Full Circle

Friends, greetings from sunny New York City, where your good friend Sarah’s day is jammed full of urology medical research work, some cardiology, some chasing down clients who are 2 months late in expense reimbursements, a first date, and a business dinner with a long-time doctor Friend/client and his lovely wife, whom I want to be when I grow up.  That lady is smart, beautiful, well-spoken, gracious, clever and grounded, not to mention ridiculously well-connected to interesting people, and he is tough as nails and just an excellent, excellent doctor who taught me so much.

 

I met this couple when I was assigned to a urology research project while working in men’s sexual health.  If you know me at all, you know I am quite comfortable talking about taboo health subjects, and that includes sexual health. Sure, sure we make our jokes about it, too, but when it comes down to business, sexual health is a big deal.  How a person connects to the person they love is everything, and sex is part of that (unless they are siblings, in which case…ew.)

 

Imagine me as my 23 year old self in my new Ralph Lauren blue pinstripe suit from Dayton’s (now Macy’s), with matching Evan Piccone navy blue shoes and crisp white shirt, simple faux pearl necklace and earrings.  This outfit was the most expensive thing I had owned, ever, besides my old Nova with a 350hp engine, and that car was so well-used by the time I got it, that the speedometer never worked (which got me out of several tickets, along with my batting my baby blues, as usual, ahem).

 

There was a big conference in big ol’ New York City, and I flew in from Minneapolis to attend the conference, present data from 2 of my clinical trials to all of our doctors, lead conversations with those doctors on what we should do next for our research platform, and, to attend surgical cases.  I was terrified.

 

I was terrified, but I had to be the leader, which is what happens over and over and over in my life.  No one sat me down and taught me how to present or what to say. No one had me do a dry run presentation.  No one reviewed my slides, and here I was, some 20 something year old kid, getting ready to talk to and debate with the top urology surgeons in the world.  How I get myself into these situations, I will never quite understand, because there is no WAY we would allow this to happen these days…oh no…someone far senior would be presenting and leading conversation, if you could get all of those doctors in one room at once, that is.

 

My presentation went beautifully, but only because my college professors were terrifically tough on me a few years earlier. Dr. Serie, my immunology and biology college professor, would grill us up and down a topic, in order to make sure we had not just memorized facts but could actually discuss and argue our points effectively.  I learned so much from her, and I miss her terribly now that she is gone, because she was a rock for me in my college life and in my career.  She taught me how to be funny and fierce, how to be cool even when you were not cool.  She was a bad ass, and I wanted to be one, too.  Being a bad ass means that you know all the rules, you know all the facts, and you know how to make sure no one puts you in a corner you cannot talk your way out of, with actual data.  Because of her, I was ready to present and debate data with these doctors at this NYC conference.  I nailed it, but just barely.

 

I nailed it because the toughest doctor of all was well published, and I knew what his angle of questioning would be, because I knew how Dr. Serie would have questioned me. I knew he would question my studies’ results based on age of the patients we used in our analyses compared to his own practice, and I knew he hated our product.  I knew he would challenge me on outcomes, because his own personal medical practice outcomes were different than our large clinical trial outcomes, and he did. And he came at me hard, with his facts and his paper citations, in front of my bosses, in front of their bosses, in front of our CEO, and in front of all the other doctors in the room.  Imagine me, little Sarah, in my first gig, being tested like that, knowing that if I got it wrong, the company, my team, my bosses, would look bad, and this product that we had worked so hard on to get right, might not be able to be used in treating patients who needed some help. 

 

I had to get it right, because I believed in this product, and my team did, too.  What he didn’t realize, this super excellent surgeon, this leader in the industry that everyone respected so much, is that I had watched him, studied him, very, very closely, and so I was prepared for him.  Everyone knew his name, around the world, and they got quiet and sat up more straight when he walked into a room.  He, too, was and is a ballbuster, and when he speaks in that loud, leader voice, people shut up and listen. He is so tough, he is so experienced that he gets the toughest patients with the hardest cases, and he was excellent at what he did. 

 

One of the things I learned to do as I grew up was to watch people who are excellent.  I watch their mannerisms, I listen to the way they speak.  I watch how they look at people, how they hold their body position as they talk to people, when they are listening and when they are speaking.  I listen if they use strong words of emotion or facts to back up their positions.  I listen and watch to see if they touch people on the arm or if they call people names instead of backing up their points with data and facts.  I watch to see if they puff themselves up by shaming people or by being excellent, and mostly, once they are excellent, I watch what they do with it. 

 

Friends, I have seen and studied excellence for years, watching, always, always watching, because I have seen people shoot up the ladder and be the very best, only to tumble down hard because they got greedy, they got vain, they became hated because they were good but forgot to realize that a whole team of people both before and below them helped to get them there, and they became more about the image than the excellence.  I am most afraid of becoming that way, and so I pay attention and make sure to humble myself all the time, such as in Kitchens and in other situations where I am not the expert, in order to remind myself that there is always something to learn from everyone, and to remind myself to enjoy being on top because it is fleeting and temporary, usually, but not in the case of this doctor.

 

This doctor was not one of those guys. This doctor was the real deal, and I and my bosses knew it.  He was not even supposed to be there that day, and he rsvp’d last minute, but I knew that was his style, so I prepared for him and his questions that I knew would be coming.

