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The most important feature of any leadership relationship lies within the self. The leadership relationship begins when a leader makes an impression on one or more individuals. The next step is creating relationships with those individuals. Finally, the most challenging step is maintaining those relationships. Creating and maintaining relationships are an investment of time and energy by all parties. In order to invest, individuals must believe and trust the object of that investment. Having personality traits, values, and philosophical perspectives that are consistent, trustworthy, and inspiring are the most important aspects of leadership. These key aspects start with the self. To be an effective leader, it is crucial to understand and ultimately be comfortable with that oneself. This is a process that should be at the core of every phase of life, where one must consistently reflect on his/her values, beliefs, and experiences in the greater context of life.
This paper reviews my competencies related to these area of self-leadership. These are philosophical foundations, ethics, values and spirituality, learning and human development. I review some of my experiences and readings that have helped me understand what these competencies involve and I also mention artifacts that document some of my learning in these areas. I believe we create values and schemas through stories that influence us. Thus, I review stories that have shaped both my values and my being. I hope to open a window into my inner self through the formative stories that have influenced me and to share the knowledge that I have used to reflect on those experiences.
This competency is about the belief systems that is at the core of a person’s leadership paradigm. Though many don’t actively contemplate on the philosophical concepts behind their leadership styles, we have all, passively, inherited the wisdom of those that have come before us. The essence of many of our current philosophical beliefs about leadership originated thousands of years ago when great thinkers (philosophers, sages and prophets) dwelled on this central ideas, which are what make a great leader.
The subject of leadership has been ubiquitous among philosophers. From Socrates to Plato to Cicero and then branching out to Thomas Aquinas, Averos, Avecena, Hume, Hobes, James and many others, many thinkers have had a philosophical perspective as it pertains to the subject of leadership. Thus, to truly understand where we are today, we need to know where the concepts were born, and how they have evolved. Though I received my traditional education in university classes and books, I received my most valuable lesson on leadership in the most unexpected of places.
It was in December of 1999 that a long forgotten and desolate land in the middle of Asia was struggling to survive under the reign of the despotic government of the Taliban. This fanatical organization had no ties with the West and very few ties with any other countries. Their recalcitrant and self-destructive ways had propelled the country into utter chaos. The country had the worst health parameters in the world and everyone had turned their back on the suffering of its women and children. After all, what benefit would be gained in spending resources on a people and a land that was unredeemable?
At the time I was a resident physician at Georgetown University, leading a comfortable life in Virginia. Due to my Afghan lineage, I had slightly more interest in the needs of the country than most people around me. Every once in a while I would hear of the atrocities or the natural calamities that had befallen the beleaguered people. My friends would ask “Who would go there to help under these conditions? Why would you take the risk?”.
One day while reading the newspaper, I came across an article telling of a group of American physicians who were traveling to Afghanistan in hopes of rebuilding the medical school and providing better healthcare. The group was from Loma Linda University, led by a physician named Gordon Hadley. Dr. Hadley had visited Afghanistan more than 30 years earlier and had helped establish the medical school curriculum. He now hoped to rebuild the medical school with the help of the Taliban Regime. This represented a worldview that Loma Linda University and Dr. Hadley embodied. It was a worldview of servant leadership and seeing value in every person, and living this view with every action and deed. Seeing a model of servant leadership in such a functional and effective way that generated broad and long-term change completely altered my view of leadership (Greenleaf & Spears, 2002). I began to realize that when it came down to human affairs, the egalitarian approach of valuing people for who they are is not only an empathic and emotional decision, but can produce the highest utility for all.
