Operating Room Team Quotes

He shakes his head. “I’m sorry, but the official Home Office superhero team is going to have to conform to public expectations of what a superhero team should look like, or it’s not really going to work terribly well. There’s room for one person of color, one female or LGBT, and one disability in a core team of four – if you push it beyond that ratio it’ll lose credibility with the crucial sixteen to twenty-four male target demographic, by deviating too far from their expectations. Remember, reasonable people who acquire superpowers are not our target. This is a propaganda operation aimed at the unreasonable ones: disturbed hero-worshiping nerd-bigots who, if they accidentally acquire superpowers, will go on a Macht Recht spree unless they’re held in check by firm guidance and a role model to channel them in less destructive directions.

One time during Indoc while we were out on night run, one of the instructors actually climbed up the outside of a building, came through an open window, and absolutely trashed a guy’s room, threw everything everywhere, emptied detergent over his bed gear. He went back out the way he’d come in, waited for everyone to return, and then tapped on the poor guy’s door and demanded a room inspection. The guy couldn’t work out whether to be furious or heartbroken, but he spent most of the night cleaning up and still had to be in the showers at 0430 with the rest of us. I asked Reno about this weeks later, and he told me, “Marcus, the body can take damn near anything. It’s the mind that needs training. The question that guy was being asked involved mental strength. Can you handle such injustice? Can you cope with that kind of unfairness, that much of a setback? And still come back with your jaw set, still determined, swearing to God you will never quit? That’s what we’re looking for.

The orchestra musician’s plight caught the interest of Harvard researcher Richard Hackman, who was studying the job satisfaction of workers employed in a variety of industries. Orchestral musicians were near the bottom, scoring lower in job satisfaction and overall happiness than airline flight attendants, mental health treatment teams, beer salesmen, government economic analysts, and even federal prison guards. Only operating room nurses and semiconductor fabrication teams scored lower than these musicians.

Within Room 40 itself, however, management of day-to-day operations fell largely, if informally, to Cdr. Herbert Hope, recruited in November 1914 to bring naval expertise to the interpretation of intercepted messages. His savvy was badly needed, for the group’s staff were not navy officers but civilians recruited for their skill at mathematics and German and whatever else it was that made a man good at breaking codes and ciphers. The roster came to include a pianist, a furniture expert, a parson from northern Ireland, a wealthy London financier, a past member of the Scottish Olympic hockey team, and a dapper operative named C. Somers Cocks, who, according to one early member, William F. Clarke, was “chiefly remarkable for his spats.

There has been so much misinformation spread about the nature of this interview that the actual events that took place merit discussion. After being discreetly delivered by the Secret Service to the FBI’s basement garage, Hillary Clinton was interviewed by a five-member joint FBI and Department of Justice team. She was accompanied by five members of her legal team. None of Clinton’s lawyers who were there remained investigative subjects in the case at that point. The interview, which went on for more than three hours, was conducted in a secure conference room deep inside FBI headquarters and led by the two senior special agents on the case. With the exception of the secret entry to the FBI building, they treated her like any other interview subject. I was not there, which only surprises those who don’t know the FBI and its work. The director does not attend these kinds of interviews. My job was to make final decisions on the case, not to conduct the investigation. We had professional investigators, schooled on all of the intricacies of the case, assigned to do that. We also as a matter of procedure don’t tape interviews of people not under arrest. We instead have professionals who take detailed notes. Secretary Clinton was not placed under oath during the interview, but this too was standard procedure. The FBI doesn’t administer oaths during voluntary interviews. Regardless, under federal law, it would still have been a felony if Clinton was found to have lied to the FBI during her interview, whether she was under oath or not. In short, despite a whole lot of noise in the media and Congress after the fact, the agents interviewed Hillary Clinton following the FBI’s standard operating procedures.

