The Dodo Club (54th Edition)- Lessons from Heart Attacks

A note from me:

Hi Folks,

The last couple of weeks have passed fairly quietly.  There have been plenty of bits and pieces for us to sort out before our long adventure to Australia, where I’ll be a visiting research fellow at the University of South Australia before returning to the Netherlands in time for Christmas.  I’ve been to that vast and varied country several times in the past on business, but it is Mary’s first time.  For me, however, I’ll also get to see the interior of the country for the first time towards the end of our visit as we cross the country from south to north, Adelaide to Darwin, for a several-day trip on the “Ghan” train.  

In Australia, I’ll have discussions and hold seminars in several places, drawing on my experience in strategic planning, scenarios, and energy transitions.  I’m hoping to learn from these experiences as well as help the understanding of others.  In addition, I intend to explore how effective theatre could be as an approach to reaching the hearts and minds of people in exploring serious themes like how our decisions in the present affect sustainability for generations ahead.  

Drawing on different areas of my experience, I’ve drafted my first play in 25 years that we will work on – provisionally entitled “Memories of the Future”.   I’ll be able to work with a few actors and both academic and practising theatre experts in Adelaide.  I’ve some experience in theatre directing, and Mary is a brilliant acting coach.  I’ve also already benefitted from guidance and great editing from our dear friend Jenny here in the Netherlands and her lifetime of professional theatrical and writing experience.  

Encouraging people to care enough to act is a matter of the heart as well as the head, which links a little with the topic of this Newsletter.  I hope you find this interesting and valuable, and possibly even life-saving for some.

My Bi-weekly Guide:

Some lessons from Heart Attacks (and Art)

Over the years, people have had very different ideas about the human heart.  For many cultures throughout history, it hasn’t been considered a particularly important organ in the human body. In the West, the heart only became an important symbol for love during the Middle Ages, and scientific appreciation of the function of the heart as a pump that circulates blood came only in the 17th century, primarily from the work of William Harvey.  

The "heart renaissance" of the 15th to 17th centuries, featuring the work of figures like Leonardo da Vinci and Andreas Vesalius, laid the groundwork for Harvey's conclusions. 

Here is a reproduction from one of da Vinci’s notebooks.  Leonardo initially had access only to hearts from oxen and pigs, but later in his career was able to view human dissections.  He integrated scientific curiosity with great artistry.

Leonardo's investigations of the heart and circulation began in the 1490s, and this anatomical overview was produced around 1510 while he was based in Milan. The sketch is part of the Royal Collection, held at Windsor in England.

Leonardo didn't understand that the blood was in a full circulation system, but he made a number of advances in the understanding of blood flow. He found that the heart is indeed a muscle and that it does not warm the blood as was thought at the time, and also that it has four chambers, and he connected the pulse in the wrist with contraction of the left ventricle.

We now understand the full medical significance of the heart and the seriousness of its good functioning for every minute of our lives.  We worry about anything interfering with this, such as a “heart attack”.

It seems over-dramatic to write this, but I have experienced two heart attacks in the past. I am absolutely fine now, and this past week I had my annual check-up with the cardiologist, and all is well.  

It seems over-dramatic to write about this because we are so very used to seeing dramatic heart attacks in films and television programs.  We see the man (almost always a man) grasping his left arm or chest in sudden pain, then collapsing to the ground and usually dying.  That was not my experience.  I learned a lot, however, from the reality of my personal experience – lessons that can help others personally and also be applied in organisational settings.

5 Lessons from Personal Heart Attack Experiences:

1. Received wisdom is not always wise:

   
   The most important lesson I learned is that, along with many others, I didn’t experience “Hollywood” symptoms.  There was no crushing pain in the chest and no preliminary pain in the left arm.  I didn’t collapse to the ground - that happens when you have complete cardiac arrest and the heart stops.  But actually, a heart attack begins once the heart starts to be starved of blood and this can be a gradual process.  How this feels is very different for different people.  I went through a rehabilitation course with 30 men and almost none had experienced the received wisdom of left arm/chest pain.  I started with a periodic odd feeling in my throat making me want to swallow, which felt a little like I feel when starting to come down with ‘flu.  Over the next 4 or 5 days, that feeling became more frequent and more difficult to handle as I became a little breathless and had to sit down.  I learned that other people began with an odd feeling in their shoulders or their jaw, or their back. 
   
   The point is that I didn’t act until it was almost too late because the “story” in my head wasn’t telling me this was the early stages of a heart attack.  And this turns out to be true for most people – particularly women, apparently, whose symptoms can be very subtle.  The lesson is, a heart attack is usually not like in the movies!  If you feel anything “odd” in your body – something not quite right – please get it checked out quickly by a medical professional.  I’m sure many Dodo Newsletter readers will be of a certain age, and this could save your life.  Everybody’s cardiac arteries become less elastic as you get older and this makes them more susceptible to blockages. 
   
