Ladies and gentlemen, please take your seats. Our session is about to begin. Please welcome your president, Dr. Dean Taylor, and special guest, General Robert Brown. ♪ Rah, rah, rah, boomer, brave old Army team ♪ ♪ March to the fray, fight on to victory ♪ ♪ Possess the fearless Army brave ♪ ♪ Meet Navy ♪ Well, that was for all the Naval Academy guys over there. Yeah, all these Navy guys over here, that's for you. It's not a bad school, it's a second choice. You couldn't get in West Point, we understand. Well, this is such a pleasure and an honor for me to share with all of you, one of the great leaders in America and the world, and my good friend, Bob Brown. We met each other when we went to West Point, 47 years ago, believe it or not, coming out of, both coming out of Michigan, coming out of high school. And interestingly, Bob and one other guy out of Michigan were really good basketball players. And Bob was recruited to the University of Michigan, had a full ride scholarship. And the other guy that was a really good player was recruited to Michigan State. So they were rivals in high school, they were both getting publicity. And Bob's dad would say, Bob, I don't understand it. Why is this Johnson guy getting all this publicity? You should be getting the publicity. Well, Magic Johnson went on to have a pretty good career. This guy went on to be recruited by Coach K, came to West Point, and had an even better career. Well, it's true. You served our country for 40, how many years? 42 years, served two combat tours in Iraq, retired as a four-star general, is the commander of the Pacific troops, over 100,000 troops across the Pacific. And along the way, he's had some orthopedic issues, beginning as a cadet, where he ruptured his patellar tendon in his senior year, and that kind of derailed his basketball career. We might hear a little bit more about that. And then, he was a frequent flyer in our operating rooms, and that's where I got to know Bob even better through the years. And along the way, we've also, I tried to teach him how to play golf. That wasn't so successful. He tried to teach me how to surf, and it was about the same. Failed miserably, yeah. And we both like to fish, so we're going to Alaska to fish here in a couple weeks. So, Bob, just to kind of start things off, I mean, we've got a lot of people here that have come to this meeting to learn how to be better surgeons, how to take care of athletes better, and you're a military guy. I mean, why the hell are we bringing you to the AOSSM meeting? What do you have to share with all these surgeons? Yeah, well, thanks, Dean. And I want to, before I answer that question, I do want to thank, there's an individual here, you know, the first time I was ever injured, my senior year, cap of the team, never missed a game or anything, and then suddenly driving down the lane in the game, torn patella, tendon, kneecap broken in half, but Dr. Walt Curl, who's sitting right over here, and Dr. Keith Markey. Really, I shouldn't even have been commissioned to serve, but he did such an amazing job wiring my knee together though I do remember when you pulled the wires out after six months, that hurt a little bit. I do remember that. But I shouldn't have been able to, and I was able to serve in the infantry, the toughest branch, jump out of airplanes, you know, go to combat, do all that stuff. Thanks, Dr. Curl. And then Dr. Bob Arciero is out there somewhere. There he is. Okay, so when I was captain, yep. Captain Brown, teaching at West Point. I'd had about 70 operations up to that point, and I was thinking of getting out of the Army. Went to talk to Coach K, actually. Was thinking of coaching, doing different things. But then Dr. Arciero took care of me, and I ended up staying in and kept going. So thanks, Bob, really appreciate it. And then Dean, I think five times has operated on me, and I kind of always felt like, hey, if he did it right the first time, maybe he wouldn't have needed the other four, you know? But no, seriously, amazing, always there with me. And ended up having 18 knee operations, in that time in the military, and eventually new knees from Dr. Boulanese at Duke, where Dean assisted ably, and yeah, pounding away. And so I'm just grateful. So I think one reason I'm here is I'm a frequent flyer, as you said, and as a patient. So I have some experience as a patient. But leadership is leadership, I found. It's kind of amazing. You think they're all different, and it doesn't matter whether it's the boardroom, the battlefield, the operating room. Certainly the stakes are different, and certainly different circumstances, but the principles are the exact same. And so as we look, you know, there's no question, you know, working together and learning, that soft skill, if you will, of leadership. I think all, you know, fields have technical portions that they work, and those skills are important in every profession. You've got to be technically competent, or you're not going to be much of a leader at all. You've got to have that technical, but we tend to stress the technical. It's kind of easier to measure, kind of straightforward. And then there's a kind of soft, I would say, you know, it's what we call in the military, it's an art and a science. And the leadership, the art, the soft skills, and to be truly great in any profession, you've got to combine those and understand where they fit in. And so I think that's why it certainly applies everywhere, and I've seen that over the years. Yeah, and we look forward to learning more about those soft skills, what I called yesterday, those hard to learn skills. Yeah. Because you're right, it's so important. And so that's why, to me, I'm so grateful for you to be here to share those with us. And you mentioned being a patient, 18 operations. So you got to see a lot of different docs. You experienced a lot of different environments where you had surgery. And so along those lines, what can we do better from your experience, and what did you see in physician leadership, both good and bad? Yeah, well, again, I was fortunate enough to have the best of the best, the guys I just mentioned and a few others. But then in between, in some of those other surgeries, it wasn't always the best. It was really, again, just all the technical. And I never felt like those other individuals really truly cared about me. It was just almost like you're a number, and we're gonna get through it and move on, as opposed to holistic, really that approach where you know they care about you, which is a credible principle of leadership. When you look back, the best leaders you've had in your life, if you think back to the best leaders, it's not necessarily the smartest person. It's the one you know truly cared about you. And how do they demonstrate that? They're not doing it to look good. You know they're doing it for the team. And so those great physicians, that was obvious. And the not so great, again, technically, maybe they were fantastic, good enough, but it wasn't the whole picture. And that's really key. So I think it's really smart. You're emphasizing this, and you're seeing, learned a ton from all the different forums on leadership, which if you stop learning, it's probably time to stop leading and get out of the way. You gotta constantly learn. Yeah, and I think that's so important. And that's, obviously you know, you've spoken at the Fagan Leadership Forum, and we've learned from you there. This part of being a surgeon, a