A leader…must have the determination to stick with it

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“A leader, once convinced a particular course of action is the right one, must have the determination to stick with it and be undaunted when the going gets tough.” Ronald Reagan (1911-2004)

Anyone who has followed this column over the years (and I know one or two of you are out there) is aware that I am an avid sailor. My wife, Pam, and I grew up in and around sailboats and our children have hardly known a summer that did not involve cruising under sail.

Beyond the sheer delight of working a boat across the water with nothing more than the wind, I love sailing because it has nothing to do with medicine. The ability to occasionally focus my mind and energy on the boat helps recharge my batteries for the ongoing struggle that is federal medicine in the age of sequestration. While the practice and art of sailing and medicine are vastly different in their execution, success in either endeavor has many parallels.

Recently Pam and I, along with some good friends from Texas, competed in the annual Maryland Governor’s Cup Race (http://www.smcm.edu/govcup/) on our cruising catamaran, Family Knot (Gemini 105Mc). This is an overnight race that begins in Annapolis and ends at St. Mary’s College on the St. Mary’s River off of the Potomac, a distance of 68.6 nautical miles.

As sail racing goes, this event is not particularly dangerous, although the race did tragically once claim a sailor’s life in 1994. Anyone familiar with the Chesapeake Bay knows how fickle weather conditions can be, and participants of the race often experience extremes of weather, dead calm to a real blow, all in the same race.

In addition to the weather  are the challenges of sailing at night with many other racers, commercial shipping traffic moving up and down the bay, unlit buoys and randomly placed fish traps (long nets on poles extending about 100 yards into the bay) for added navigational excitement. This is all accomplished late at night when most people are tucked snuggly in bed. In short, it is a sailing challenge that demands a captain and crew with some determination and strength of character to complete.

As Family Knot’s captain, it is easy at the end of the race, with a beer in hand, to understand why I subject myself and crew to the hardships of the competition. It is a great feeling of accomplishment, it is objective proof of sailing ability. And this year we actually placed third of seven boats in our class. Of course these feelings are hard to imagine at 0300 as exhaustion sets in and you find yourself trying to wrestle a malfunctioning headsail down in a strengthening breeze and pitching deck. To safely sail on the bay at night requires constant attention when fatigue can make even the simplest decision or activity difficult.

One might ask, reasonably so, why subject the boat and crew to these conditions if it is not necessary? Why not sail only in fair weather, during the day, when the going is easy, pleasant and without stress?

From my perspective, the controlled challenge and managed risk of the race make me a better captain of the boat and strengthen the confidence and abilities of the crew. The feeling of accomplishment in completing this sailing challenge cannot be matched in fair-weather sailing. Additionally, fair-weather sailing often can turn foul with little warning. The experience gained from the controlled stress of distance racing can make all the difference in navigating the boat through difficult conditions safely so fair weather conditions can be enjoyed in the future.

I was actually thinking about this editorial late at night during the race, because I could not help but see similarities in the challenges of completing Governor’s Cup and the current trials federal medicine is undergoing, as we try to navigate projects forward in the face of sequestration uncertainty. I am not suggesting that the past 12 years of conflict have been “fair weather” for federal medicine, but programs have been flush with cash, which does make program execution easier.

In many respects, in terms of my own federal medicine career, I feel like it is 0300 on the boat, I am tired and stressed, the finish line far beyond my sight, and I am struggling with a malfunctioning sail. Sequestration is a work climate that few, if any, federal medicine planners could have predicted. In fact, because the anticipated consequences were so severe, nobody really believed that Congress would allow sequestration to be implemented.

Of course, if things such as malfunctioning sails or sequestration were predictable, they really would not be problems. I subject myself and my crew to the stress of the Governor’s Cup because I can see the benefits of staying the course and finishing the race. Sequestration has made all of our federal medicine projects more difficult. If we are confident in our federal medicine course, we have every reason to remain undaunted by this financial storm and stick with it, even though the going will be rough for the foreseeable future.

We in federal medicine have overcome so many recent challenges of more significance than sequestration; we can and will weather this storm as well. The federal medicine crew, like my own, will be better in the end because of it.

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