Tragedy On My 100th Day As CEO With Dr. Diana Hendel

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TSP Diana | Hope And ResilienceEpisode Summary:

The 100th day is typically a milestone for any career. For Dr. Diana Hendel, however, it came with a tragedy that changed her life and led her to a profound understanding of trauma and how individuals and organizations can come out of it with hope and resilience. Joining John Livesay, she shares the tragedy on her 100th day as CEO, and how she learned to let go of the blame, shame and guilt that came with it. Diana’s career spanned more than 25 years of experience in leadership at all levels of complex organizations. She was the CEO of Long Beach Memorial and Miller Children’s & Women’s Hospital and currently serves as Senior Partner with Partnership Advantage. Join in as she shares the story of how she and her organization came out stronger after the traumatic experience – a powerful message which she brings out to the world through her new book.

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Tragedy On My 100th Day As CEO With Dr. Diana Hendel

Our guest is Dr. Diana Hendel, the author of Responsible. She shares what it’s like to be a CEO of a major hospital and have a tragic shooting take place and how she helped heal her post-traumatic stress disorder, as well as that of the fellow employees and the hospital itself. The lessons that we all need about the things that don’t kill us can in fact, make us stronger and how we can let go of this need to have guilt, blame, and shame. Instead, go on a journey where we see themselves or other people in this story of resilience. The book is called Responsible. You’re going to enjoy her story.

Dr. Diana Hendel is an experienced healthcare executive, inspirational leader, and a team builder. Her accomplishments span a career of many years with experience in leadership and all kinds of complex organizations. She was the former CEO of the Long Beach Memorial and Miller Children’s & Women’s Hospital. She led one of the largest acute care trauma and teaching medical centers on the West Coast. She is a senior partner with Partnership Advantage, which is a consulting firm that helps individuals and organizations achieve optimal performance for the betterment of the communities they serve. Her areas of expertise include a strategic vision, business growth, as well as creating agile and resilient teams. She’s held many leadership roles with all kinds of hospital and healthcare associations. She has a new book out called Responsible. Diana, welcome to the show.

It’s great to be here, John. Thanks for having me.

I touched on a few things about your career. I’d like to ask you to take us on your own story of origin. You can go back to childhood, college, wherever you want. Where did you start your journey to get into healthcare? Did you always dream of running a hospital? Is that a little girl’s dream that I don’t know about?

I grew up in Southern California and went to school at UC Irvine. I’m interested in biology. My undergraduate degree in major is biology. As I was thinking about careers and where I wanted to best serve, healthcare jumped out at me. There were many aspects of it that were important to me. One, the technical aspects, the operational aspects were quite intriguing. My graduate work was in pharmacy. Systems, processes, analyses, and therapeutics were all interesting to me. More than that, I loved the way hospitals ran. I loved that the focus was on people. The focus was on creating this well-orchestrated team that had to work in sync and that not any one patient can be cared for by one person. It takes an entire team.

When I thought about a career in healthcare and particularly in hospitals, it makes sense that when I was growing up, I was involved in sports and played all kinds of different sports. In those days, you didn’t specialize in the sport. We played all of them. I played a lot of individual sports, but the ones I enjoyed the most were team sports. I liked being part of a team. I liked competing with the outside. We had to create camaraderie and unity. We had to be in sync. We had to settle differences. We had to be well-orchestrated. You can see the analogy between a hospital and being on sports teams. It was natural from my upbringing and my childhood and the things I was interested in to then embark on a career in healthcare and particularly in hospital care.

TSP Diana | Hope And Resilience

Hope And Resilience: So much has been written about individuals who have been traumatized, but very little has been published about the impact of trauma on organizations and on their culture.

 

How does someone get to become the CEO of a hospital? That would be of interest. Not many people achieve that level of success. An analogy would be you’re a teacher and then you become the assistant principal and then you get to be principal. Is it that step-by-step process?