physician, is so key, in addition to being technically excellent as well. And you know, as we talk about those leadership challenges, and for all of you, Bob was known as one of the greatest team builders in the history of the United States Army. And many people may not understand this. A four-star general, in the history of the United States, we've only had, well, when you were promoted a four-star, you were only, in the whole history of the United States military, you were the 216th four-star rank. This doesn't come along very often. They may have gotten the wrong Robert Brown, but I'm not complaining, you know. Government bureaucracy, you know, common name and all. Yeah, I was very honored. George Washington was the first. Ulysses S. Grant was the second. And it kind of blew me away. So yeah, it's, I'm very fortunate. Well, it's a testament to your leadership, and to your team building skills. And you were known as one of the great team builders in the history of the Army. You wanna talk a little bit about that? Because we have to build our teams and our clinics. I mentioned it yesterday. Our teams and our ORs, our teams everywhere, on the sports medicine teams as well. Yeah, no, I'd be honored to. And on the tables out there, you'll see like a card, and I'm gonna talk about the team part that I will immediately give credit, completely stole that from Coach K. And I learned a ton from Coach K. West Point's the best leadership school in the world, but I learned the most leadership on the basketball court. So let's see, John Kelly, where are you at, our boxer? Come on up, John. Yeah. Now John's dad was a Marine, World War II vet, and taught him boxing early. And so I just wanna use this just to demonstrate. The team, look at him, he's getting ready to hit me here for God's sakes. Yeah, it's unbelievable. So the real principle, and by the first thing is, I have a big advantage because if you just put our arms out, he's trying to block me there, but if you just put our arms out, he can't reach me, I can reach him, so that's a good deal there. But he looks pretty tough, so I don't know. Sometimes I spar with somebody in front of the crowd, but I don't think I'm gonna do it here. But the main thing is, if you go at somebody like this, all right, what are you gonna do? You're gonna break your finger, like I broke that one there, and maybe some of you out there could help me fix this, I don't know, but you're not gonna be effective. Or if you're like, you know, so, but like this with a fist, you're gonna be effective. Except he's pretty good, he's pretty agile. So again, normally we might go a few rounds, but you look too tough, John, so I just, thanks for being a great demonstrator. Yeah. So the, so the fist, and each finger is named a portion of, and this is really, I mean, I would just say that, you know, Coach K was an amazing, amazing team builder. When you look at what he has done, both college level, and then also what he did with the Olympic team, many people thought, oh, there's no way he's gonna be able to build a team from the NBA. And I used those principles from leading 32 people as a lieutenant up to about 130,000 in my last command each time. So the first is trust, and you'll see it on that circle there. And trust is the bedrock. We were just talking before this, you know, trust, you can't accomplish having an effective team without trust. And we'll talk a little bit more here. How do you build trust? You really have to work on that. And I find that a lot of organizations, they just take trust for granted. They think it's just gonna automatically happen, but trust you have to work at. It takes a lot of work to get trust in an organization, and a nanosecond to lose it, right? The video has to match the audio with trust, and trust is so important. It is the bedrock. In the military, in particular, I mean, we trust each other with our lives. So I mean, we're not talking, leadership is leadership, yes, but business is about losing money, perhaps, but, and for all of you, doctors, the lack of trust and problems that could cause from that could also be loss of life. So it's a very important thing and very critical to trust. Next is communications. And you will find that effective communications on a team is, again, something that people will not work on. They take it for granted, but 99.9% of the time when there's a problem on a team, it's communications. You know, a text in all capitals taken the wrong way, a email taken the wrong way, somebody says something that's taken the wrong way, and getting effective communication throughout the team. You know, are you going left, right, up, down with the whole team, not just a small portion, but are you hitting the whole team with that communication? You know, absolutely key. Third, the next would be pride. Again, something that we don't talk about enough in organizations, why everybody wants a vision of where are we going? What are we accomplishing? They want to be part of something bigger than themselves. And that pride is that vision. And sometimes we'll kind of forget why we're doing something, and they'll lose its importance. And, you know, you'll fail as a team. That pride is critical. Next, when you take a look, is collective responsibility. It says responsibility on the sheet, but it's really a collective responsibility. Teams will typically point to the leader, that Taylor, you know, he screwed up, he did this, he did that, very easy to point to the leader. And, but no, it's looking and being able to look and say, look, this was partly, this was my fault. This is a collective responsibility within the team, not just pointing at the leader and blaming the leader. And developing that in the team takes a lot of work. All those things I just talked about, trust communications, but getting to where you can truly take collective responsibility for what the team's doing. And finally, is one of the principles we already mentioned in leadership, caring. But folks on a team, do they care? Well, if they have the vision, the trust is in the team, you're working on it, they're going to care. And if they don't care, you know, you've got other problems. So are you working on how they care? But if you put all those together, you go from, you know, really disjointed, where you're only going to have issues, even if you have part of it, to where you're going to succeed. Although I don't know, against John, he was blocking me pretty well there, so maybe not. But that fist for a team is really critical. I'm kind of very proud that whether, again, it was a small team or large team over the years, those soldiers, you know, knowing they were on a team and the pride, it was always called coach, you know, not general, for example. So that's kind of the team and absolutely critical if you want to be the best. I mean, if you want to just get by and okay, well, yeah, you don't need that. But if you want to be the best in any field, in any area, you'll need that to form the effective team. That's phenomenal. And you do that better than Coach K now. Well, I'm not getting crazy now. No, I'm serious. You do that better than Coach K. And it's interesting. I'd like to dive in a little deeper to care. And for those of you who aren't at the tables, you could probably pick up some of these. These are on all the tables. Care, okay? So in our class, and I told you, it's not very common to have even one of your classmates become a four-star general. In our class, we're very proud. Our