Code Blue! We’re losing him!” The EMTs hustled the gurney containing Erik Dawson’s broken body into the operating room where the surgical team waited. The nursing staff literally ripped his clothes off as they worked to stabilize him. “What do we have here?” the lead surgeon asked. His assistant didn’t bother to look up as she answered, “Auto accident. An eighteen- wheeler smashed his car into a guardrail.” The lead surgeon whistled through his teeth. “It’s a miracle he’s still breathing. Let’s keep him that way.” As the surgical team moved into action with skill born of practice, Erik drifted on the fringes of consciousness. Erik’s thoughts raced. What? Where? Anesthesia put him under, but as the doctors began their work and his parents prayed fervently in the waiting room, Erik spasmed and stopped breathing. Family Matters, from Home Again

Back in America, Donald Trump had, as a candidate, preached the virtues of withdrawal. “We should leave Afghanistan immediately,” he had said. The war was “wasting our money,” “a total and complete disaster.” But, once in office, Donald Trump, and a national security team dominated by generals, pressed for escalation. Richard Holbrooke had spent his final days alarmed at the dominance of generals in Obama’s Afghanistan review, but Trump expanded this phenomenon almost to the point of parody. General Mattis as secretary of defense, General H. R. McMaster as national security advisor, and retired general John F. Kelly formed the backbone of the Trump administration’s Afghanistan review. In front of a room full of servicemen and women at Fort Myer Army Base, in Arlington, Virginia, backed by the flags of the branches of the US military, Trump announced that America would double down in Afghanistan. A month later, General Mattis ordered the first of thousands of new American troops into the country. It was a foregone conclusion: the year before Trump entered office, the military had already begun quietly testing public messaging, informing the public that America would be in Afghanistan for decades, not years. After the announcement, the same language cropped up again, this time from Trump surrogates who compared the commitment not to other counterterrorism operations, but to America’s troop commitments in Korea, Germany, and Japan. “We are with you in this fight,” the top general in Afghanistan, John Nicholson, Jr., told an audience of Afghans. “We will stay with you.

The game within the game is the game that only the players see. They experience it in relation to one another on the floor at a particular time and in the middle of the action. It is one of the nuances of the game of basketball. As Knick teammates during those years, we knew what a teammate was going to do almost before he did it. We helped one another on defense and shared the ball on offense. We made room for each of us to be his best within the context of the team. For example, I often would see Clyde come down the floor with the ball. I'd catch his eye. I knew he wanted to go down my side of the floor. In order to give him a little more room to move, I would clear out. That way I didn't clog up his space. Or, when I had the ball on the side and he was at the top of the key, waiting to go backdoor, our center knew he had to move to the other side of the floor to create the room for the backdoor bounce pass from me to Clyde who was moving down the lane toward the basket. That was the game within the game. On one level, the game within the game was a matter of mechanics but is also operated on a psychological level in that we truly were all for one and one for all. We challenged one another in practice to become better. We helped one another come back from defeat. We inspired one another to reach our peak team performance. None of us felt we could be as good alone as all of us could be together. Our unity came sometimes with laughs, sometimes with conflicts, sometimes with moments of collective insight, but it was that spirit of camaraderie which brought us together in a way that allowed the fans to see something very special.

I stood before the group. “Whose fault was this?” I asked to the roomful of teammates. After a few moments of silence, the SEAL who had mistakenly engaged the Iraqi solider spoke up: “It was my fault. I should have positively identified my target.” “No,” I responded, “It wasn’t your fault. Whose fault was it?” I asked the group again. “It was my fault,” said the radioman from the sniper element. “I should have passed our position sooner.” “Wrong,” I responded. “It wasn’t your fault. Whose fault was it?” I asked again. “It was my fault,” said another SEAL, who was a combat advisor with the Iraqi Army clearance team. “I should have controlled the Iraqis and made sure they stayed in their sector.” “Negative,” I said. “You are not to blame.” More of my SEALs were ready to explain what they had done wrong and how it had contributed to the failure. But I had heard enough. “You know whose fault this is? You know who gets all the blame for this?” The entire group sat there in silence, including the CO, the CMC, and the investigating officer. No doubt they were wondering whom I would hold responsible. Finally, I took a deep breath and said, “There is only one person to blame for this: me. I am the commander. I am responsible for the entire operation. As the senior man, I am responsible for every action that takes place on the battlefield. There is no one to blame but me. And I will tell you this right now: I will make sure that nothing like this ever happens to us again.” It was a heavy burden to bear. But it was absolutely true. I was the leader. I was in charge and I was responsible. Thus, I had to take ownership of everything that went wrong. Despite the tremendous blow to my reputation and to my ego, it was the right thing to do—the only thing to do. I apologized to the wounded SEAL, explaining that it was my fault he was wounded and that we were all lucky he wasn’t dead. We then proceeded to go through the entire operation, piece by piece, identifying everything that happened and what we could do going forward to prevent it from happening again.

