Have a Hitch in Your Get-a-long?

His eyes squinted meanly into mine, and his lip curled in a sneer that revealed brown-stained teeth. I didn’t think we should be bothering him right then.

“Walk up to him like you mean business,” the instructor insisted. “Put out your hand, grab the front of his foreleg, and lift. If you show him that you’re in change, he’ll lift for you. If he doesn’t see you as the alpha, he won’t...”

I marched up, posture erect, with the mien of a leader. I reached forward and ... thanks be ... up the leg came. Not wanting to look a gift horse in the mouth, I quickly used the pick to clean the debris from around his ‘frog.’ Carefully lowering the hoof, I brushed off my hands, and scuttled back.

“Again,” commanded the wrangler.

I circled the stallion cautiously, and dove for the other front hoof. This time, I didn’t pull any wool over his eyes. He knew he didn’t need to take orders from me. He ignored my tugs, keeping all feet firmly planted on the ground.

“Don’t keep trying! Back off and start again.” I stopped tugging, patted the nice, big horsey on his neck and shoulder while murmuring soothingly, and retreated. Then I girded my loins to try again.

“Hold up ... Did you notice what you just did?” I was attending a leadership skill workshop featuring horses. Horses model follower behavior with a strong instinct of self-preservation. They sense which leader to follow, they flee from danger, and ignore lesser species from which they feel no threat or dominance.

Our horseplay had revealed one of my leadership issues: praise when not deserved due to a need to be liked, even if my orders weren’t carried out. A hitch in my get-a-long.

Horsing around spotlighted other leadership challenges. As the day-long class progressed, we ran the horses in a ring, guiding them from behind with the tassel and the crack of a whip.

We stood in the center of it all, pivoting while the horses did the work. Whoa! Another example of wearing blinders.

Do you lead from the front, pulling and tugging your endostaff and colleagues along in your wake? I did and occasionally still do waste energy this way. Could you learn to lead from behind, coaxing them to run as you pivot lazily? I’m practicing this one. You see, until this recent workshop, I was never taught how to lead.

You see, doctors aren’t taught leadership; we gain our status as leaders by our seniority and the length of our snowy coat. But some of the IQ-rich folk in white coats are lacking in EQ — author Daniel Goleman’s concept of emotional intelligence. EQ is about self-governance and control, about correctly reading others’ subtext, and about encouraging growth in your subordinates and building a strong team.

Unfortunately EQ is often inversely related to IQ, and many book-smart folks seem to lack this horse sense and don’t perceive their EQ deficiency; and you can’t beat a dead horse, nor make a live one take a drink.

Leadership within nursing is often a horse of a different color. Leadership is seen as a learnable skill, and my belief is that most nurses, given their choice of a more nurturing, empathetic profession, likely possess a higher EQ. Many nursing schools feature classes on leadership, and frequently, young nurses are assigned night charge duties to gain leadership skills.

Nurse managers in endoscopy suites often call for minions to transiently fill their shoes, or take on projects. This allows a dark horse candidate nursing leader to advance through skill and ability, not by seniority right. Is your endoscopy staff encouraged to take the bit in their teeth and lead?

Hold your horses ... do I attribute the leadership challenges in medicine to poorly trained, emotionally stunted leaders? Horse feathers. Medicine differs from general business because we are so estrogen-rich. It’s hard for a woman to lead women, as it’s against our upbringing.

Communications expert Deborah Tannen writes of the confused adult interactions of men and women, and its origins in our childhood recreation, as boys tend to ‘game’ while girls ‘play.’ Boys’ games feature leaders, aggressive competition among friends, winners and losers, and no hard feelings. The play of girls requires that all be on an equal footing; any young girl attempting to take over the play may be ostracized. Pat Heim and Susan Murphy, authors of In the Company of Women: Turning Workplace Conflict into Powerful Alliances, further explored the dynamics of groups of women led by women, and our sociologic expectation that women colleagues will remain ‘dead-even’ just as we were taught as young girls. It is tough to maintain ‘dead-even’ play while leading a team and giving orders. To become a leader in the endoscopy suite, women leaders need to communicate effectively with the majority.

Endoscopy unit directors need to evaluate themselves for deficiencies in emotional intelligence, and encourage staff to embrace trial leadership positions to practice their skills. We must give a nod to our sociological expectations of staff and colleagues and play by women’s rules when leading women, and not mimic the male leadership style.

We need to fix the hitch in our get-a-longs. Women in all areas of gastroenterology need to read, practice, and experiment in being leaders, so that we may step forward and attain the respect and the salaries that we deserve for our work.

And that’s straight from the horse’s mouth.

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