motto, class of 81, strength is one. Doesn't rhyme, it's the same word, but it works. And our classmates all sign our notes to each other, SAO, strength is one. And Bob Brown, Dan Allen, and Jimmy McConville, who just retired last year as the Chief of Staff of the Army were our four-star generals. And this, just a couple months ago, Jimmy McConville was honored at West Point as the Distinguished Graduate Award. Doesn't happen very often. John Fagan, by the way, is one of two doctors who have been Distinguished Graduates in the United States Military Academy. Well-deserved, yeah. So we're at the Distinguished Graduate Ceremony and with some of our classmates, and we're talking about Bob and Dan and Jimmy, and we're saying, can you guys believe that these guys got promoted to four-star general? Remember when they were cadets? I mean, we didn't think they would last past five years. And they didn't really distinguish themselves as cadets other than maybe on the basketball court or in the social scene or elsewhere. Why did these guys get promoted to four-star general? What was the common thing that they all had? The answer we came to was they were kind. They're kind people. They care. And in medicine, obviously, that's a huge part. We talk about taking care of our athletes and our patients. But to take it to another level, that caring that you talk about is so key in leading, and we need to take it to another level in medicine. Now, I believe that you can learn leadership skills. A lot of us have, not me, but Bob certainly had that inherent leadership skill of care and caring. So my question for you, it's a long, drawn-out question, but I love the story, is how do you teach that principle of care as one of your five principles? Well, when you look, there's a saying, soldiers don't care how much you know until they know how much you care. And I think you could apply that. A patient doesn't care how much you know. Well, I guess they probably care a little more, maybe. But they really, how much you care is a key part of it. And so when you say teach it, I think one of the things teaching is, I think, again, in any profession, you don't start off, I guarantee you, I never strive to become a general. Yes, you want to do the best you can do, but for the right reasons, and the selfless service, care for others. And Colin Powell said, when folks stop coming to you with your problems, it's one of two things, that they know you don't care anymore, or they don't trust you anymore. And it's very true. And a soldier can tell all of us. It's very interesting. And I'd have soldiers with PhDs and some that barely got a GED. But all of us, from the time we're born, are evaluating those that lead us. And coaches, teachers, parents, and the number one thing, again, is do they really, truly care about us? And also, I think, when you say caring and being kind, I think some people will say, and this happens in the military, like, oh, so you're soft and you're easy. No, I mean, oftentimes, the best way you show you care, for a soldier, the best way you show you care is tough, demanding, realistic training that's very hard, that'll save their life in combat. And my standard was always, I needed to be able to look the parents in the eye and say, I've done everything I can do for your son or daughter, or I couldn't live with myself when we lost lives in combat. You have to train as hard as you can. So that caring is really tough. Now, at the same time, an individual has a problem and loses a parent, you're gonna show that compassion, of course. So when you say teach it, it really gets at building that trust in an organization. And it's not about you. And again, I believe that's in every profession, really, the folks, if you're sitting there saying, I'm going to be, you're not, if you're thinking it's about you advancing, you're not gonna make the right decisions for the organization, for the people. And I've seen that many times, there'll be, you know, you get to a certain level in the military, and you're through a bunch of commands and things, and there'll be individuals that were close to being a general. But you could tell they were doing it to be a general and they make the wrong decisions for the organizations, for, you know, and that's, so you shouldn't be. And so it's kind of weird, you would think, well, geez, you would have to strive for that from the beginning, no. And again, I don't think that's any different in any profession. It's really got to be about the organization more than yourself, the patient, in doctor's cases, the, you know, the soldier, in our case. And so it's the teaching is, that's not all about you. And it's about truly caring and doing the right thing. And about, I would tell you about 15 times in my, you know, service in the military, I was almost relieved my career was almost over. And it was for nothing illegal or immoral. I did was one of my subordinates would do something wrong, and you'll see under leadership principles in this form, talks about give the credit and take the blame. And so one of my subordinates would do something wrong, and I'd say, OK, don't blame Captain so-and-so. Relieve me, whatever. And so about 15 times that almost happened. And you have to be able to look yourself in the mirror. And when those things happen, and we'll talk probably a little bit later about failure and how you deal with that, but it really gives you the right perspective. And so you do it for the right reasons. And then, of course, there's also a lot of luck and timing and mentorship and other things involved, but you don't set out to be. I used to get asked that a lot by young soldiers when I'd talk to them. They'd say, hey, sir, what does it take to be a general? I'd say, obviously, not good looks. Oh, well. Anyway. I think for those of the people who know about John Bergfeld and the Warthog Society, Bergfeld learned that the warthog was named by one of the national animal societies the ugliest looking animal. It could stand on its feet for days at a time and go without food for days at a time. He goes, that's just like my fellows. So that's how the Warthog Society came to be. So yeah. That's a good one. You're a little bit better looking than a warthog, I think. Barely. What you just said, though, let's unpeel that, because there's a lot there. I think the idea of putting yourself below a higher purpose, the organization, your patient. We talk about selfless service. That's one of the Army's values. You'll see on the cards of the Duke health care leadership model that we used to have selfless service on there, but now we have service. Not that I don't think selfless service is important, but I think sometimes, if you just say the words, it leads to maybe a misconception that you have to put yourself out there with disregard to your own well-being. But it's still an important principle. And maybe we'll talk about burnout and mental health things later, but that idea of putting others ahead of yourself is so important in building that trust. And you talked about you got to be good, the trust equation. You got to have credibility, reliability. That intimacy, getting to know the people. But the denominator of self-interest buries that. And as someone that really emphasizes that as an Army value, how do we really build that into everybody's value within health care? Yeah, first and foremost, I mean, most organizations don't put much of any effort into building trust. I mean, they just automatically