He ran long at the White House, and arrived late to his next meeting with Hillary Clinton, Jake Sullivan and Frank Ruggiero—their first major strategy session on Taliban talks after the secret meeting with A-Rod. She was waiting in her outer office, a spacious room paneled in white and gilt wood, with tasseled blue and pink curtains and an array of colorfully upholstered chairs and couches. In my time reporting to her later, I only ever saw Clinton take the couch, with guests of honor in the large chair kitty-corner to her. She’d left it open for him that day. “He came rushing in. . . . ” Clinton later said. “And, you know, he was saying ‘oh I’m so sorry, I’m so sorry.’ ” He sat down heavily and shrugged off his coat, rattling off a litany of his latest meetings, including his stop-in at the White House. “That was typical Richard. It was, like, ‘I’m doing a million things and I’m trying to keep all the balls in the air,’ ” she remembered. As he was talking, a “scarlet red” flush went up his face, according to Clinton. He pressed his hands over his eyes, his chest heaving. “Richard, what’s the matter?” Clinton asked. “Something horrible is happening,” he said. A few minutes later, Holbrooke was in an ambulance, strapped to a gurney, headed to nearby George Washington University Hospital, where Clinton had told her own internist to prepare the emergency room. In his typically brash style, he’d demanded that the ambulance take him to the more distant Sibley Memorial Hospital. Clinton overruled him. One of our deputies on the SRAP team, Dan Feldman, rode with him and held his hand. Feldman didn’t have his BlackBerry, so he scrawled notes on a State Department expense form for a dinner at Meiwah Restaurant as Holbrooke dictated messages and a doctor assessed him. The notes are a nonlinear stream of Holbrooke’s indomitable personality, slashed through with medical realities. “Call Eric in Axelrod’s office,” the first read. Nearby: “aortic dissection—type A . . . operation risk @ > 50 percent”—that would be chance of death. A series of messages for people in his life, again interrupted by his deteriorating condition: “S”—Secretary Clinton—“why always together for medical crises?” (The year before, he’d been with Clinton when she fell to the concrete floor of the State Department garage, fracturing her elbow.) “Kids—how much love them + stepkids” . . . “best staff ever” . . . “don’t let him die here” . . . “vascular surgery” . . . “no flow, no feeling legs” . . . “clot” . . . and then, again: “don’t let him die here want to die at home w/ his fam.” The seriousness of the situation fully dawning on him, Holbrooke turned to job succession: “Tell Frank”—Ruggiero—“he’s acting.” And finally: “I love so many people . . . I have a lot left to do . . . my career in public service is over.” Holbrooke cracked wise until they put him under for surgery. “Get me anything you need,” he demanded. “A pig’s heart. Dan’s heart.

I’m Jay Powers, the circulating nurse”; “I’m Zhi Xiong, the anesthesiologist”—that sort of thing. It felt kind of hokey to me, and I wondered how much difference this step could really make. But it turned out to have been carefully devised. There have been psychology studies in various fields backing up what should have been self-evident—people who don’t know one another’s names don’t work together nearly as well as those who do. And Brian Sexton, the Johns Hopkins psychologist, had done studies showing the same in operating rooms. In one, he and his research team buttonholed surgical staff members outside their operating rooms and asked them two questions: how would they rate the level of communications during the operation they had just finished and what were the names of the other staff members on the team? The researchers learned that about half the time the staff did not know one another’s names. When they did, however, the communications ratings jumped significantly. The investigators at Johns Hopkins and elsewhere had also observed that when nurses were given a chance to say their names and mention concerns at the beginning of a case, they were more likely to note problems and offer solutions. The researchers called it an “activation phenomenon.” Giving people a chance to say something at the start seemed to activate their sense of participation and responsibility and their willingness to speak up. These were limited studies and hardly definitive. But the initial results were enticing. Nothing had ever been shown to improve the ability of surgeons to broadly reduce harm to patients aside from experience and specialized training. Yet here, in three separate cities, teams had tried out these unusual checklists, and each had found a positive effect. At Johns Hopkins, researchers specifically measured their checklist’s effect on teamwork. Eleven surgeons had agreed to try it in their cases—seven general surgeons, two plastic surgeons, and two neurosurgeons. After three months, the number of team members in their operations reporting that they “functioned as a well-coordinated team” leapt from 68 percent to 92 percent. At the Kaiser hospitals in Southern California, researchers had tested their checklist for six months in thirty-five hundred operations. During that time, they found that their staff’s average rating of the teamwork climate improved from “good” to “outstanding.” Employee satisfaction rose 19 percent. The rate of OR nurse turnover—the proportion leaving their jobs each year—dropped from 23 percent to 7 percent. And the checklist appeared to have caught numerous near errors. In