The central idea behind servant leadership is to put others first. Though this idea has been around for many years, it was first coined by Robert Greenleaf in his essay, “The Servant as Leader”, in 1970. It was here that he was quoted as saying;
The servant-leader is servant first. It begins with the natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. That person is sharply different from one who is leader first, perhaps because of the need to assuage an unusual power drive or to acquire material possessions. The leader first and the servant first are two extreme types. Between them there are shadings and blends that are part of the infinite variety of human nature. The difference manifests itself in the care taken by the servant first to make sure that other people’s highest priority needs are being served. The best test, and difficult to administer, is: Do those served grow as persons? Do they, while being served, become healthier, wiser, freer, more autonomous, more likely themselves to become servants? And, what is the effect on the least privileged in society? Will they benefit or at least not be further deprived? (Greenleaf, 2002)
This type of leadership is more consistent with the participative (democratic) leadership than the autocratic or laissez-faire leadership styles. “Autocratic leadership revolves around command and control, and laissez-faire leadership is a disconnected model where the leader has minimal to no involvement and influence on the followers” (Vugt, 2004). Servant leadership is all about the empowerment of the person so that they are left with greater resources, and are better than before the leaders interjected in their lives. This concept continues to resonate with me and my idea of empowering leadership, which originates from a belief in each person’s infinite cognitive capacity and a leader’s ability to optimize that capacity. To date, majority of leadership in many different contexts have followed an autocratic model, which is intrinsically incompatible with a servant or empowering model. Much of today’s leadership style stems from the power structure and isolated nature of leadership, which leads to and promotes a self-serving, goal oriented process. This may ultimately develop into disassociation from the followers. This dissociation in turn creates further isolation and autocratic leadership (Williams, 2014). In contrast, servant leadership starts with the other in mind, and starts with trust in the follower and acknowledgement of all the characteristics that make up a follower. This acknowledgement can be used as a stepping stone to identification of their strengths and building, through resource (knowledge, time, material) allocation, and ultimate empowerment. This creates a following that is empowered and has reached its full potential, but this path has servant leadership as a necessary requirement (Russell, 2001). Why can’t empowering leadership start simply at the allocation of resources level, and needs the leader to start with the other in mind? It is because one extremely important part of leadership is trust, and trust can only be engendered if the commitment is genuine (Sendjaya, 2010).
Empowering leadership is an acknowledgement of the incredibly unique gifts of each individual and what they can bring to society, if empowered with the right tools, at the right time, for the right projects. This concept builds on the idea that, as leaders, we can bring the full force of our follower’s brains (1 x 1027 neuronal connections) to its full creative potential when we empower them with the right tools and conditions (Zhang, & Bartol, 2010).
My leadership style over the past few years has been a blend of empowering leadership and servant leadership. Through my efforts in the Healthy Aging Committee of Department of Aging, I incorporated empowerment in the vision statement. I have also helped create and lead the Inland Empire Aging Collaborative, Institute for Healthy Aging, Alzheimer’s disease Communities of Care Collaborative, and the Healthy Aging Collaborative. In all of these efforts, I have included empowerment in the vision and mission statements, and have made sure to operationalize it in the goals of these efforts. We have also empowered the community through educational programs and associations where different partners with unique strengths build the capacities of others (http://www.instituteforhealthyaging.com/philosophical-foundations.html).
I have read many books to develop this philosophical perspective, some of which include Principle Centered Leadership by Stephen Covey, A Higher Standard of Leadership by Keshavan Nair, The 3 Keys of Empowerment by Ken Blanchard, Spiritual Health and Wellness by Siroj Sorajjakool, and Mandela’s Way by Richard Stengel. These books cover many stories and concepts, but at the center they all speak to leaders that started leadership with an intent to serve and empower those who followed them. Each leader strongly believed in orders and in the full capacity of other human beings. It was this belief in others, and their desire to empower others that placed them in a position of leadership.
Over the next few years, I would like to focus on empowering leadership by reconnecting with the healthcare community about their fundamental concepts of medical practice and determine the reason they chose the field. I believe most doctors chose to practice medicine because they believed in serving others for the greater good. Indeed, the years of schooling and long hours can drain servant leadership out of most physicians. It is difficult for them to see that simply serving others brings long-term change in our short-cut, ‘instant gratification’ culture, which can dissuades many from this approach. Thus, an empowering model would be more appropriate. Such a model would give medical providers a method to work towards the goals, and would inspire them to excel in their noble profession.
Ethics, Values, and Spirituality
Ethics, values, and spirituality are central to my approach to leadership. I would go as far as to say that they are central to any leader's approach. These are the concepts that frame and give oversight to how we see the world around us. Without values and an ethical framework, the leader will be deciding on the vision, mission, and goals solely framed by the linear landmarks of the project. They will not take into account the broader implications of the project over time, the greater community, and humanity in general. Ethics and values simply place a historical perspective of what is right and wrong for human beings beyond the myopic limits of the given project. The spiritual perspective elevates it to even higher vision. It gives it context beyond one's immediate life and meaning from a much higher altitudes.