assume it's going to be there. So you deliberately have to work. And there's the, of course, day-to-day, as you were just mentioning, the credibility. You can't tell them one thing, and then you're off with no credibility, not able to demonstrate the trust. And then there's the competence aspect of it as well, of course. There's also the getting to know the individuals extremely well. Bottom line, that takes a lot of time, and it's not easy. And you're already, again, in a field such as you're in or in the military, you're busy. And so the trust can be kind of an afterthought. You don't think about it all, an afterthought. But when you really put an effort into it, and you work it, you incorporate it into daily activities and daily events, it starts to become part of the organization. And you'll create a trusting environment that can also be called a learning environment, where people are not afraid to fail. People aren't afraid to come forward with ideas and feel empowered, et cetera. But it takes a lot of work. And when there's a failure, you can't overreact, or you lose that trust pretty quickly. And I've seen this. You're empowering individuals because there's a trust. And I've had, even in combat, individuals are doing something, and they fail at it. And so higher headquarters, I was deployed once in lovely Mosul, Iraq. I had about 12,000 soldiers in a striker brigade. And an individual did something wrong. And of course, the three-star general gets a hold of me. He's like, how can that happen? How can this happen? We've got to punish this guy. And I'm like, well, wait a minute. He was trying to do the right thing. Again, nothing illegal or immoral, just didn't work out the way. And I said, if you punish him, you will stifle all empowerment, all initiative within the whole organization, which today is so important. Because it used to be that you could have a patent-type leader, a draconian authority, authoritative figure that knows everything, right? Well, that's long gone. The fog of war, the fog, the confusion in any profession used to be not enough information. Now what is it? Of course, it's too much. We're overwhelmed with information. So you have to empower to get the most out of people. And that trust, you can't empower without trust. And you can't empower without knowing those individuals. So it's absolutely key that you accept failure. Again, I'm not talking about something illegal or immoral. We're trying to do the right thing, and it doesn't work out. You've got to back them up to build that trust. And then I would also say, when you have that trust, folks will understand a few times when maybe you can't. You're in a crisis mode, and you can't explain why you're doing something. Hey, get through that door. Do this. Stop that bleeding, or whatever. You don't have time to explain. They'll understand it when you've built the trust and you've worked it consistently. They'll accept it. Now, if that happens continuously, you're going to start to lose trust, because folks want to know why. And that's part of building the trust, sharing, and the communications among the team. So just in combat, an operation we had in Mosul, Iraq, and al-Qaeda had really taken over the city before we got there and we arrived. And it was a tough situation. Had about 12,000 soldiers. And we had a major operation coming up involving all 12,000 soldiers. So we prepared for this very hard. We rehearsed. We built trust for a long time. But you're leading up to the operation. So as commander, much like on this sheet, you'll see Eisenhower. I'm not trying to compare myself to Eisenhower. But you'll see Eisenhower talking to soldiers before D-Day. This is before the jump. Just had the 80th anniversary of D-Day. And that's Eisenhower talking to soldiers in the 101st Airborne Division before the operation. All the plans are out. And you go out as a commander, and you're talking to the troops. And interestingly enough, in this picture, they're not talking about technical stuff. They're not talking about the jump, the fight. They're talking about fly fishing. This young man in this picture was from Wyoming. And Eisenhower was a fly fisherman. They're talking about fly fishing. So they're building that intimacy. Building that intimacy. That third base. And the soft skills, if you will. Not the technical and the leadership that's being demonstrated. So before this major operation in Mosul, I'm out going to all the units. And gathering folks and sort of talking about, hey, here's why we're doing what we're doing. Explaining what's going to happen. I mean, there's a very high chance people are going to lose their lives in this operation. It's very complex. And I'm talking at one particular formation, a couple hundred soldiers. Talking to them around in a circle like a huddle. And this one young sergeant, he said, hey, sir. You don't need to explain it. We trust you. And quite honestly, right now, I almost get choked up just thinking about that. So his life is on the line. And he's, I don't need the explanation. We trust you. And that's why I knew we had done the building the trust right. It's not a one, say it's not a crisis that's about to happen and you can turn it on. It's a process you have to work. And then when you have it, it's unstoppable. And that operation, eventually three months later, we would defeat Al Qaeda. And that was the start of it with that operation. But that's trust. And it's not easy to build. I'm not saying it's easy. It takes a lot of effort, a lot of time, and it's tough on you as a leader. But if you don't have it, you won't accomplish what you want to. And if you have it, you can accomplish anything. That's such a huge point. Bob is here to have a conversation with all of you, not just with me. Please, if you have questions, come to the mics while I ask a follow-up onto that. Actually, I could have followed up on about 10 different things that you talked about. But at one point you said, I never was trying to be a general. I was never trying to be a general. And I think maybe some of the people younger, some of the early career members of our organization, maybe they were trying to be the next Jimmy Andrews or Neil Ellitrush or Bob Arciero, and to be that elite team physician, orthopedic surgeon that everyone looks to. But there's a lot of hard work that goes along with that. And you told me that after your five-year commitment, you went into the next job thinking, nah, this will be my last job. And you said that at every job. I don't know how many jobs it was, 18, 20 jobs after that when you get a different assignment thinking, OK, yeah, I'll do that. That's a good job. How do you have that mindset that, OK, this is something that is along the path, and I'm not doing it to be a general? How do you develop that mindset to stay focused and present in your current job without thinking about those aspirations that we all have? Yeah, and I think someone could hear that and say, oh, come on. You have to have a little bit. You're thinking a little bit about those things. But really, I think to be successful, of course, you want to do the best you can. I'm not saying you're not going to be the best at whatever you're doing. You're trying to learn your skill, learn your profession, be as good as you can possibly be. But it can't be that success is measured by this. I'm going to be the number one orthopedic surgeon. I'm going to be a sports medicine surgeon or doctor at University of