The concept of leadership is so broad. It’s such a vast topic that it’s difficult to come up with only one definition of “Leadership.” If we were to ask a room of 100 people and professional development experts, we might very well get 100 different answers. I think a lot about what leadership means to me. What does leadership mean to you?

I was first exposed to the concept of leadership as a young, shy high school student, leading a program for middle school girls to encourage interests in science and medicine. But it wasn’t until I was a sophomore in college at Brown that by chance (because of a crush on a cute BOLT leader!) I joined the Brown Outdoor Leadership Training (BOLT) program and learned about another kind of leadership. I was placed in a backpacking group of eight sophomore women and two women BOLT leaders. We went on a week-long backpacking trip in the gorgeous New Hampshire White Mountains, many of us never having backpacked or even hiked before. We carried 50-pound packs, hiked over 80 miles, crossed rivers, and climbed up and down what seemed like insurmountable cliffs together. We pitched camp with tarps, built fires, hoisted our food into trees to keep them safe from bears, and learned how to tie knots together. We learned about Wilderness First Aid. We learned about LNT- Leave No Trace- caring for our environment and leaving it better than how we found it. We reveled in the stunning natural beauty all around us. We told stories and sang trail songs, and we laughed so hard together that we could barely speak.

While we learned many outdoor skills, and had new and countless fun outdoor experiences together, at the core of the BOLT philosophy was using the outdoors as a classroom, and a tool, to teach and learn about teamwork and leadership. We not only learned about the outdoors, teamwork, trust, group facilitation, listening and mediation skills. We learned about the kind of leadership that sets a strong example, but also one that steps back to allow, develop and empower others to step up and lead. The sense of community, togetherness, cooperation and camaraderie, the sense of esprit de corps and having each other’s back — this was life changing for me. This was the first time I felt like I belonged, and that I could help others feel like they belonged, too.

My experience on that first BOLT trip was so life changing for me that I became a BOLT leader and leader trainer for the next 3 years, and then continued to help at base camp with the annual BOLT trip in the New Hampshire White Mountains trip for several more years while I was a Brown medical student. My experience in BOLT was not only life changing and formative — I look back on these years as a BOLT participant and leader as one of the peak experiences of my life.

It was against this backdrop of my strong, bonding BOLT team experience that I entered into the next several years of my medical training, first as a combined internal medicine-pediatrics intern and resident, and then as a pediatric hematology/oncology fellow in an intense, competitive and rigorous academic program. The contrast of the culture of medicine with that of my prior BOLT leadership experience was marked. Very rarely did I experience, sense or feel that I “belonged.” In fact, medicine culture was almost entrenched in something quite opposite. The general attitude was one of “if you don’t know for sure, don’t dare speak” and “if you don’t know, don’t let on that you don’t know.” Team rounds were often grilling sessions, even when not overtly so. Team members were often belittled by our senior residents or peers, either behind their back or directly, for not knowing the answer, diagnosis or differential. If we were struggling, we hid our struggle. Medicine was a culture and experience of silence. It was a culture so stark in contrast to the deep trust, safety, open learning and camaraderie of my prior BOLT leadership experience.

It was no fault of the senior residents, fellows and attendings I was learning from. Almost without exception they were and are wonderful human beings, who cared deeply about patient care and training the next generation of doctors to become excellent clinicians and researchers. But they too had been trained and molded in a culture of intensity, isolationism, lack of trust, and silence. They didn’t know anything else, or know any other way, to model leadership.

Also hammered into us was the strict hierarchy of medicine. Medical students were below the interns, who were below the senior residents, who were below the fellows, who were below junior attendings, who were below senior attendings, and so on. You didn’t dare question anyone above you, and as a trainee, pretty much everyone was above you. And if you did question, you became a marked person — one of “those” interns or medical students, ostracized, rejected, and looked down upon. There was no coming back from there.

Whoever was “in charge,” was in charge as a positional leader. You did what you were told, not because you necessarily respected your leader, but because the leader in charge above you told you so. Even more so, as we completed our training, we were indoctrinated into the even more treacherous minefield of being woman physician attendings in often rigorous, competitive, gender biased and malignant workplace cultures. Positional leadership was all we were exposed to, and all we often saw, during our medical training and afterward.

It comes as no surprise then that so many women physicians I know struggle with their perceived lack of power because of their lack of position. “If I don’t hold a leadership title, then I’m not a leader.” “No one will listen to me because I’m not the medical director or division chief.” I hear this over and over again from friends and colleagues. When I’m completely honest with myself, this is what I believed deep inside myself, too.

Now, six years after completing my fellowship training, I have only just begun to see another way, and to understand another kind of leadership. Over the past two years I became an almost obsessive reader of leadership books, a total leadership junkie. I felt deep within my gut that the style and form of leadership I saw modeled around me couldn’t be all there was, or all there could be. I knew from my former deep experiences as a BOLT leader and leader trainer, that there was another way — an empowering, inclusive, less hierarchical and more collaborative way– to engage with staff, trainees and students.

I longed for the sense of belonging and warmth I felt as a BOLT participant and leader, and for the deep trust I felt with my BOLT peers — a deep trust that has continued with countless BOLT friends, more than 20 years later. I longed for everyone around me to feel liked they belonged, just as I had felt, so many years before.

When I think about what leadership means to me, my answer may not be the same as that of the other 99 people in the room. Or even what I thought leadership was 5 years ago. To me, leadership means staying true to my deepest core values of joy, love, freedom, empowerment, courageous integrity, service and learning. It means using my inner strength and my influence, whether I hold a title or not, to encourage, develop and serve those around me — across, below and above — on all levels. It means empowering others around me to become more than they are now, to reach for and find their own potential as leaders, and individuals. It means modeling the kind of leadership I long for from others. It means being the cheerleader in the background for others, as they step into their own personal definitions of leadership.

I have no doubt, as I go forward through life, that my own definition of leadership, will continue to change and grow. Because we are all on our own personal, life-long leadership — and learning — journeys. Our growing never ends.

What does “Leadership” mean to you? What kind of leader do you want to be? What kind of leadership do you want to see? What kind of leaders do you want to develop around you?

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