The three people I admire most in life are each embodiments of the values, spirituality, and real change that I seek to bring to the world. Though I do not have any direct history with any of these three men, their stories, sacrifices, and philosophical approaches have had an immense impact on my life. Mahatma Gandhi, Dr. Martin Luther King, J., and Nelson Mandela each possessed a consistent set of values, belief in those values, and the courage to live those beliefs. Each man faced unfathomable challenges and often placed themselves in perilous situations. Yet with sheer resolution, they were able to bend the arc of history for the greater good. They were steadfast in their beliefs because their values came from universal truths, not bound by capricious laws, local traditions, or comforting historical patterns. Rather, their ideas came from a universal all-encompassing truth: belief in a higher power. In this belief, they sought comfort, found courage, and were ultimately able to persevere and succeed.
In our time I have seen no stronger ethics, values, and spiritual aspects of leadership than in these three men. If we hope to systematically integrate these core truths into our society, we must first clearly define them. The simplest definition of ethics is; systematizing, defending, and recommending concepts of right and wrong behavior (http://www.iep.utm.edu/ethics/). Today ethics can be divided into three components: metaethics, normative ethics, and applied ethics. Metaethics focuses on the origin of different types of ethics and where they come from and what could be their sociological and psychological implications. Normative ethics works at the everyday level and tries to deduce the correct codes of conduct for the different social structures. Finally, the field of applied ethics delves into the specific areas of potential ethical conflict such as abortion, animal rights, and capital punishment (Thiroux, 2011). Values are the rules that have been internalized within a person, not dictated from society, but rather from one’s own beliefs. The difference between ethics and values is that ethics is imposed from outside and values are what is drawn from inside (Stanford 2011). Spirituality is very difficult to define, but one that resonated with me was the relationship that each individual has with a perceived higher being and/or higher purpose (http://umm.edu/health/medical/altmed/treatment/spirituality).
Central to my desire to be a true leader is a strong foundation of values and spiritual connection. Spirituality gives a leader’s perceived values or ethics stability beyond the capricious whims of time, space, and circumstance. It is only with this inculcated stable set of operating principles that one can hope to influence others during times of change and chaos. These are the concepts that frame and give oversight to one’s perception of the world. Without values and an ethical framework, the leader makes decisions on the vision, mission, and goals solely based on the linear landmarks of the project. A leader without these key elements will not take into account the broader implications of the project over time, the greater community, and humanity as a whole. Ethics and values place a historical perspective of what is right and wrong for human beings beyond the myopic limits of the given project and time. The spiritual perspective elevates it to even higher vision, by giving the project context beyond one's immediate life and meaning from a much higher altitude. I have always tried to live my life according to a stable set of ethics and values, which are centered on acknowledging the beauty, power and potential in others, and consequently servicing and empowering others to create a greater harmony in our world. I see a much higher purpose and order in all this, and clearly see my role in the greater order of things.
Over the last 5 years, I have made sure to assimilate my values in everything I do. I have sacrificed monetary gain and power for what I believe in hopes of making the greatest difference for our world. My greatest calling is to empower those around me and to empower my patients and my community. Throughout a very busy work and community effort, I have strived to excel in what I have done, which has led to multiple awards of excellence (Top Doctor of Inland Empire, and the AOA award (http://www.instituteforhealthyaging.com/ethics-values-and-spirituality.html). I have also lived by my value of constantly bettering myself and learning by enrolling in graduate program (PhD) in leadership, nearly completing a DrPH in Public Health, and completing a very competitive Executive Leadership program at Harvard University. Most importantly, though, I have done all this because I live life passionately and abundantly, blessed by my greater purpose. Several artifacts in my website show my competency in this area: (a) The support letters from the churches in artifact section of my portfolio reveals my passion for community faith-based empowerment (b) The website and advertisements that I have included in my portfolio page for ethics related to the healthy aging conferences, which we have held three years in a row, speak to my passion for involving the entire community (faith, academic, policy makers, and business) in empowering everyone towards healthy aging.
