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“The Only Thing We Have to Fear, is Fear Itself.” FDR

“A Mindful Leadership Story by Dr. Joseph Zarge”

Like many adolescent science fiction enthusiasts of the 1970s, I read Frank Herbert’s Dune and closely identified with the protagonist, Paul.  When faced with a life-threatening situation, Paul would repeat this mantra to calm his mind:

“I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will permit it to pass over me and through me. And when it has gone past I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain… “

Paul’s words have stayed with me throughout my life, especially during challenging situations like my medical training, work as a physician, and athletic endeavors. In these moments, I have learned to focus on calming my mind so I perform to my best potential. Through experience, I know that once panic and fear take over, the likelihood of a good outcome drops considerably.

During my surgical residency in a trauma bay, I saw first hand how the skill of remaining calm and not allowing fear or panic to take over, is paramount. I quickly learned that while academic prowess and surgical skills were important, the residents who excelled were the ones who were able to perform under intense pressure and “keep their cool,”– especially when blood is spurting to the ceiling and a patient on the verge of death. In these type of emergency, life or death situations, the medical leader who was able to remain calm, made it easier for the medical team to follow instructions and achieve the best results for their patients.

There is a saying, “the first blood pressure to be taking in a life threatening trauma code should be the trauma leader’s and not the patient’s. Calm yourself, then spring into action.” My experience of being in the trauma bay reinforced the “fear is a mind killer” mantra. By observing surgical faculty and senior residents, I learned the value of having a calm leader in charge – someone who did not get pulled into the fear or panic that present during a “storm” of trauma.

I chose vascular surgery as my medical specialty and trained in Chicago. I also had the good fortune to train under a chief vascular surgeon who was known for intraoperative tirades and giving residents a hard time. However, I elected to choose him as my mentor because he had a reputation for being the best in the business. In the early days of my training, I remember being intimidated by this doctor’s “style,’’ that is his abrasive demeanor and verbal assaults during surgery. In fact, he would remain confrontational during the most difficult and delicate parts of the operation. Over time, I learned he had served as a surgeon in the military, operating in the most stressful environments and soon understood he was creating an exaggerated stress, to see if I could perform under “wartime” situations. I realized he knew he would not always be there to assist me, and was forcing me to develop the skill of keeping a clear mind during the most intense, extreme surgical situations.

To me, mindful leadership is the ability to keep one’s mind clear and calm, especially during the most difficult moments. I’ve witnessed smart people make terrible decisions and mistakes not because they did not know what to do, but because they were blinded by fear and panic. As a vascular surgeon in Atlanta, I continue to focus on remaining calm when there is a crisis, remembering my training and recalling the “fear is the mind-killer” mantra. In the operating room, I must lead and be certain of my decisions. It is one of the greatest “rushes” of surgery, and also the most terrifying. Fear is the mind killer but remaining calm in life’s storm allows the mind to see through the storm and beyond it.

Dr. Joseph Zarge is a successful vascular surgeon in Atlanta, Georgia. He is on the surgical faculty of Emory University School of Medicine and has been named as one of Atlanta’s Top Doctors in Atlanta Magazine.  On a more personal note, one of Dr. Zarge’s proudest accomplishments, along with his wife Ellen, is raising two sons, one who was just named valedictorian of his high school.  In addition to his professional work, Dr. Zarge relies on his “fear is a mind killer” mantra during his many athletic endeavors including skiing and tennis.

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