1. Simone, Joseph V. MD

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Editor's Note: Revisit Dr. Simone's thoughts on leadership from this throwback column, first published in the July 25, 2015, issue of Oncology Times.

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Joseph V. Simone, MD... - Click to enlarge in new windowJoseph V. Simone, MD. JOSEPH V. SIMONE, MD, has had leadership roles at many institutions and organizations, and has served on the NCI's Board of Scientific Advisors. His

I never thought I would ever see, much less report on, a speech by a pope on leadership. So imagine my surprise when I saw an article in the Harvard Business Review (April 2015) in which Gary Hamel reports on a speech by Pope Francis to the Roman Curia; the Curia consists of the cardinals and bishops who manage the large array of administrative bodies of the Catholic Church. Hamel then "spent a couple of hours translating the Pope's address into something a little closer to corporate-speak."


Although Pope Francis was speaking to leaders of the Church, Hamel thought his approach was refreshingly direct with an understanding of "human proclivities" (read: weaknesses) and that, nonetheless, the Pope said "leaders should be held to a high standard, since their scope of influence makes their ailments particularly infectious." It seems that Pope Francis continues to surprise us, whether we are Catholic or not. My parents were Italian-Catholic immigrants, so I am a "cradle Catholic."


It is interesting that the Pope chose to use the term "diseases" for the shortcomings of bishops and priests, and he added, "They are diseases and temptations which can dangerously weaken the effectiveness of any organization." I shall list the diseases (some are shortened) and include some of the Pope's comments in Hamel's translation in quotation marks; For some of the "diseases," I will add some of my own comments, particularly when there are parallels in academia, medicine, and other organizations that we belong to. Some of the "diseases" may surprise you.


1. Thinking we are immortal, immune, or indispensible.

"Neglecting regular checkups. A leadership team, which is not self-critical, which does not keep up with things, which does not seek to be more fit, is a sick body."


We have all seen examples of this, particularly a belief that they are indispensible. No one is indispensible and good leaders know this and always prepare for a smooth succession should he/she be disabled. I worked under two leaders in my career who had an advanced case of this disease. One failed to see that things were not going well and began to blame others for the decline-he, of course, was immune to blame. Another was so enthralled by the stature and income he enjoyed as CEO that he was afraid to make or allow any changes-a deadly situation.


2. Excessive Busyness

"This is found in those who immerse themselves in work and inevitably neglect to rest awhile, which leads to stress and agitation. A time of rest, for those who have completed their work is necessary, obligatory, and should be taken seriously by taking more time with one's family and respecting holidays as moments for recharging."


Many of us, including me, have had this disease at one time or another, particularly in the first few years after training and after each promotion. This disease can sap one's energy excessively and distance oneself from family.


3. Mental & Emotional "Petrification"

"It is found in leaders who have hearts of stone, the 'stiff-necked;' in those who eventually lose their interior serenity, alertness and daring, and hide under a pile of papers, turning into paper pushers and not men and women of compassion. It is dangerous to lose the human sensitivity that enables us to weep and to rejoice with those who rejoice. Being a humane leader means having the sentiments of humility and unselfishness, of detachment and generosity."


I have known and pitied some with this disease. A lack of humility is especially damaging to a leader; the ability to laugh at oneself provides a partial cure, and if one adds generosity, one may cure himself of this disease.


4. Excessive Planning & Functionalism

"When a leader plans everything down to the last detail and believes that with perfect planning things will fall into place, he/she becomes an accountant or an office manager. Things need to be prepared well, but without ever falling into the temptation of trying to eliminate spontaneity and serendipity. We get this disease because it is easy and comfortable to settle into our own sedentary and unchanging ways."


Anyone who has developed a strategic plan or written a clinical trial protocol is in danger of thinking that all the thinking has been done. Leaving some breathing room for unexpected events, such as financial disappointments or a change in staff, is one way of avoiding this disease.