It can be. To your point earlier, did I grow up as a little girl wanting to be a CEO? No, I didn’t. What I was interested in was learning and growing at each stage. How I became a hospital CEO was, I have a clinical background. I started at Long Beach Memorial as a pharmacy student. I did an administrative residency after a clinical residency. I found that as much as I enjoyed clinical pharmacy practice and the department of pharmacy, I liked the inner workings, the operational connections with all the different departments, laboratory, nursing, medicine, etc.

Over the years, I took on more and more responsibility and progressively got larger promotions and more responsibility for hospitals. Over the years, I gained a lot of experience in how hospitals ran and their strategic tactics, working with teams, being effective as a leader. I knew what it was like to be at every level of leadership, from the ground up, from being the student to then becoming the CEO. It was a calling. I love the role of CEO. I loved being involved with the hospital, its operations and its strategic future. I also love the connection with the community. Most hospitals are cornerstones of the community. They’re the bedrock of the community. They’re often one of the largest employers in the community and often a large educator, all the student nurses, physicians, and pharmacists. I like being connected to both the community and running this large business.

How many people were you managing when you’re the CEO?

Our hospitals were three hospitals in the city of Long Beach. They were a part of a larger health system. We had over 6,000 employees and about 2,000 independent physicians and specialists. At that time, there were 2,000 or 3,000 independent contractors and other consultants that worked there. It was a city within a city.

You’re like the mayor of that city. It got its ecosystem and who gets allowed in and all of that stuff. How long were you the CEO before this life-changing incident happened where there was a shooting? How long were you the CEO before that happened?

It happened on my 100th day as CEO. While I’d been in the system and the organization for more than twenty years at that time, it was my 100th day. I know that because I always created 100-day plans. On that day, I stopped and thought about what it meant to be on my 100th day, and the words I said out loud were, “I’ve got this.” What I meant by that is I knew there would be a lot of challenges in the future. I knew I had a lot to learn. At 100 days, I had a strong sense that I knew that I could do this job and I knew I could do it well.

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Take us back to that monumental day. You’re like, “I got this. I’m feeling confident.” There are some contingency plans for anything, whether it’s an earthquake, shooting, flood, you name it. Whatever could go wrong, everybody has to try in some way to prepare for something. Take us back and paint a picture for us, Diana. What day and time was it? How did you find out about what was going on?

It was April 16th, 2009. It was mid-morning. I was in my office, which is adjacent to the lobby. A little before noon, a man came into the lobby and entered the outpatient pharmacy, which was adjacent to it. He shot and killed the supervisor of the outpatient pharmacy. The shooter then traveled through the hospital quite a long distance to the other side of the hospital outside the emergency department and encountered another man who was the executive director of the pharmacy services. He shot and killed him. A few moments later, just before the police arrived, the shooter shot and killed himself.

Did you hear the gunshots?

I did not hear the gunshots. I got immediate reports of the gunshots.

How much time between the first shooting and the second shooting?

About two minutes.

There’s not a lot that you can warn people or anything.

TSP Diana | Hope And Resilience

Hope And Resilience: There are patterns of individual responses and reactions that are normal to trauma and they can shape how they respond in the future.

 

What is important to know is that any shooting and anytime someone comes into a hospital and kills people, it is shocking. What was particularly shocking about this shooting was that the shooter was an employee.

I didn’t see that plot twist coming. Were these personal specific people that he targeted? He knew his way around. I thought it was going to be a disgruntled patient with some pharmacy issues. It’s like the postal workers get accused of being upset at their boss and losing it.

This employee was a beloved employee. The shooter was beloved. He had been our employee of the quarter, recognized the month before. It begs the question and what emerged instantly was why. All motives eventually were dismissed. The only one that remained and became an urban legend was the question of whether he had shot and killed his bosses because of the upcoming layoff. The layoff as motive became ingrained certainly for me, personally. As the CEO, I had made the decision to do that layoff. The pharmacy department was my home department. These were my friends. These were people I knew well. By virtue of my role, I was the first responder to all three scenes within moments after it happened. The shock of encountering the two victims and then encountering the perpetrator who had killed himself was individually or personally to me extraordinarily shocking. My world was shattered.