   I ended up in surgery and intensive care for a period because I waited too long to act.  In contrast, three years later, I was out jogging and began to have a funny feeling in my throat.  This time, I suspected that this was my body’s way of telling me something serious.  I went straight to the doctor, who sent me immediately to the hospital, where they inserted an additional stent into my heart the next day.  Two days later, I was already enjoying a long-planned holiday abroad with the family!
   
   The broader lesson is that received wisdom isn’t always wise and that sometimes we need to question ourselves and assess whether the reality of what is going on is what we have come to take for granted.  I’ve explored this for energy transitions, for example, in Newsletter Edition 18 and a short Article.
   

2. Confirmation bias can be deadly:

   
   Why didn’t I think I may be having a heart problem?  Well, the initial feeling was a little like something I sometimes feel when I’m coming down with the flu.  I’d just returned from a trip to London, so I did a Google search and found there was a bit of a flu epidemic going on there, so I took that as confirming my conclusion. Instead of doing more than superficial scanning, that was enough for me – I was only seeing things that confirmed what I already thought.  I then became pig-headed in my opinion of what was going on and didn’t respond to the concerns my wife and mother were beginning to express. 
   
   The broader lessons are to be aware of the prevalence of confirmation bias, try to analyse beyond the superficial, and encourage others to speak out and criticise what you are thinking – and really listen to them!
   

3. Minimise your maximum regret:

   
   I wouldn’t go to the doctor for several days because I didn’t want to put them to any trouble, particularly over the weekend, and I didn’t want to embarrass myself by appearing weak when I believed there wasn’t a serious problem.  Misplaced consideration for others, vanity and stupidity!  I was increasingly aware of the minimise maximum regret (MMR) perspective in evaluating business investments, but completely ignored it here in my personal life.  My regret would be small if I had gone to the doctor and, indeed, there was nothing unusual wrong with me.  I would have used up a little of his or her precious time, and I would feel a little embarrassed.  By not going early, I actually risked my life and my family’s future well-being.  A huge potential regret!
   
   Considering different scenarios and assessing decisions in the light of the different regrets incurred across them (costs, risks, and missed opportunities) is at the heart of wise decision-making.  This is also a theme in this brief Article on Smart Business.
   

4. Recognising the significance of early signals:

   
   The contrast between my two experiences is pretty stark. With the first, I spent a considerable period in discomfort in hospital intensive care, with a long recovery period.  For the second, it was less than a week before I was firing on all cylinders again.  I recognised the early signals, had a good storyline in my mind that helped me make the right sense of them, and I acted early and appropriately with professional support and interventions.  I had learned my lessons!
   
   We need to be both aware of early/weak signals and also have a good framework for making sense of them.  In an organisational setting, scenario thinking can be of significant value in helping with both of these.  See also Newsletter Edition 2.
   

5. The value of well-constituted human systems:

   
   We are immersed in multiple human systems and social institutions that are operating around us.  We are often unaware of this, or take it for granted.  This can lead us to neglect the importance of their quality and to invest sufficiently in maintaining and enhancing them.  I am so grateful for the quality of health service treatment I received in both France and the Netherlands.
   
   In rural France, when I eventually agreed that a neighbour could call for some help, within 15 minutes, there were two teams of paramedics (pompiers) at our home with a doctor, and I was quickly taken in their ambulance to the hospital for assessment and preparation for surgery the next morning.  In The Hague, I went to the doctor, who summoned a taxi to take me to the hospital, where I was also assessed and prepared for surgery the next morning.  All the parts of the jigsaw fitted together.
   
   The broader lesson?  Invest in, and appreciate, good systems and institutions.

In summary, I am alive and well and have learned somewhat from my experiences.  My wife will tell you that I wasn’t always quick to learn – I was pretty stupid in rushing back to work following the first heart attack, which happened while I was away for a long vacation, so I could pretend nothing had happened!  Perhaps inattention to proper rehabilitation contributed to the second heart attack. 

What is important to me now, however, is that you learn from my experiences and that you avoid a serious heart attack or act very early on any sense that something may be wrong.  I also learned from doctors that they would much rather spend 15 minutes letting you know there is nothing seriously wrong with you than spending hours and hours later dealing with the consequences of delay.  

Question of The Fortnight

Every fortnight, I’ll be asking a thought-provoking question in hopes of sparking interesting and enlightening discussion.

I’d love to hear your response! You can do so by simply responding to this email.

Today’s question is:

Has this issue of the Newsletter highlighted anything significant for your personal or organisational life?

The Dodo Club Online Course

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This covers scenario/systems thinking for grappling with uncertainty, an introduction to energy transitions, and the development of strategic character in leadership.

In the interest of avoiding the fate of that unfortunate bird, the Dodo, this course aims to help us secure our own personal legacies within a changing world and the energy transition - and to leave a healthier planet for future generations.

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A series of follow-up courses that treat the main topics in increasing depth and detail will be provided if there is sufficient interest.