Until I became a part of the leadership program, I had an amorphous sense of ethics, values, and spirituality. My perspective has greatly changed, through leadership and management programs, and the six classes on religion and ethics (Ethical Issues in Public Health, Healthcare and Dynamics of Christian Leadership, Philosophy of Religion, Christian Bioethics, Art of Integrative Care, and Ethics for Scientists). I have also been molded by independently reading books such as Ethics and Leadership by William D. Hitt, Medical Ethics by Gregory Pense, Practical Ethics by Peter Singer, and The Speed of Trust by Stephen Covey. These readings have better illuminated my thoughts and have helped to synchronize my values with my life’s journey and purpose. I, like many before me, struggled regarding the role of ethics in leadership, the definition of ethics, and its application. Hitt (1990), in his book Ethics and Leadership, helped me understand the concept of deontological ethics, which highlighted the role of intention above that of the outcome. This concept tries to get a handle on the highly complex and emotional aspect of human behavior, which recognizes the impossibility of distilling human ethics to purely mathematical outcome based models, and recognizing the intensions as lowest denominator of human transaction. This is in direct contrast to Peter Singer and his Utilitarian ethics, which place great value on the outcome (happiness). Happiness-based ethics, whether limited to the individual, or higher denominators such as community, nation, or humanity, still misses the complexity of performing a pure mathematical outcome analysis to population ethics, and lacks the necessary humility when dealing with ethics and human emotions. The deontological method takes into account the individual as a complex, flawed, emotional, yet valuable being in himself, and is weary of creating population based happiness models of ethics (Vetter, 2008). Similar models have had dire consequences when a few have determined that happiness of the larger group supersedes that of a smaller group.
Upon reading Stephen Covey’s book, At The Speed of Trust, it became evident to me that the deontological approach was perfectly consistent with genuine leadership that can only come about when originating from the true intention of a leader, and trust can only be engendered when one’s leadership originates from one’s true intention and not with the outcome (independent of each person) in mind.
This learning process has also had an unexpected consequence of connecting me to a higher spiritual source since this thought process naturally moves one’s values away from the material outcomes and to intrinsic values in each individual consciousness. This overt awareness of my ethical motivations has also had a fortuitous effect of bringing peace to my actions. I no longer cared about the outcomes that were beyond my control and simply focused on my intentions, which had the unusual effect of involving me in projects that had no immediate material or academic benefit to me personally, but were consistent with my believe of serving others and creating trust in my community. In the last few years, I have cancelled many lucrative clinics and national talks in order to provide community empowerment and lead pro bono local conversations. It is with this mindset that I strive to lead a life of service leadership while working as a neurologist.
During the past five years in the Inland Empire, I have worked in multiple free clinics, educated more than sixty faith communities on healthy living, led multiple collaborative efforts in the hopes of growing the community, and have created unity within those communities in order to bring out the best in this region. My efforts have led to the creation of the Inland Empire Aging Collaborative as well as Alzheimer’s disease Communities of Care Collaborative. These two collaborative endeavors focus on empowering communities to help themselves. At the core of our efforts is the ethical issue of aging and the tremendous loss of power and control that takes place in our society as we age. We hope to marshal the community resources in order to empower the elderly and give them control as they age.
Learning and Human Development
Leadership fosters an understanding of the principles of learning and is committed to continuous personal, interpersonal, group, and organizational learning. Learning and human development is central to leadership today more than ever before. Leadership in the 21st century is about a continuous quest for knowledge, and constantly keeping informed about the ever-changing information horizons. Most importantly, leadership is about leading by empowering others through knowledge.
If there is one thing that has been consistent in my life, it is my insatiable pursuit for knowledge. Concurrent with this quest has been my appreciation and desire for empowering others through knowledge. This quest to learn and to teach others has come in a full circle in the last few years. I have combined my love of knowledge, teaching and healthcare into one. This passion to educate patients, families, and their communities came after a great deal of reflection on what I was seeing in the clinics. Some examples of my work with patients can be seen on the pages; (http://www.instituteforhealthyaging.com/senior-centers.html), (http://www.instituteforhealthyaging.com/healthy-aging-communities.html), (http://www.weebly.com/weebly/main.php), & (http://www.instituteforhealthyaging.com/philosophical-foundations.html). I have spoken in dozens of churches about the concept of prevention and community involvement in the prevention process. This shift in my approach to medicine, I believe, was my most courageous act, as it is extremely difficult to turn away from the intrinsic forces that have physicians seeing patients every 15 minutes or the habit of living on procedures and surgeries instead of focusing on educating the patients, their families, and the community.