Connecticut, for example. You mentioned Bob. So it can't be. It's got to be about being your best, but at the same time fitting in where you're going to contribute the most. And that's that, again, if it's for you, you're not going to build that team and have that trust and have the key aspects to be successful as an organization. And so I think that's it. I'm not saying that you don't want to be the best. Of course you do, and you want to do the best you can. And then I think mentors play a key role. It says on here, mentorship is your legacy, and you need it. I don't think there's a successful person I know would not be here at all without a half a dozen mentors who gave me incredible advice and wonderful, in those tough times, when you have a failure, you have to have your network established before the failure. Who can you go to? And that may be your mentor. That may be, in my case, in the military, a chaplain. And like you, Dean, I married way above my pay grade. My wife of 43 years that I could go to. But you can't think of that in the crisis. You have to have that established beforehand. So as you're working to build that trust, it can't be about you, bottom line. People can see right through that, and it's obvious. And I definitely saw that in coaches early on in my life. I saw the example of my high school coach, and certainly from Coach K, 110% saw that. And to this day, his loyalty and his selfless service to others. Yeah, and I mean, I see it more often than not. The great jobs go to the people who are keeping their heads down, working hard, and not the people that are politicking. And so I think your points are great. And the people that are trying to get to something are more often than not not going to get there. We've got a couple of questions here. Is that Jimmy Bailey? Yes, sir. General, thank you so much for your decades of leadership and service to our country. Truly amazing. Dean Taylor, thank you for setting this up. You alluded to failure. And some of the most important lessons in life come out of failure. So I'm told. I'm sure it'll happen at some point. As a graduate of Naval Academy, you never fail, so no problem. Wait a second, does that go to that confidence with humility thing? This is my question, sir. So as a graduate of our second most esteemed service academy, West Point, I'm sure you can speak volumes about failure. If you would please share with us, sir. Go Navy. Thank you very much. That's all fair, because I went right after Naval Academy. And honestly, we joke. We love. We're a joint team, the military, an amazing team. And there's nothing better, I'll tell you, when I was on the ground in combat and a Naval fighter pilot above me, they were my best friend. There's no question about it. Only one day of the year that doesn't occur. Army, Navy, football there, but other than that. And who has the commander in chief's trophy? Yeah, I think we do. Again. I think it's at West Point, right? Yeah. Anyway, yeah, failure is a, clearly, if you think, let's use sports analogy, when you win a game, you don't do much analysis. You won, and good coaches do, but the players, you won. OK, there were some things went wrong. But when you lose, what happens? Oh my goodness, you just peel that back, and you analyze the heck out of it. What went wrong here? You're frustrated. And it's very similar in anything that you're attempting. There's failure. It's tough, but you learn a lot from it if you handle it right. And it's the old, it's not getting knocked down, it's getting back up. But I have seen in younger generations, when you know you're getting to be an old person, and you're talking about younger generations, there's a fear of failure, more than I believe my generation had, a lot more. And I think a huge part of it is, we used to keep failure fairly isolated when you fail, among family and friends. And now when you fail, what happens? It's tweeted, it's text, it's blogged, it's memes, it's everywhere. And so I can see why there's more fear of failure, because it's very hard to keep it isolated. But, you know, so that's a challenge. And again, I could go into, we could spend two hours talking about failures, but I think the most important thing and when you're a leader and you fail, having that support network beforehand enables you to have the folks you can have your little pity party with when you failed and you feel terrible, and whether it's a minor thing or a major thing, and you get it out of your system, but the folks you're leading can't see that. You know, and that's a tough thing. And I've been in scenarios where we've had a loss of life, and, you know, it's just terrible. It's the worst thing, worst experience on the face of the earth, losing a soldier in combat. You know, I'd lost soldiers in, you know, the terrible tragic automobile accident and so forth, and it's terrible, but there's nothing worse than in combat, and you have ordered them to do something, and they lose their lives. So you talk, you know, the failure there, it is often darkest before the dawn, and you can't dwell on the failure, the entire mission will fail. And so you learn from it, you grow, you make a General Marty Dempsey, an amazing leader, would say, you have to make it matter. Their lives matter. And so, you know, taking that failure and as the leader, yes, you're there, you're, you know, I remember memorials. I felt like I was having a heart attack the first memorial I went to in combat. I felt like the Army from day one at West Point, when Dean and I were standing there with shaved heads, they prepared me for everything, except casualties in combat. And I don't know how you prepare for that, other than, again, you get a support team beforehand, and you know, and then as you're going through it, it's just very, very tough, but you have to make it matter and know that, you know, if it were you, you would want them to carry on and do their very best. So you learn from that, and success depends on being able to continue to get up. So you learn more from failure than success, and it will lead to eventual success if you do it, if you handle it right. So, but failure is a, you know, if you're not failing, you're not doing anything. And you're failing because you're not doing anything. Jimmy, are you not doing anything? I think he did say he's never failed, but yeah, you're not doing anything, and that's failure in itself, right? So I guess that's, you've got to be, you have that resilience to bounce back, but it's tough. But at the same time, in leadership, again, I'm not saying those close to you don't know, you can't just hold it all within you, you got to have your support group, but never went in front of soldiers, you know, if as a leader, after you failed in any organization, and you're just like down in the dumps in front of everybody, you know, it's going to be a tough, tough day, and tough, you're not going to make it. You've got to pull yourself together as a leader, and look at the, learn from it, and get better from it. What was your biggest failure, or not maybe your biggest, but share one. Thanks, Dean, for that wonderful question. It's okay, I mean, we fail all the time, right? Yeah. But maybe, maybe rephrase that. The toughest moment after failure. Or your failure that you learned the most from. Yeah, I mean, I learned from every failure, a ton. And I don't know that I could pinpoint, but again, I would just say, you know, whenever those tough moments in combat where the enemy