduled for a certain time, they worked your medicine and nourishment around that (the tray of inedible food showed up in time to allow you not to eat it before going off for the test). The transport folks showed up when they were supposed to and the test clinicians were in their place ready to do their thing. I think we could learn a lot in systems work by observing the medical profession and how it handles these issues. Great planning at every turn.

However, I saw something that made me worry, not just about patients but about our students. Because, with all their systems, they still didn’t communicate with each other. There seemed to be a strict hierarchy at work. Surgeons lived on their own planet. Like the rock stars they thought they were, they barely were seen outside of the surgery rooms and then didn’t really deign to speak to mere mortals. The general practitioners interacted with the patient and the residents. The residents talked to the interns. No one talked to the nurses who were really the only people who knew what was happening with the patient.

The practical outcome was that you need an advocate watching things at all times or you will be given the wrong medication or have the wrong procedure done. As I watched all this happening, I wondered how much of this goes on in our schools. We know policymakers aren’t really listening to professional educators. But what happens within our own circle? Do superintendents care what principals think? Do principals honor the opinions of their teachers? Does anyone ask the children how they are feeling or what they want? Is anyone listening to anyone else? What happens to good education when the listening system breaks down? And do the children who really need an advocate have one?

Reality Rules
Now, my little story has a happy ending. I survived, minus one nasty gall bladder. In a few weeks I felt better than ever. I got back to making plans. So while you are out there making your plans, try to remember they need to have a systems approach to them if you have any expectation for success.

And try to listen a little more. And see that your children have a protector. And understand most of it is out of your control. One of my favorite jokes is the one that asks, “Do you know how to make God laugh? Tell Him you have a plan.” You can plan for the future. Just don’t expect reality to cooperate with you.

Paul Houston is AASA executive director.