After working for several years in the patient mills, I realized that my work was not making the necessary difference. We were putting band-aids on significant medical problems to the point of no return. The only way that we could make an impact on the health care system would be in the communities, at the level of prevention and education. Yet, there were no incentives for preventive care as our system is focused on disease and treatment.
In this journey, I had to first learn, before I could teach. In my search for better understanding of learning and the theories around the concept I found the historic work of Dr. Bloom as chair of the committee that devised the taxonomy of learning in1954. The taxonomy was created as a formal method of, systematically and reproducibly, educating different students at different levels. What has come out of this concept has persisted, in different iterations, for more than 60 years (http://en.wikipedia.org/wiki/Bloom's_taxonomy). The original idea stratified education along three domains: cognitive (knowledge & critical thinking), affective (attitude and emotions), and psychomotor (doing). An important aspect of this concept is that higher levels of learning are dependent on learning and mastering the lower levels, and that the three domains are interdependent at some levels. Each of the domains encompassed other sub domains. Bloom and the rest of the task force had one main goal to reduce the annual comprehensive exams to assess by creating educational objectives. Cognition’s original six sub-domains included; knowledge, comprehension, application, analysis, synthesis, and evaluation. These were later revised to remember (I know), understand (I comprehend), apply (I can use it), analyze (I can be logical), evaluate (I can judge), and create (I can plan). As an example the cognitive domain has seen greater delineated to 19 sub categories, which are interdependent and build from lower levels to higher levels (Anderson, 2001). The main purpose of the revisions were to change the language from nouns to verbs (application). For example, with the new approach, the aspect of understanding would involve students drawing, or rewriting, or symbolizing what they have just learned. The affective domain revolved around emotional concepts and consists of five subcategories; receiving, responding, valuing, organizing, and characterizing. The first level is receiving, which implies that in order to move through to the other levels one must be open and receptive to information and the potential emotional aspects involved. In my personal journey to educate my patients and the community about prevention and lifestyle I have learned to get my audience to be receptive before anything else can be achieved. If they are not open to the idea, they will not listen let alone value it, internalize it, categorize it or go on to the action phase (http://www4.edumoodle.at/gwk/pluginfile.php/109/mod_resource/content/5/forehand_bloomschetaxonomie02.pdf). The psychomotor domain was the least developed one, which has since blossomed and now involves elements such as perception, set, guided response, mechanism, complex overt response, adaptation, and origination (Krathwohl, 2002). A tremendous amount of literature and application has come about from this sentinel original work, which has given educators more nuanced approaches to behavior of teaching and learning (http://www.celt.iastate.edu/pdfs-docs/teaching/RevisedBloomsHandout.pdf). Looking through the work of Bloom, colleagues, all those who have come after him and reflecting on it from a neurological perspective I can see these levels being superimposed on the anatomical and neurologic landmarks that have been delineated in the last few decades. One of the first sub categories of the taxonomy is knowledge, which neurologically can be mapped to the mediotemporal lobes of the brain, which is the short term memory centers, occipito-tempero-parietal association region, which is the information processing area, and frontal lobe, which functions to help us process and comprehend concepts (Demasio, 2000). At the same time, our ability to understand words takes place in the left parietal lobe, specifically, Wernike’s cortex, which has the sole role of understanding language (Robson, 2013; Lesser, 1986; Heilman, 1976). The emotional aspects of cognition originates in the amygdala, which is part of the limbic emotional systems involving the hippocampus, amygdala, fonix, parahippocampal gyrus, cingulate gyrus, and dentate gyrus (Joseph, 2011). Some of the newly recognized structures helping in learning and teaching, which involve our ability to empathize with others are the mirror neurons as well as the cingulate gyrus (Iacoboni, 2009). Today we are able to not only map the functional centers of the brain across different activities such as learning, but to observe it as it takes place using such tools as functional magnetic resonance imaging (fMRI) (Chen, 2012). Having greater knowledge of the neuroanatony, as well as a better look into the functional aspects of the brain through imaging (fMRI) we now recognize the importance of the affective aspects of the brain on the processing and memorizing component’s accessibility to learning as well as its resilience as we age (Sherzai, 2011). The future of learning and teaching is very bright as we will be able to maximize the tremendous capacity of the amazing brain, with its 100 trillion connections, through individualized, strength based, and technologically based tools and processes (Zull, 2011).