gets a vote, you know, and they may have done something you didn't anticipate, and you lose soldiers, that's the toughest. And coming back from that, it does take incredible effort with that support team, and then really finding the things you could do better, and fixing them quickly, and then in the entire organization, keeping that focus on what the mission is, and that trust that you know, hey, you know, they got us this time, but we're gonna learn from it and get better. So I'd say that, yeah. Yeah, that's good. So. Others, you got a couple others? Yeah, Bob, this is one of our former presidents of this organization, Pete Indalicato, a long time team doc at the University of Florida. Thanks, Bob. And thank you, Dean, for putting this together. It's fascinating. So my question is, is it more difficult to establish yourself as a leader in today's world, in today's world of social media? And assuming the answer to that question is yes, what suggestions do you have to use social media as an asset, rather than as a negative effect? It's a great question. And yes, absolutely, it's tougher. Because it's, you know, it's an avenue where folks can be anonymous, you know, and it's great, you get feedback. You know, and in, I'd say anybody about 40 and under, they're not looking you in the eye anymore and coming to you with problems. It's just not the way they handle things, the way, you know, again, I'm making us feel old up here, but, you know, it's just easier. And now, if you establish in an organization, a social media outlet, or a blog, it'll be packed. You know, you can't read it all, you know, so it's how they communicate. And I think you learn some tough lessons. If you don't figure out how to leverage social media as a leader, you're gonna be behind and it's gonna, it's gonna be something you can never solve. So you have to address it and you have to be proactive with it, as proactive as you can be. And that's tough because we used to say, you know, be, yeah, you gotta be fast, but the truth is slower than a lie. A lie's halfway around the world while the truth's still being verified, you know? And so, but you're the first, would it be the first with the truth? But of course, then we look at what's the challenge today? What is the truth with disinformation? I mean, I thought, for example, you know, with the information age and connectivity and globalization that the downfall of a Russia, the downfall of North Korea, China, would be that their people would have access and find out ways to get the truth. Well, it's the opposite has happened. Authoritarian regimes actually have an advantage is they can shut people out completely and then they can provide disinformation to them and they believe it and you don't get the truth. And so, it's a real challenge and organizations, I believe you have to stay on top of it, get somebody. I don't think it can be you, you know, you're busy as a leader and I've seen leaders try to keep up with social media and it's very, very difficult as the leader. You got a lot of responsibilities, but you certainly can have someone who is speaking for you and the command or the organization and they run potentially controversial things through you, you know, and you build that trust and they can respond faster and address social media. If you don't, you're losing a whole chunk of the population and organization. And so, it has changed things significantly and it's fascinating. I mean, I could go into another hour just how it's changed when something happens anywhere. You know, in our case, when there's a casualty, you wanna make sure it's the right process being notified when social media can be out instantaneously, which is not a good thing, you know, for someone. So, how do you deal with that? How do you handle it? You've got to address it, you gotta put somebody in charge of it and you gotta try to stay on top of it for certain and that's not easy. And I don't think you can do it yourself, but you have to be involved, for sure. I'm just gonna follow up on that just a little bit and push back on you a little. Is that okay, sir? Yeah, absolutely. Sir, is that all right? Please, you were number two in the class. I was on the dean's other one, I can tell you. Yeah, I'm gonna get Mark Miller for that. That was not supposed to be widely known. So, you know, a couple of times you said, you know, the younger generations, you know, fear of failure and they're looking at their phones. I think it's not just the younger, I'm gonna defend the younger generations because I think it's not just the younger generations. I think all of us have a greater fear of failure because of social media. And I think the younger generations are smart and they're gonna figure out how we do social media so that we don't have that fear of failure. And I'm really enthusiastic because I work with medical students and fellows. And I agree with you 100%. I didn't mean, I didn't really mean to, just trying to point out how it's different. But I agree with you. A few years ago, when I was preparing to go a tough combat operation and I was watching, you know, the younger leaders a lot and they were different than I had been. And they did not seem to me as dedicated as I had been. And I would tell you, honestly, they were smarter than we ever were. And they got it right. They understood balance. You know, I would stay in a particular job, I would stay just because the boss was there and do, you know, and you just, and they leave and they were right. You know, and then I saw them in combat. They were amazing. I mean, selfless, unbelievable heroes. The next greatest generation, they're amazing. But it is different. I, you know, so I didn't chop them down in any way. It is different. And I do agree, everybody is afraid of failure more because of that. But I think even more the younger generation. Yeah, we're counting on them to fix all the things that we've screwed up over the years. And we're gonna need it. It's a crazy, crazy world. Yeah, so the Reverend and the boxer. Yeah. John D. Kelly IV. After he kicked my butt in boxing. No way, you got a good lead left. I can see that. General, I just wanna thank you for everything. And to my so most brethren here, I'm humbled every time I'm around these guys like Jimmy and John and Bob. But anyway, your leadership is evident. You're a humble guy. You're kind, I see that. The question I have for you is, our young men and women are getting waffled with stressors that I never saw my first year of practice. Could you share with the audience some of the personal habits you use over years, which enabled you to prioritize and execute? What are the things you did on a daily basis, sir, that you could share with these young men and women? Yeah, no, great question. Thanks very much. I think balance is critical. And I feel very fortunate. Now, when I say balance, it's a fantasy that work and your family life are gonna be perfectly balanced. There's no way. If you're gonna be successful, it's a lot of hard work. For all of you, you're putting in incredible hours of medical school. I mean, it's unbelievable to you from the very start for us, deployments and stuff. So it's never gonna be balanced. You're gonna be gone. But I felt it was very important. And for my family, I'm incredibly proud of, incredibly successful family. But they knew, I had three daughters, and they knew if I could be with them, I would. And I wanted to be with them. And that's not always the case, I think. And