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Dame Claire Marx: on kindness and compassionate leadership

Every so often, I’m stopped in my tracks. Over the last few days that’s happened twice. The first time was when the news emerged that Dame Clare Marx, Chair of the General Medical Council, was stepping down from her post, having been diagnosed with pancreatic cancer. Her letter announcing the news to colleagues is both deeply sad and very inspiring. She speaks of the importance and power of kindness in everything that doctors do: she has championed compassionate leadership for the length of her career, and she has used her GMC Chair role to promote such leadership.

She says that the impact for her of the kindness of her medical team is profound, and she comments that, as doctors, ‘our empathy and professionalism shape a patient’s experience almost as much as our diagnostic ability or surgical skills’.

‘No greater comfort than human connection’

She reminds us that neat outcomes – the kind of outcomes that represent a whole solution for patients (a hip replacement, for instance) – are rare in medicine, and, given this, that doctors have significant power to ‘soften the blow of bad news’. Her remark that ‘there is no greater comfort than human connection’ is, for all its brevity, full of wisdom and insight. She reminds the readers of this letter that ‘in addition to compassion for our patients, we must show respect and kindness for colleagues’.

Respect, valuing, listening and belonging

She reflects on her career that ‘in my happiest moments, I felt respected, valued and listened to. I felt I belonged’. Her wish is that ‘every doctor and every patient experiences the compassion that defines first-class care’.

While the whole letter moves me, these latter reflections are perhaps what move me most. In an NHS which spends years training medical staff on the most demanding of technologies, techniques and processes so that they become technical experts of the highest order, the NHS staff I encounter from a variety of roles, and notably through Coaching through COVID , bring to coaching challenges which so often relate somehow or other to being ‘respected, valued, listened to and belonging’ – or rather not experiencing all or one of these. They comment that leaders and managers often fulfil their roles with a distinct lack of these qualities (with some remarkable exceptions). Equally, as patients, we take for granted that the NHS will be there whenever and for whatever we need it: how much do we bring respect, valuing, listening and kindness to our interactions with those who serve us?

The cost when these qualities are absent

The sadness is the cost in distress, emotional and physical tiredness and exhaustion, despair, loneliness, fear, and a sense of just wanting to get out. And, very significantly, the cost to the patient of being cared for by staff who are tussling with all this: what might be the cost in terms of patient safety, quality and pace of recovery, and wellbeing?

Humanity

I remember coaching a pain specialist who reported that since he’d started listening to his patients, he needed to prescribe less. Extrapolate that to the thousands of doctors employed in the NHS, and the implications are significant. And yet for me, it’s the humanity that’s at the heart of this: it’s the humanity between colleagues and by leaders that can evoke distress or joy, isolation or feeling part of something bigger, motivation or disengagement.

The value of listening

The second experience that has stopped me in my tracks is a commentary by Rabbi Lord Jonathan Sacks, former Chief Rabbi.

He comments: ‘Often the greatest gift we can give someone is to listen to them. Viktor Frankl, who survived Auschwitz and went on to create a new form of psychotherapy based on “man’s search for meaning,” once told the story of a patient of his who phoned him in the middle of the night to tell him, calmly, that she was about to commit suicide. He kept her on the phone for two hours, giving her every conceivable reason to live. Eventually she said that she had changed her mind and would not end her life. When he next saw the woman he asked her which of his many reasons had persuaded her to change her mind. “None,” she replied. “Why then did you decide not to commit suicide?” She replied that the fact that someone was prepared to listen to her for two hours in the middle of the night convinced her that life was worth living after all.

He also tells the story of the Queen having invited Holocaust survivors to a reception at St James’ Palace. ‘Each had a story to tell, and the Queen took the time to listen to every one of them. One after another came up to me and said, “Sixty years ago I did not know whether tomorrow I would be alive, and here I am talking to the Queen.” That act of listening was one of the most royal acts of graciousness I have ever witnessed. Listening is a profound affirmation of the humanity of the other.