As President Ronald Reagan famously joked with the chief surgeon on March 30, 1981, as he was wheeled into the operating room at George Washington University Hospital, after being shot by John Hinckley Jr., “I hope you’re all Republicans.” (To which the surgeon, a self-described liberal Democrat, replied, “We’re all Republicans today, Mr. President.”)

Scott allowed us to conduct a paranormal investigation of this property, and I invited one of the teams I am a member of, the Georgia Ghost Society, to take part in this one. We were also extremely lucky to have John Zaffis, world-renowned demonologist, with us. He is referred to as the “Godfather of the Paranormal,” having had around thirty-five years of experience with hauntings, demonic possessions and paranormal investigations. We found it interesting that we were allowed to conduct our investigation completely alone. None of the salon’s employees had any interest in being there at night, and we realized then how serious they were about that. Drew Hester, co-director of the Georgia Ghost Society, recalls our investigation there that night: While running the baseline upstairs I had the Tri-Field Meter. Throughout the rest of the house turned salon, the baseline showed normal readings, but suddenly the meter went off the scale and we both jumped a little. Then it went down to normal. We looked at each other and shrugged it off assuming it was due to natural energy floating around. Then it happened again. This took place about 5 times, each time with about 30 to 45 seconds in between. Interestingly enough this correlated with what a sensitive had “felt” earlier that evening before we even entered the location, when she mentioned the feeling of a woman walking or pacing back and forth in the upstairs area. John Zaffis states: The salon investigation was one I went into not knowing the researchers at all yet, nor the history of the place, but it turned out to be a surprisingly good hunt that night. When the ghost came into the room upstairs with us, just about everybody had some type of experience with something. We encountered the most activity on the second floor and I know we had at least more than one ghost up there with us. We all walked away knowing that the building where Voila Salon operates out of was definitely haunted by several ghosts dating back many years.

When a sixteen-year-old female epileptic patient was undergoing brain surgery in the late 1990s, the neurosurgeon Itzhak Fried kept her awake so she could respond to what was happening.[58] This was feasible because there are no pain receptors in the brain.[59] Whenever he stimulated a particular spot on her neocortex, she would laugh. Fried and his team quickly realized that they were triggering the actual perception of humor. She was not just laughing as a reflex—she genuinely found the present situation funny, even though nothing humorous had occurred in the operating room. When the doctors asked her why she was laughing, she did not reply along the lines of “Oh, no particular reason” or “You just stimulated my brain,” but instead would immediately find a cause to account for it. She would explain her laughter with a comment like, “You guys are just so funny—standing around.”[

One of Ross’s biggest gripes was the way I operated in meetings, something that had always driven the team crazy, too. He called out my bad habits: I was notoriously impatient, prone to distraction, and a fidgety nail-biter. I also talked over people and dismissed underdeveloped ideas that deserved more conversation. Ross said, “You can’t put all of your attention on the content in meetings. You have to reserve at least 10 percent of it to observe what’s happening in the room, to watch the body language and pick up on how people are truly feeling.” It was a radical notion for me, the idea that I was responsible for reading the room. And I wasn’t even sure why it was important, until Linda sharpened Ross’s point: “Everything you do is a clue for other people about how it is and isn’t okay to behave,” she said. “When you yawn during a presentation, or miss a deadline, or interrupt a speaker, you’re telling everyone that that behavior is acceptable.” Until then, I’d been oblivious to how I was being perceived. So, to prove the point, Ross made me stand on a conference room table during a staff meeting and look down at everyone while we had a conversation. It felt ridiculous, totally uncomfortable, but it taught me about the CEO’s megaphone effect. “You know when you say things like ‘Hey, we should go and do this,’ but you don’t really mean it? In fact, you’ve given it no more than five seconds of thought?” Ross said. “Someone is going to go run and waste time doing that thing you didn’t even want them to do, because you’re the guy with the megaphone. You’re standing on top of the table.” Other times, I’d explode into the office on a Friday morning and announce, “I want to wrap every water tower in New York in a charity: water banner,” and I’d expect everyone to leap into action. Ross had a shorthand for my impulsive ideas. He’d say, “Scott. Squirrel”—as in “Don’t be like a dog chasing after every squirrel you see.” Sometimes I’d fight back and say, “No, this is not a squirrel. Doing this one thing is the whole point.” But most of the time, I’d back off, and my team would breathe a huge sigh of relief.