so I really emphasize, and then all my hobbies were family. Everything we did was family while my children, I mean, I didn't go, my golf game's terrible because Saturday, I'm working my butt off all week. The last thing I wanted to do is on Saturday, go spend half a day with my buddies at work. I'm gonna be with the family. And now I'm still suffering that. Dean can kick my butt in golf, and it's painful, but maybe someday I'll get it back. So I think really important, and balance the things I did. When I first deployed to combat as a colonel, it was later in life, had been Cold War and all these different things, and Haiti, Bosnia, peacekeeping. But when I was in combat, I've had this guilt if I worked out and took care of myself by working out. And that's how I handled stress before I deployed, working out, physical fitness, just wonderful for that. So I'm in combat the first few weeks, and there's always somebody in harm's way. And I just was like, I didn't sleep enough, and I didn't go work out. And after a few weeks, my staff, they were like, they said, don't you wanna go work out? You're kind of grumpy, you're not yourself. And I was not myself, and I was not relieving the stress. And I realized that was stupid. And so I got sleep, which was hard, but I got sleep, and I worked out, I even did yoga. I would actually go shoot free throws, would call me, I'm in combat, I'm shooting free throws, I'm doing yoga. What was your percentage? Like 98, I'm telling you, it was. And anyway, but those were all stress relievers, relief for me. And again, maintaining contact with the family. Fortunately, the years where we could never, we might get lucky, you get one Zoom call, not Zoom in a day, but one VTC with a family in a year. But later you could Zoom and you could talk. And so part of my balance was once a week, late at night, yeah, but talking to my family and staying close and staying involved and everything else. So the balance is important. It's never gonna be an absolute balance if you're gonna be successful, that's a myth. But what is it? And then I'd say the other thing is I did have bosses that made that difficult sometimes. I was a battalion commander, it's a lieutenant colonel, you have a brigade commander as a colonel. And this particular brigade commander, he was like one of those guys that worked 24 seven. So it'd be like eight o'clock at night, he'd call me at home and say, I'm at the office, where are you, Brown? I'd be like, I'm home with my family and that's where I'm gonna be. And I had learned from some mentors, one of them, General George Casey, who just really learned how to exhibit balance after working too hard. I learned from him, like get home and be with your family at a reasonable hour. And so you can be with them. And then if you've got to do more work, go in at four in the morning, three in the morning, when they're not awake anyway, and get it done then. And so it was hard because I thought, well, that boss, it's affecting me, but hey, that's what it is, okay? Again, I'm not striving, I'm just doing the best I can do and part of that is his family. And then the other thing I will say, going back to failure, the few times, quite a few times I failed, but when my family was there, when it wasn't deployed somewhere and I failed, my wife and my family were there in the worst of times when you thought it's all over and they're there like a rock and so you realize what's important. And I balanced even more when I, I thought I was pretty good, but I got even better. And so I think that's, and then I mentioned also, I think it's very important, prepare bad things are going to happen today and things you don't anticipate. Again, when Dean and I were young officers, we could almost plan for what's gonna happen and any bad that's gonna happen. We'd feel like we would fail. We'd failed as planners and if we didn't predict what was gonna happen, it was kind of more predictable world. Now that's the opposite today. I mean, expect the unexpected. In fact, it says on here, trusted teams of professionals that thrive in ambiguity and chaos because that's what it is out there. It's ambiguity and chaos. Things move so rapidly now in any profession, in any field that it's really ambiguity and chaos. And we used to say, be comfortable, but 15 years ago, be comfortable in ambiguity and chaos. Well, that's not enough anymore being comfortable. You've got to thrive in it and trusted teams of professionals that trust in the team will help you do that. And that's when you see the best corporations, they thrive in ambiguity and chaos. You see the best sports teams, the ones that excel the best, it doesn't matter, the best organization that's gonna thrive expecting the unexpected now. And so again, in balance, you better have built that team that's gonna personally help you because we all need it. Who is a trusted person when the crap hits the fan that you can go to and you know you can call and talk and they'll bring some sense back, hey, it's not as bad as you think. And then who's that trusted team you can go to when you're as low as you can get, but you can't let the organization see that and you got to lead still. You got to have that in place before the crisis. It's hard to form a relationship during a crisis. You better have formed them before or good luck. I think that point about, yeah, forming those relationships, you can't balance things here, but you have to be focused, dedicated. I mean, the family thing for me, you all met my family yesterday and it was, you know, I get emotional about it because they're there for you in your worst of times. And in the best of times. So in, I'm going to take a little tangent here. I'm going to take the presidential prerogative. Presidential prerogative. You guys didn't get to meet my daughter, Kate, yesterday. I mentioned her. She was in Los Angeles for the Television Critics Award and her documentary was up for the best documentary called, and some of you have seen it, Quiet on Set. Well, they won the best documentary of the year from the Television Critics Award. We are so proud of you, Kate. And thanks for supporting me. Thanks for being here, all of you. And you're right. A tremendous example of that. That rock, superstar Ann, but the balance also. Amazing family. All right. I don't know who that is. Leah Brown, I'm in Phoenix and I'm Navy as well. So go Navy. All right. Now I know who it is. Good to see you. Thank you so much, General, for being here and giving us such great advice and lending your expertise. I'm going to ask a hard question. Okay. And how do you, what is your advice or what is your input on addressing gaps in leadership and blind spots in leadership and how we navigate this minefield of inclusivity and in those conversations? What's your advice on that? Because this is a challenge for us. Yeah, no, that's a great question. So if I can make sure I've got it right. So talking like gaps in leadership where your boss may not be the best leader and then also gaps in inclusive where you may not have the right representation in the leadership and you see that it's not fair. A lot of both, but a lot of the second. And mostly the blind spots, it's not necessarily intentional in bad leadership. It's just that they're blind spots that people experience brings. And how do we address that in a fair way? Yeah, well, it's a tough, tough issue because we tend to pick in any field, when you're selected for a leadership position, again, any