It’s one of those things that happened where it would be a lot to digest. You know someone who’s been murdered. Two people you know are your friends and the third is a beloved employee. Our system is not wired to handle that back-to-back trauma. You talk about in your book, Responsible, that you realized you were experiencing your own PTSD, which I want to talk about. Is this still painful for you to discuss?

Interestingly it doesn’t trigger me in the same way it did. As I completely processed and integrated it, recovered and healed, I feel it’s important to talk about less the actual details but to introduce and to come out as a leader who had PTSD and as a patient who had PTSD. That wasn’t apparent immediately. I knew I was shocked but I was well-trained to respond to a disaster. Hospitals are good at responding to disasters. We’re practiced in it. Our structures and processes are well oiled. We do them well. This was a situation where we were responding to our trauma. We were accustomed to people being brought to us but not responding to our own.

I’ve heard horror stories of someone being brought into the ER that’s part of a gang shooting and then the gang breaks in to finish the job off. I can only imagine how dramatic that would be. To know the people and then feel on some level that you’re responsible for triggering that behavior, that’s a lot to process. My next question is, how did you come up with the book, Responsible? I’m sure everyone reading is going, “Surely, she’s not saying she was responsible for causing that guy to kill those people and himself.” What does the title mean?

I wrote the book for a number of reasons. One, it’s a tribute to my former colleagues, the ones who were killed and to my former coworkers. I ended up staying as CEO for the next six years. I had grown up in this organization. The other reason for writing it was an exploration of the word responsible. We say, “The leader is responsible for what happens.” We say, “The buck stops here.” We say, “Who’s held accountable for when things happen?” Our first question when something happens is why it did happen. What could have been done to prevent it? What provoked it?

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What I discovered is that while it was irrational to believe I was responsible or to feel responsible, it wasn’t all that off-base given our societal messages and my upbringing of responsibility. I didn’t feel like I caused it. It was a slippery slope with a sense of responsibility. I wrote it to introduce that concept and to explore it. When individuals and an organization are traumatized, there are biological responses that happen involuntarily. There’s the fight-flight-freeze response that happens biologically. I thought it was important to introduce how PTSD develops and how you can recover from it, but also the impacts of trauma on an organization. We don’t think of organizations themselves being traumatized.

The first step is realizing you’re a medical professional. Sometimes doctors are the worst patients. That’s the standard line anyway. You think, “Surely, I’m equipped to handle this. I’ve been trained.” You write about it in your book, the sheep in wolf’s clothing. Tell us that story of when you realized, “I’ve got this. I’m suffering from post-traumatic stress syndrome. I can’t sleep. I got all the symptoms.”

I did get help right away. We certainly brought in help for all those affected. I didn’t think I was immune to the need for help. I got help right away. What I didn’t appreciate was that usually, when severe trauma that shatters your worldview or shocks you significantly happens, rarely are you needing to return to the same place that happened. Usually, there’s a distance or separation. You can remove yourself.

It’s like the people in 9/11 don’t need to go back there for a while.

When things happen in schools, churches, and other places, often they’re torn down. A memorial is created in their place and then they’re re-established. This was a 1 million square-foot hospital that had been there for decades. We certainly weren’t moving or closing. We didn’t close that day. We’re 24/7 operation. There’s no closing. We kept going. We had 600 patients still to care for.

You don’t go home and check yourself. You don’t go like, “I need a minute here.” You’ve got to function and your adrenaline kicked in.

To your point, many people but certainly hospital people are stiff up for lip or resilient or tough. I had been through lots of adversity, hardship, setbacks, failures, and disasters. I’ve had a lot of practice going through that. I knew well enough to get help and I did get help. What I didn’t appreciate was that staying in the same place certainly could have a long-term impact. I don’t suggest anywhere in the book or even now that I should have left sooner, not at all. In parallel, a lot of my healing was because it was due to the bonding, the camaraderie, and the teamwork that we all experienced. It was the worst day of our lives and I saw the best in people. In parallel, the bonding and camaraderie served to heal. I got to a point where I wasn’t going to be able to fully recover and heal without stepping down.

TSP Diana | Hope And Resilience

Hope And Resilience: While going through trauma can shatter you and your organization, you can emerge stronger and better than you would have been had you not gone through it.