5. Poor Coordination

"Once leaders lose a sense of community among themselves, the body loses its harmonious functioning and its equilibrium; it then becomes an orchestra that produces noise; its members do not work together and lose the spirit of camaraderie and teamwork. When the foot says to the arm: 'I don't need you,' or the hand says to the head, 'I'm in charge,' they create discomfort and parochialism."


I have seen a bad case of this disease in one institution I worked in and in many others as part of my consulting work. Like kids in a sand pile the leaders competed, froze out colleagues, or in some other way eroded the space for good will and partnership. See the diseases below for other examples.


6. Leadership's 'Alzheimer's Disease'

"This consists in losing the memory of those who nurtured, mentored, and supported us in our own journeys. We see this in those who have lost the memory of their encounters with great leaders who inspired them; in those who are completely caught up in the present moment, in their passions, whims, and obsessions; in those who built walls and routines around themselves, and thus become more and more the slaves of idols carved by their own hands."


I am willing to bet my car that 90 percent of readers know of leaders like this-egocentrism taken to a pitiful extent. And the next disease is similar.


7. Existential Schizophrenia

"This is a disease of those who live a double life, the fruit of hypocrisy typical of the mediocre and of progressive emotional emptiness which no title or accomplishment can fill. This disease often strikes those who are no longer directly in touch with patients and 'ordinary' employees, and restrict themselves to bureaucratic matters, thus losing contact with reality, with concrete people."


8. Rivalry & Vainglory

"When appearances, our perks, and our titles become the primary object in life, we forget our fundamental duty as leaders-'to do nothing from selfishness or conceit but in humility count others better than ourselves.' As leaders we must look to the interests of others."


This is probably the simplest and most important disease; what is a leader for but to lead and help those under his/her leadership?


9. Gossiping, Grumbling, & Backbiting

"This is a grave illness which begins simply, perhaps even in small talk, and takes over a person, making him a 'sower of weeds' and in many cases, a cold-blooded killer of the good name of colleagues. It is a disease of cowardly persons who lack the courage to speak out directly. Let us be on guard against the terrorism of gossip."


10. Idolizing Superiors

"This is a disease of those who court their superiors in the hope of gaining favor. They are victims of careerism and opportunism. They honor persons rather than the larger mission of the organization. This disease can affect superiors themselves when they try to obtain the submission, loyalty, and psychological dependency of their subordinates, but the end result is unhealthy complicity."


I would add that overdependence on superiors can be equally damaging and can lead to a career catastrophe.


I shall simply list the remaining diseases since some overlap with the above and I will record only a brief comment by the Pope or me, if any.


11. Indifference to Others

This is ably covered above and speaks for itself.


12. Closed Circles

This is also covered above, particularly in "gossiping" and "idolizing," though the closed circles of cliques that exclude many colleagues is a very specific and destructive disease.


13/14. Extravagance & Self-Exhibition/Hoarding

These two are covered tangentially in "closed circles" and "indifference to others." But Francis makes explicit points about the turning of one's service role into a vehicle for storing power. As a Catholic, I see it as a rebuke of cardinals and bishops who focus on rising up the hierarchical ladder, and do it with extravagance in their own lives. However, academia has no shortage of this disease. It is no coincidence that Francis chose not to reside in the Vatican with its upscale and elaborate quarters, but rather in a simple apartment nearby; and he has chosen to wear simple vestments when he travels. He is a leader by example.


15. The Disease of a Downcast Face

"You see this disease in those glum and dour persons who think that to be serious you have to put on a face of melancholy and severity, and treat others-especially those they believe are their inferiors-with rigor, brusqueness, and arrogance. In fact, a show of severity and sterile pessimism are frequently symptoms of fear and insecurity."


In my career, this last sentence rings very true, and I could name a dozen who fit the description; they are unhappy people who make those around them unhappy.


"A leader must make an effort to be courteous, serene, enthusiastic, and joyful, a person who transmits joy everywhere he goes. A happy heart radiates an infectious joy: it is immediately evident! So a leader should never lose that joyful, humorous, and even self-deprecating spirit which makes people amiable even in difficult situations."


I must say that this is my favorite of all the diseases, especially the curative prescription offered by Francis.