Cassandra Learns a Leadership Lesson

Author: Avital O’Glasser, MD

Over the summer, I attended a leadership retreat.  One of the core themes that emerged was the concept that “leadership is about managing losses.”

Leadership is about managing losses.

We were then asked to pair-and-share examples of losses we had experienced in our experiences as leaders and followers.  I wracked my brain–financial losses? Loss of available staff? Loss of creative time and emotional bandwidth? Yes. All the above.  Especially during the COVID-19 pandemic. 

And then it hit me–gender equity and DEI work is about managing losses.  

Leadership is about managing losses.  

And these losses do not have to only be tangible or material.  They can also be intangibles.

Being a woman in medicine is about managing losses.  Being an underrepresented minority in medicine is about managing losses.

Not being heard is a loss. Not being believed is a loss.  Not being listened to is a loss.

Being gaslit is a loss.

Being mansplained to is a loss.

Constantly feeling like me, like a “Cassandra” is a loss.

Constantly fighting misinformation and disinformation while simultaneously facing harassment for speaking the truth is a loss–a loss of identity, authority, and safety. 

The leadership retreat teachers then went on to apply this concept to organizational leadership–that losses are a systems issue, not only personal feelings and failings.  Losses aren’t created by “laziness” by employees, but instead may be the manifestation of the same systems-level challenges that lead to burnout, moral injury, and threats to mental health.  Intangible losses include the loss of psychological safety, trust, and a community that actively listens.

And while it may seem mundate, losing MedTwitter due to dramatic changes instituted by its new ownership (beginning in November 2022) is a loss. In our workshop activity, I ultimately decided to explore this recent “loss”.  Rather than frame it as the loss of an open browser on my computer or the loss of an app on my smartphone, I pulled in shared wisdom from the MedTwitter community itself–and the bigger, broader lessons about what MedTwitter was helping us handle, learn from, manage and at time, grieve.  We’ve already lost a support space that was not “stifling of creativity and expression”, the “safe & energizing place for the nerds & misfits & outcasts & wallflowers” that “allowed voices normally silenced to speak loudly”.  Dr. Jerge articulate the loss as that resulted because, “Elon has taken something that saved lives, built careers, helped the minoritized and disenfranchised, became an agent for advocacy, dialogue, discussion, progress, and community and functionally burned it to the ground.”

The workshop teachers then shared the pearl that leaders are also grief counselors.  I’m not sure Cassandra would readily agree that the Trojans accepted her role as such, but you might have much more success in this role, especially by engaging stakeholders and allies.  We don’t bandaid the loss.  We don’t ignore the loss.  We don’t sweep it under a rug.  We don’t bandaid  the gaslighting.  We don’t ignore the mansplaining. We don’t sweep the harassment under the rug.  We name it; we honor the loss; we move forward empowered by our positive memories and by seeking opportunities, healing, boundaries, and agency.

So yes, leadership is about managing losses–and it is also about creating and embracing.  It is about embracing uncertainty rather than mourning the loss of certainty.  It is about embracing followership rather than mourning the loss of authority.  It is about embracing that someone’s resistance to change may be more a manifestation of their grief than stubborn obstinance. It is about embracing the ability to articulate your authentic truth rather than mourning failed attempts to conform to an antiquated stereotype of a leader.  

We may not be able to prevent all losses.  We may not have to accept all losses.  But we can honor and respect that loss can and should be grieved.  We can honor and respect that our stakeholders and those who trust our leadership will guide them through grief, when it arises. And, whether or not we believe that possibility now, we can channel our experiences with grief into our next rounds of opportunity, agency, and growth.

About the author: Avital O’Glasser, MD, is a hospitalist at Oregon Health & Science University and the editor of the WIMS blog and co-editor of the WIMS Book (Twitter: @aoglasser).