 

A lot of CEOs are afraid that if they say they have PTSD, they can’t function. They have to step away from their job and miss months or weeks. What was your situation?

That’s interesting. I felt a calling and the importance of staying. It never occurred to me to leave. I wasn’t worried that if I said I needed help that I would not be able to remain CEO initially. What I found was that over time, the organization had moved on. The handful of people who were closest to it had moved on and gone to other places. I found that I became extremely isolated while surrounded by lots and lots of people. It became important that the organization deserved a healthy CEO and I deserve to recover. After six years, I stepped away. I wasn’t as afraid to say I needed help. It was clear that having PTSD, having nightmares, having flashbacks, losing sleep, that was taking a toll on my health.

Do you get triggered sometimes walking in the building?

Often, because it had happened in three different locations and in locations that were right near my office, there wasn’t any time that I didn’t walk through. After the shooter situation, that was the new term in 2009. In fact, we didn’t have disaster protocols for that. We wrote them for hospitals thereafter based on our experience. At the time, I viewed the hospital as a sacred place, as an ultimate safe place. I thought it was the safest place I could ever be. That sense of safety and security was shattered. It can be difficult then to remain in that same setting.

That leads to a perfect transition to where we are with some people returning to the office. I’m careful about my wording. I’ve been talking to one of my clients, Gensler, the world’s largest architecture firm. They create a lot of workspaces. It’s not a return to work. When you say that to people, they get angry because they’ve been working hard from home. It’s to return to the office. Suddenly, if the office because of the disease no longer feels like a safe place, your timing is perfect to help people deal with this issue. “Is it safe to go back to a workplace and be exposed to germs, especially if I’m at high risk or I’m living with somebody who’s high risk and all the issues around that?” Before we get into that, I want your expertise on this. What does it look like for an organization to have PTSD? You never thought about it like that and I haven’t either. That will help us help others returning to the office if we can say this is what it looks like when the organization has it. What does that look like? How can people identify it?

Much has been written about individuals who have been traumatized, but little has been published about the impact of trauma on organizations and on their culture. There are parallel paths similar to the individual. Even though everyone within the organization has experienced a trauma, to make a parallel with COVID, even though all of us are experiencing COVID, we’re not all experiencing it the same way, in the same degree, and in the same impact at this moment. That may change in the future. Similarly, for organizations, there were people close to it who had survivor guilt and had self-blame. There were people further removed who thought, “I didn’t know those people. That was tragic but life goes on.”

It’s the ripple effect and the idea that you have this large body of people or this culture of people who all had a different experience with that trauma. The patterns I noticed initially and similar to COVID was, “We’re all in this together.” That sense of camaraderie and togetherness. Also, what emerges is varying degrees of blame, guilt, and shame. When I say blame, it ranges from one end of the spectrum of the shooter being crazy to who and what made him do it and everything in between. One end of the spectrum leaves the shooter very much responsible for the shooting, his actions, but also the notion that if he was crazy, it leaves a lot of unpredictability. Who else among us might be crazy, especially employee of the month?

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I would love your opinion on this. I gave my TEDx Talk, Be The Lifeguard of Your Own Life!, around my own experience of being laid off. After being in a job for fifteen years and the industry is being disrupted, it was challenging even though I talk about who we are is bigger than what we do for a living. Especially if you’re a CEO, I would imagine it’s challenging to not let your identity get tied up with your job. If someone is beloved and an employee of the month and they feel like they’re losing that identity, we never know what the trigger is. I would be mad and scared, hurt but I certainly wouldn’t go “ballistic.” That’s you. You’ve got some emotional intelligence, some support group. Maybe this is all that person had. Who knows? How do you not take being laid off personally? If it’s between laying off some people and the company or the hospital continuing to function and pay their bills versus keeping everybody employed and everybody going down, you’re not thinking rationally. Your brain has been hijacked.