Awareness is the crucial starting point for change

Sadly Rabbi Sacks is no longer with us, but his insight and wisdom remain. How would it be if all of us, as leaders, spent just a couple of minutes each day being aware and conscious of compassion, kindness and listening? Awareness is the crucial starting point for change.

^{Photo by} ^{Priscilla Du Preez on Unsplash}

The impact of kindness and compassion

The news emerged that Dame Clare Marx, Chair of the General Medical Council, was stepping down from her post, having been diagnosed with pancreatic cancer. She reflects on her career that ‘in my happiest moments, I felt respected, valued and listened to. I felt I belonged’. Her wish is that ‘every doctor and every patient experiences the compassion that defines first-class care’. It’s the humanity between colleagues and by leaders that can evoke either distress or joy, isolation or feeling part of something bigger. How would it be if all of us, as leaders, spent just a couple of minutes each day being aware and conscious of compassion, kindness and listening? Awareness is the crucial starting point for change.

Power and the leader

One of the most striking features of power is, it seems to me, how multi-faceted the topic is – and how richly the facets interrelate and intersect and interdepend. There are many and varied implications for the exercise of leadership, and leaders can benefit from reflecting on these. For instance, a variety of perspectives are afforded by looking at ‘my’ power, ‘your’ power, ‘our’ power, and the power in and of the system. Further, within each of these comes the contrast between personal power, the power afforded by title or status, and the nuances of the perception of power that arise in the presence or absence of fear or shame. power can be ‘power over’ or ‘power with’ – and the latter implies more sustainability through relationship and connection. Power, courage and compassion can go hand in hand.

Integrity and power

The client’s terms of engagement transgressed my own deepest values, including integrity. This kind of behaviour on the part of consultancies seems widespread. Further, the attendant disservice to the ultimate end user stems from the enforced compromise of professional integrity, and the imbalance of power is experienced by many of their associates to be abusive. As professionals, are we prepared to tolerate this kind of attitude, behaviour and lack of integrity inherent in the contracting from so many perspectives? Are we really powerless or can we find ways to bring our power respectfully to a rebalancing that will be in all our interests?

Peace, ease and fulfilment

I accept that it may make no sense to juxtapose a street sweeper's relatively simple situation with my clients’ complex roles and environments. On the other hand, I’m very curious about how leaders conceive of their responsibility (and opportunity) to design and embed working lives for themselves, their peers and their reports which release greater peace, trust, ease and fulfilment - and thus greater effectiveness. More than that, I worry about their health, their wellbeing and their longevity if leaders don't take that responsibility.

Integrity, safety and wellbeing

I’ve just done something I’ve never done before: I’ve handed back a 4-year contract. At the heart of my decision was an inability to tolerate a client’s terms of engagement – both the formal, explicit terms, and the informal, implicit terms. My deepest values (integrity, professionalism, honesty, care for the coachee experience, respect, acknowledgment, being heard) were compromised. I felt deeply unsafe: my trust in the client was entirely absent. What was happening was moral injury, and the experience was threatening my wellbeing by demanding that I don’t behave in integrity – and I can only maintain my wellbeing if I’m behaving in integrity. I’ve learnt too that doing what matters deeply to me is a significant enabler of tough decisions and tough actions.

'I' or 'we' as a model for leadership?

What happens when a leader or a nation sees the future not through a lens of relationship, action and impact, but through a lens of isolation, cutting off supply routes of collaboration and support? Is this the model of leadership that we really need? ‘You’ and ‘yours’ can actually be the route to ‘me’ and ‘mine’ if only we choose to look through a broader lens. As a coach, I may enquire with a coaching client more explicitly into the implications of ‘I and we’ in contrast with ‘I or we’, at individual level, team level, organisation level and beyond. Putting ‘I’ before ‘we’ risks shutting off not only precious resources but also risks shutting off precious rewards. ‘We’ before ‘I’ might lead to rewards we hadn’t dreamed of.

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