 

I studied him, and I researched and pulled his dozens of research papers and read them up and down, back and forth, for hours on my own time, before this conference, because I knew I had to be ready for his questions.  I had my database teams pull our studies’ data in ways that had not yet been looked into, for our products, and it irritated those teams, because they were busy, and because I did not have time to provide a rationale for what I wanted, I just needed it done.  Little Sarah was a bit of a ballbuster, even back then, it seems.  I just was not very gracious about it, because I had not yet learned the finesse of being a woman ballbuster, which requires a shift in approach compared to how a man does it.  Feminist or not, if you want what you want, you have to play in reality in the business world, and it helps to have a little sweetness, and I do, but I did not always have that.  I pulled and analyzed this data in the way this doctor would, so that I could have those back-up slides ready for him, with surgical case anecdotes and case report form data ready to quote.  He put me through the wringer.

 

OH did he put me through the wringer, challenging my data, my methods, my rationale, and every data point that was a deviation from the median and average.  I was ready.  I had run the data with and without those outliers, so I had multiple conclusions ready for his questions, which no one seemed to have expected, judging from the way my boss went pale when this doctor stood up (STOOD UP!) to first put me through my paces.  I was terrified.  My palms started to sweat, and my pupils got smaller, because I respected this guy so much, and I wanted to be graded by him, judged by him, to see if I had what it took to do this job.

 

He challenged me over and over and over again.  I pulled up back-up slide after slide, agreeing with him yet gently and firmly pushing back, showing him another way to look at the same data set.  It was tense.  Not all doctors are this way, and the more soft-spoken ones watched this tennis match of wits and science, back and forth, back and forth, as I paced the room, pulling out analysis after analysis, data set of this study and related projects that no one expected to talk about that day. It went on for 25 minutes, as he took over my 45 minute meeting, and we all let him, because when it came down to it, this guy’s opinion would be the toughest to get on board, and if you got him, you got everyone.  Dear God he was tough on me that day and I can feel the adrenaline just remembering this day with him, because it is one of my favorites.

 

This doctors remains one of my most loved mentors BECAUSE he was tough on me, and he would not let my team or any other spin and tweak data just to sell more products, no, he wanted to make absolutely sure the data we used to decide how to market our products to doctors, and how to train those doctors and surgeons on how to use our products, was truthful, was ethical, and would work, for most of the patients, anyway.  I loved him.  I still love him.

 

I loved him in a way that was not romantic or sexy, but in a way that inside made me yell, “Yes!  That’s it!  Awesome question!  Thank you for being hard on us!  Thank you for helping me make sure we thought of every little thing and then some! You rock!”  But, of course, in the room, in that hotel meeting room like so many hundreds of others I have led meetings in since then, we acknowledged each other with little nods and “yes, of course’s” and agreements and gentle, gracious agree-to-disagrees that were quiet and respectful.  He was excellent, he still is excellent, and when I saw him sit down, get quiet, so quiet that whole room turned and looked at him, to see if he had anything else to say, I knew I had to just….wait.

 

The whole room of doctors and researchers and bosses and I waited for him for what seemed like 2 days, but was really about 25 seconds of silence.  Finally, he looked up, and he nodded, and he said, “Ok.”  That word, that little 2 letter word, that word without one trace of a smile, was all I needed to know I had done ok, I had passed the test, and I had helped to convince this doctor, thanks to the work of my very hard working team, that this data was real, and that these patients could be treated with our product to help them have better lives, more connected and beautifully personal lives, with the people they loved best. 

 

I was on cloud nine, and that big ol’ American girl smile of mine could not be contained as I wrapped up my conclusions and shook hands and hugged everyone after the meeting was complete.

 

There are moments, still, when I meet up with the doctors who were in that room, who talk about that exchange, and we laugh about it, now, now that they know me as grown up ballbuster Sarah who is softer now, gentler now, wiser now, a little more gracious now than I used to be. The fire is still there, make no mistake, but I do not need to prove myself so hard anymore.  Now, I am the tough one, and I am the one who is the Go To to figure out if something is excellent, if it passes the test.  I take it very seriously, because I want to get it right.

 

As I prepare today to teach my graduate school classes in a couple of weeks on my trip home to Minnesota, I am smiling to myself, thinking of how nervous some of them always are, as they present their research to me.  I have a quiet little laugh to myself thinking about how easy it is to see if they have prepared, if they have done their research, or if they skated through and slapped on some snazzy graphics, thinking I will not notice their lack of facts and data.  I know that my job as a professor who teaches these students ethics and patient safety and how to think about data instead of just memorizing it and repeating it, is to push them, to test them, to help them be the very best they can be.  The way I learned this was from the teachers and doctors before me, who did the same thing for Little Sarah.  Funny how everything comes full circle when you are busy with life.

 

So, as I put together my slidesets and hand-outs for classes, and as I write the quizzes and exam questions, I took a moment to send a thank you note to my former boss, to that doctor and several others, and to the partner of my long-gone professor, to let them know how grateful I am for those tough days, those long, stressful days of learning to be a leader, a teacher, and someone who could not be more proud when they get it….right.

 

Wishing you a good day today, Friends, as you think about the people around you whom you, now, teach and make excellent.  It is a serious gig, this teaching, but I am sure that tonight over dinner, as I thank this doctor for teaching me, that we will have our usual sexual function and sexual health jokes, as we always do, because even in excellence, we are Friends, always, because we respect each other and trust each other, and that is what makes me happy today.

 

With love from New York, soon to be Minneapolis,

Your Good Friend Sarah