That’s the key. Your brain is hijacked. These thoughts and feelings that emerge initially are the results of trauma. It’s not necessarily whether it’s rational thinking. It’s our survival mechanism. To your point, most people who face layoffs do adapt and yet there is an impact on their identity or on their ego. Even the fear of paying bills, it’s much more than losing a job. It equates to our value, all those things. At the other end of the spectrum, it then became this sense of, who made him do it? What pushed him into doing that? There was a wide range of opinions, mostly as the result of our brains being hijacked. The layoff as motive narrative was not the only narrative. It happened to be central to me. There were lots of narratives that emerged. I don’t know all of them. I know most of them but that one resonated and traumatized me for obvious reasons. It’s because I had been the one to decide on the layoff. The overarching is we’ll never know. There’s a sense of uncertainty. We had to grapple with that.

It’s fascinating because friends of mine who work in other industries have said that the most stressful part of the whole quarantine situation for them, besides their own impact of having to work from home, teach their kids, not take their kids to school and the kids are traumatized, they miss their friends, all of that. You now need to lay off X percent of your team that you’ve assembled for the last year and a half or two years. I don’t think anybody usually thinks about the person having to do the layoffs and how traumatic that is, especially if you care about your people. You’re focused on the person receiving the news.

If you’re an HR, that’s part of your job. You’re trained how to stay neutral and let the person have their feelings and all that stuff. In this situation, it’s like we’re a speaking bureau. We have to let go. There are no live events. We’re a hotel or we’re a university even, and it’s all online. There’s a lot of gold you have from having gone through this that can help people realize this is not a normal layoff time. You get to be traumatized by having to lay off this many people all at once for no fault of anyone. Who cares?

Let’s get out of the guilt and blame or even shame of being laid off. I don’t think it’s a thing anymore because there are many people that are experiencing unemployment. That can contribute to the fear-fight-flight or “How am I going to get a job now?” It’s this bizarre time on all sides of the experience, even if you’re not someone who has been laid off. What’s interesting is a lot of my friends, their salaries have been cut 20% to 50%. They’re not laid off but they’re sure under some financial stress. It’s like I have half a leg that I had completely amputated.

They’re probably working 2, 3, or 4 hours more a day than they were before.

They’ve had to lay off the staff and they are being blamed for things. “Marketing is not doing their job.” It’s like, “What?” That’s a go-to statement for a lot of marketing people anyway, but now that’s an easy scapegoat. This concept of guilt, blame, and shame is fascinating through the lens of how do you deal with that when you have post-traumatic stress syndrome. What would be the one thing you’d want people to know about the book and why they should get it?

TSP Diana | Hope And Resilience

Responsible: A Memoir

The book immerses you in a story that, while it’s unique, it is relatable. It evokes universal feelings and thoughts. People who read the book will see themselves or others in it. It can help to normalize when individuals and organizations are traumatized, there are patterns. There are responses and reactions by the individuals that are normal to trauma. It can change and shape how we do respond in the future. To your point, in our time, individuals are under extraordinary stress. There are no easy answers. We do a disservice by reducing, simplifying, or making it one dimensional.

We do a great service by talking about the dilemmas and talking about the struggles. That’s where we as humans and our society do well is when we can surface the dilemmas without becoming polarized and without saying, “We have to choose the strength of our economy or the health of our population.” How about if we leverage both? The book surfaces that through a story. The book offers hope. It’s a message that while going through trauma, that can shatter you in an organization. You can emerge stronger and better than you would have been had you not gone through the trauma.

I talk about the importance of telling a story that other people see themselves in and how that takes people on a journey. One of my clients is a high tech healthcare company. Those salespeople are in the operating rooms with the doctors. Because of the shortage of masks and their own health issues, they have to do it virtually. It’s a whole another paradigm for everybody that makes it challenging to even “do your job” if you’re in healthcare. This concept of helping people see themselves in the story is a reason enough to get any book. We’re going to be taken on a journey where we either see ourselves or someone we know in it and we can start to recognize patterns that can help us get some new tools in our toolbox to deal with any situation, whether it’s what we’re experiencing now or something in the future. Diana, how can people find you? I know you also do some consulting. What’s the best way for people to reach out to you?

The best way is via my email, DHendel@PartnershipADV.com.

Diana, thank you so much for sharing your story. Your courage and your vulnerability inspire us all.

Thank you, John.

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