field in the military, we have very rigorous boards that meet and there's all kinds of very strict rules and blind voting, no talking, review of all the records and so forth. And so, and that goes from the time and for an officer, a second lieutenant, the first lieutenant, all the way up to two star general and then three and four star nominated by the president. So in those boards, they have to address some of those issues. For example, one thing they did, they used to have a photo, a command photo in the boards. They took the photo out. And at first you might think, well, wait a minute, isn't that? No, so that again, we tend to pick folks that look like us, have done what we have done. And so it has to be addressed because for the military, we can't be successful if we don't represent America. We have to have an organization that represents America across, that looks like America. You can't have a pockets of, it has to that we're the military for the United States of America to support and defend the constitution of the United States and we must reflect that. So there's a lot of attention needs to be paid and things that need to change to prevent us from always. And then you get into, do you, in certain instances, do you have to have where you establish perhaps a quota in those boards? And that's gone back and forth. And what I would say is, you know, the way I always handled it is, you pick the best individuals for sure, you have to have to, but if there's, among that pool of best individuals, you have to look at, do we represent the country? And if not, where we're short, those individuals in that pool, then they are a step ahead. That's just, they have to be so that you represent the population that you're defending and sworn to defend under the constitution. And there's mentorship that comes into play in selecting, sometimes just like, you know, for certain, you know, Dean and I, we talked about the mentors we had. So are those individuals that, again, may not look exactly like you, are they getting mentored right? Are they getting the right opportunities? And you can have a huge impact on that and making sure, and I take a lot of pride in having mentored a lot of leaders. And to me, you get more satisfaction from the mentorship, from what they do and their accomplishments, than any of your own, by far. So there's a real incentive there, but it's not always the norm because I think you don't immediately see that satisfaction. So I wish I could tell you everybody was like that, but it's not always the norm. But you have to really put forward in mentorship, are you giving the opportunities, especially where they're needed, where you see there's shortcomings and things aren't working out in the way they should, so you get the right representation. And I've actually been in meetings, you know, we were talking personnel, senior leaders, and you're sort of projecting to the future and you're thinking, okay, how can we structure, who needs to go where, so we get the right leaders in the right location and we get the diversity required to represent the country. And oftentimes it's pointing out, and it's often uncomfortable, you know, like I remember one of those sessions, we were looking at, say, top 100 individuals in a certain rank and who would, you know, 10 years from now, who would be, and so how do you position them in a job? And as we were looking at it, we had very few women in that pool. And there's 100 and maybe there were three women. And I said, well, this isn't gonna work. Look at this, we have 100 more, we have three women, you gotta be kidding me. That doesn't make any sense. So again, it was just sort of a selection based on, you know, it's human nature. You're gonna kind of pick someone that looks like you, that's done what you've done. So we went back and we increased that significantly, you know, just seeing that. But was that comfortable to bring up in that meeting and stuff often? No, I mean, sometimes it's an uncomfortable thing to bring up, but you've gotta tackle it. So I think, you know, tackling it head on, paying attention to it. But the one final thing I'll say is what you can't do, in my opinion, that is harmful, is you can't advance folks just to get the diversity. They still have to be qualified and earn it and be among the best, or you do them a disservice and the whole organization. Because people will know, and that gets the trust, if you're advancing someone for the wrong reasons and people don't think they deserve it, you really erode that trust. So all the more important, you're giving them the opportunities, you're mentoring them, you're leading them, you're providing what they need to be at that level, to be competitive. And so it's not seen as something because of a need for diversity, because that's very harmful, in my opinion, for everybody. Yeah, and Leah, I'd build on that, too, in saying, you know, the military is way ahead of where we are in medicine and healthcare, because they understand, yes, they're representing the diversity of our population, but they also understand that that diversity from so many levels and bringing different ways of looking at the challenges makes us all better. And I think we need to do that better in healthcare, and that's one of the lessons that I've really learned from the Fagan Leadership Program. And even long before George Floyd and everything else, we understood that bringing a diverse population of students and residents and fellows together from different specialties, from an equal mix of genders and sexual orientations and racial and ethnic differences, that made us better. And we continue to get better and look for ways that we can be more diverse and understand our challenges better. So I think it's a great question. It's a great question, and perhaps could be in addition to that fist, is, you know, the diversity of ideas on a team is critical. And the right teams have that. They get that from the trust and that learning environment that develops, but that diversity is key. I found that all the good ideas and significant ideas that developed on a team came from the person you expected and sometimes the least experienced, a different viewpoint because they weren't stuck in a certain way of doing things that we all get. Everybody says they want change, but really we're creatures of habit. They want you to change, you to change, they don't wanna change. So in that diversity, you get at looking at things a different way, and oftentimes that's the best idea you get by far, and it leads to change that's incredibly productive for the organization. So I'm up here and I'm seeing Alison Toth. I feel like Jim Valvano, when he was giving that speech, that guy's telling me I got two minutes left. I'm dying of cancer. Well, I'm not dying of cancer, but this is kind of one of the last things I have as president, and I'm having so much fun that I apologize, I apologize. We went a little bit over. I am having so much fun. This has been tremendous to do this with you, Bob. I wanna thank everybody for being here and I look forward to celebrating with everybody tonight at our final event party. Let's hear it for General Bob Brown. Thank you. Thank you for joining us. Our last game changer of the meeting will take place at 3.30. Please join us.

Dean C. Taylor, MD

Robert B. Brown, Gen. (Ret.)

leadership

trust

military career

General Robert Brown

team building

communication

resilience

social media

diversity

mentorship