with the Sravastis. If they need to make a stop or two along the way for essentials, that’s fine, but only necessary ones. Once you’re at the house with them, stay there.” Another gift. Normally that’s Vic’s job. Speaking with families, monitoring who comes to visit and what they say. The Eddison from college, from the academy, would be laughing himself shitless, but the man he is now—the agent he is now—knows to be grateful for true friendship wherever it can be found. “Finney’s got guards outside the operating room and in the scrub room, just in case,” Vic continues before Eddison can decide whether or not a thank-you would be appropriate here. “I’ll wait here with him for more updates and coordinate with Ramirez and the team down in Rosemont.” The curtain hooks rattle on their metal slide as Deshani pushes the plastic back into place against the wall. Priya settles back onto the bed, clad in fleecy, cheerful yellow pajama pants and a long-sleeve FBI T-shirt. “It’s a very well-supplied gift shop,” she says dryly, wrapping her hands gingerly around her hot

At Brookhaven National Laboratory, on Long Island, and at several other centers around the world, there are special rooms where people rarely tread. Nothing much seems to be happening in these rooms, there's no visible motion, and the only sound is the gently whir of fans that keep the temperature steady and the humidity low. In these rooms, roughly 10^30 protons and neutrons are at work. They have been organized into hundreds of computers, harnessed to work in parallel. The team races at teraflop rates, which means 10^12- a million million-FLoating point OPerations per second. We let them labor for months-10^7 seconds. At the end , they've done what a single proton does every 10^-24 second, which is figure out how to orchestrate quark and gluon fields in the best possible way so that they keep the Grid satisfied and make a stable equilibrium.

All of our phones were blowing up. It was ridiculous. It was just hard to focus in," Moseley said. "I didn't even want my phone anymore. It was just too much." So Frese asked players what they thought about giving up their phones for the entire length of their NCAA tournament road trips. The locker room agreed. Parents were given contact information for the team's director of basketball operations in case there was an emergency. Terps players told their friends they were going to be unreachable. And then they disappeared into, like, 1995 or something. "To live without your phone that long is really hard, especially for us; we live by our phones," Alyssa Thomas, the star forward who graduated last year, said of her generation. "At first we would all be checking our pockets, thinking we lost our phones or something." But then a weird thing happened,

How is Single-Person CQB Different? Single-person CQB tactics are different from tactics developed for teams and multiple teams. The reason for this is the increased risk associated with operating alone. Even if you are very experienced in team-level operations, it may still take time for you to master the specific skills and movements needed for single-person operations. Team-level CQB is generally divided into “immediate entry” and “delayed entry” tactics. Immediate entry methods call for offensive, aggressive movement and were developed by elite military special operations forces for hostage rescue situations. Delayed entry tactics are more common in the law enforcement community and are designed to minimize your exposure and maximize the benefits of cover and concealment. For single-person operations, delayed entry is generally a safer option than immediate entry. If you have a team behind you, it is possible to aggressively rush through a door to dominate a room. However, if you are operating alone with no support, it is dangerous to rush into a fight when the odds might not be in your favor. By employing delayed entry tactics you clear as much of a room or hallway as possible from the outside, before you actually make entry. The tactics in this book are primarily delayed entry tactics. Team-level CQB can also be divided into “deliberate” tactics and “emergency” tactics. The difference has less to do with speed and more to do with the level of care and attention applied to the clearing process. It is possible to execute deliberate tactics very quickly, as long as you are careful to clear each room and danger area completely. Essentially, when conducting a deliberate clear, you will not take any shortcuts.

Emergency tactics are the opposite of deliberate tactics. In an emergency situation, you may need to take shortcuts and not clear every room or danger area completely. This increases the level of risk. However, in an emergency situation where time is critical or there is imminent danger to innocent people, a tactical team might choose to assume a greater level of risk. Because of the increased danger typical of single-person operations, deliberate tactics are generally the best option. Most of the tactics in this book are deliberate rather than emergency. While deliberate tactics are preferable for single-person operations. You might end up facing an emergency situation alone and you will have no choice but to move at maximum speed and assume greater risk. This type of scenario is extremely dangerous and as an individual, there is little you can do to reduce the risk. Your best option is generally to move as quickly as possible and use speed as security, hoping that adversaries will not react fast enough to see you or shoot at you.