During the last five years, I have pursued a comprehensive educational program around behavioral psychology, community empowerment and leadership, and epidemiology and research. I have completed the necessary course-work for a doctorate in public health, with a focus on dementia and aging. I have led a team of researchers (clinicians, statistician, writers, students) on more than fifteen projects (http://www.ncbi.nlm.nih.gov/pubmed/?term=sherzai), and been accepted in a highly competitive executive leadership program at Harvard, with a focus on my management and leadership skills towards the Aging Institute (http://www.weebly.com/weebly/main.php). Throughout this effort, I have made sure to impart everything that I have learned to all around me. Thus, I have been asked to lead the student research education curriculum for Loma Linda University, which entailed teaching and empowering medical students and residents regarding research, helping them overcome their fears, and imparting them with the tools necessary to shine when approaching their own research. I have also participated in a faculty leadership program, which aims to bring a mindset of physician leadership to the physicians in Loma Linda and beyond. Education for myself, my students, my patients, and my community will always be a part of who I am and what I stand for (http://www.instituteforhealthyaging.com/learning--human-development.html).
In the next few years, I hope to use the knowledge I have acquired regarding research, management, and leadership to better the lives of communities with regards to their health. I hope to use my understanding of neuroscience of teaching and learning to help empower the community with their own health, and with the health of all those around them. By building on the learning theories, behavioral theories, as well as creating greater facilitation of learning through technology, I believe we will have a revolution in education that will change the world around us for the better.
Contributing to the Leadership Learning Group
Throughout the five years of my involvement in the leadership program, I have had the pleasure of working with some of the most enthusiastic and brilliant students. One of the most valuable components of this program has been the exchange of knowledge amongst the participants. It was in this spirit that I have been open to learning from my fellow journey men, as well as have had the honor of contributing to their knowledge. Since my background is research, I’m the director of research education in the department of Neurology, as well as the director of research education for Loma Linda University residency and fellowship program (http://swww.instituteforhealthyaging.com/learning--human-development.html), it was natural for me to serve as a mentor to some of the students requiring help on the topic of research. During the process of becoming eligible for research most of my fellow leadership members had to get training for medical and research ethics, and became quite familiar with the research ethics and limitations of human research. I have also had many conversations with my leadership group regarding the ethics of aging and why it is imperative that the healthcare community focus on empowering the elderly beyond medication dispensation. This mentoring has been a tremendous source of knowledge and one of the best parts of my journey, as often I ended up learning more than the very students I was guiding.
The aim of this group of competencies was to reflect on the self as the origin of any leadership endeavor. In order to lead others, one must capture their trust, and with that, both their minds and their hearts. Without trust, people are not willing to invest their time, resources, life, and passions to another person’s cause and vision. The object of that trust is twofold: they must trust both the leader’s integrity and his or her capacity. The first two competencies, namely philosophical foundations and ethics/morals/spirituality, speak to the integrity aspect of leadership. A broad and consistent foundation of the competencies, a sound knowledge base, and an upstanding set of values are what others want to see in their leaders. This combination of skills may not be overtly spoken about or documented, but they have been the most important driving forces in leadership for millennia. The third competency which speaks to capacity, though it has always been important, has become more important in a meritocratic, highly specialized, and metric-oriented world. Today a leader’s achievements are visible for all to assess, and their achievement regularly demonstrated in financial statements, articles, and is readily accessible for all to see. Thus, before attempting to lead others, a leader must start working from within him/herself; otherwise his/her efforts will be nothing more than contrived and false byproduct of the latest self-improvement book.
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