Teamwork may just be hard in certain lines of work. Under conditions of extreme complexity, we inevitably rely on a division of tasks and expertise—in the operating room, for example, there is the surgeon, the surgical assistant, the scrub nurse, the circulating nurse, the anesthesiologist, and so on. They can each be technical masters at what they do. That’s what we train them to be, and that alone can take years. But the evidence suggests we need them to see their job not just as performing their isolated set of tasks well but also as helping the group get the best possible results. This requires finding a way to ensure that the group lets nothing fall between the cracks and also adapts as a team to whatever problems might arise.

if there really is no way you can win, you never say it out loud. You assess why, change strategy, adjust tactics, and keep fighting and pushing till either you’ve gotten a better outcome or you’ve died. Either way, you never quit when your country needs you to succeed. As Team 5 was shutting down the workup and loading up its gear, our task unit’s leadership flew to Ramadi to do what we call a predeployment site survey. Lieutenant Commander Thomas went, and so did both of our platoon officers in charge. It was quite an adventure. They were shot at every day. They were hit by IEDs. When they came home, Lieutenant Commander Thomas got us together in the briefing room and laid out the details. The general reaction from the team was, “Get ready, kids. This is gonna be one hell of a ride.” I remember sitting around the team room talking about it. Morgan had a big smile on his face. Elliott Miller, too, all 240 pounds of him, looked happy. Even Mr. Fantastic seemed at peace and relaxed, in that sober, senior chief way. We turned over in our minds the hard realities of the city. Only a couple weeks from now we would be calling Ramadi home. For six or seven months we’d be living in a hornet’s nest, picking up where Team 3 had left off. It was time for us to roll. In late September, Al Qaeda’s barbaric way of dealing with the local population was stirring some of Iraq’s Sunni tribal leaders to come over to our side. (Stuff like punishing cigarette smokers by cutting off their fingers—can you blame locals for wanting those crazies gone?) Standing up for their own people posed a serious risk, but it was easier to justify when you had five thousand American military personnel backing you up. That’ll boost your courage, for sure. We were putting that vise grip on that city, infiltrating it, and setting up shop, block by block, house by house, inch by inch. On September 29, a Team 3 platoon set out on foot from a combat outpost named Eagle’s Nest on the final operation of their six-month deployment. Located in the dangerous Ma’laab district, it wasn’t much more than a perimeter of concrete walls and concertina wire bundling up a block of residential homes. COP Eagle’s

The best ones provide members with a solid platform on which to carry out their collective work but also leave lots of room for them to develop their own unique ways of operating.

Inside the Lakers’ locker room, the reaction was subdued euphoria. Ceballos was an obnoxious brat who played no defense and went AWOL. Horry, on the other hand, was a 6-foot-9 outside gunner (he was a lifetime 34 percent three-point shooter) and low-post defender joining an operation in need of long-range shooting and low-post defense. It was a trade that, by NBA standards, generated little attention. It was a trade that changed everything. Suddenly, instead of being a towel-throwing pain on an 11-24 team going nowhere fast, Horry was a coveted piece of a first-place club that sat 17 games over .500. During his first four NBA seasons, all with the Rockets, Horry had learned how to play with Hakeem Olajuwon, the 7-foot, 255-pound Nigerian center. He knew his job was to feed off the big man, and that a box score where Olajuwon scored 30 and Horry scored 12 usually meant Houston won. Now, with the Lakers, he was more than happy to acknowledge O’Neal’s place as the center of the basketball universe.

team working on two children who had been thrown from the back of their father’s pickup truck onto the roadway. By the time I reached the floor, Immy had been taken upstairs to surgery. The surgery had lasted almost twelve hours, and things had not gone well. The bypass pump, a relatively new technology, had malfunctioned for several minutes and Immy had lost a great deal of blood. She was on a respirator, unconscious and unresponsive, in the Intensive Care Unit. On the day after surgery, Immy’s mother told me in a shaking voice that Immy’s gown had been removed in the operating room and thrown into the hospital laundry. The medal was gone. Concerned, I called the surgery resident and told him what had happened. “Why are you telling me this?” he asked me.

This is exactly what Alan Mulally walked into when he took over as the new CEO at Ford in 2006. Ford was in serious trouble, and Mulally was brought in with the hope that he could save the company. Much as Chief Cauley had done at the CRPD, Mulally made it his first order of business at Ford to find out as much as he could about the current state of things from the people who worked there. The task, however, proved more difficult than he expected. To keep a pulse on the health of the organization, Mulally introduced weekly business plan reviews (BPRs). All his senior executives were to attend these meetings and present the status of their work against the company’s strategic plan, using simple color coding—green, yellow and red. Mulally knew that the company was having serious problems, so he was surprised to see that week after week every executive presented their projects as all green. Finally, he threw up his hands in frustration. “We are going to lose billions of dollars this year,” he said. “Is there anything that’s not going well here?” Nobody answered. There was a good reason for the silence. The executives were scared. Prior to Mulally, the former CEO would regularly berate, humiliate or fire people who told him things he didn’t want to hear. And, because we get the behavior we reward, executives were now conditioned to hide problem areas or missed financial targets to protect themselves from the CEO. It didn’t matter that Mulally said he wanted honesty and accountability; until the executives felt safe, he wasn’t going to get it. (For all the cynics who say there is no place for feelings at work, here was a roomful of the most senior people of a major corporation who didn’t want to tell the truth to the CEO because of how they felt.) But Mulally persisted. In every subsequent meeting he repeated the same question until, eventually, one person, Mark Fields, head of operations in the Americas, changed one slide in his presentation to red. A decision he believed would cost him his job. But he didn’t lose his job. Nor was he publicly shamed. Instead, Mulally clapped at the sight and said, “Mark, that is great visibility! Who can help Mark with this?” At the next meeting, Mark was still the only executive with a red slide in his presentation. In fact, the other executives were surprised to see that Fields still had his job. Week after week, Mulally would repeat his question, We are still losing tons of money, is anything not going well? Slowly executives started to show yellow and red in their presentations too. Eventually, it got to the point where they would openly discuss all the issues they were facing. In the process, Mulally had learned some tricks to help build trust on the team. To help them feel safe from humiliation, for example, he depersonalized the problems his executives faced. “You have a problem,” he would tell them. “You are not the problem.

Based on our research and interviews, we have identified nine core characteristics that mark an individual as having high potential: Drive—the unrelenting need for achievement and constant self-improvement Resiliency—the ability to persevere in the face of challenge and bounce back from setbacks Adaptability—the ability to adjust according to the situation, learn new things, innovate, and try new methods Humility—self-confidence in one’s ability while understanding that there’s always room for improvement and that others’ experiences and knowledge are valuable Integrity—an adherence to not only what is legal but also what is right Effective intelligence—the ability to apply one’s knowledge to real-world scenarios Team-ability—the ability to function as part of a team, placing the success of the whole above the needs of the self Curiosity—a desire to explore the unknown and question the status quo in pursuit of better, more effective solutions Emotional strength—a positive attitude, high empathy, and control over one’s emotions, especially in chaotic and stressful situations

Around the room, heads wobble. That’s a cultural idiom Mark’s going to have to get used to. At first glance, it looks like several of the operations team are shaking their heads in disagreement, but for those raised in India, this is a gesture of support.

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Little by little, as the team members stitched together small pieces of information, they stumbled into Ranbaxy’s secret: the company manipulated almost every aspect of its manufacturing process to quickly produce impressive-looking data that would bolster its bottom line. Each member of Thakur’s team came back with similar examples. At the behest of managers, the company’s scientists substituted lower-purity ingredients for higher ones to reduce costs. They altered test parameters so that formulations with higher impurities could be approved. They faked dissolution studies. To generate optimal results, they crushed up brand-name drugs into capsules so that they could be tested in lieu of the company’s own drugs. They superimposed brand-name test results onto their own in applications. For some markets, the company fraudulently mixed and matched data streams, taking its best data from manufacturing in one market and presenting it to regulators elsewhere as data unique to the drugs in their markets. For other markets, the company simply invented data. Document forgery was pervasive. The company even forged its own standard operating procedures, which FDA investigators rely on to assess whether a company is following its own policies. In one instance, employees backdated documents and then artificially aged them in a steamy room overnight in an attempt to fool regulators during inspections.

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