Effective leadership skills: put to the test in emergencies

I do not travel much, but recently was excited to represent my department at a special once-in-a-lifetime meeting in Asia. First, I flew to Chicago. A few hundred of us then piled into a 747 at 11 a.m., and the jet taxied out onto the runway. About to take off, we suddenly veered off to the side of the runway, the engines went dead, and fire trucks were visible heading our way.

The captain's voice (deep, slight drawl, slow almost bored cadence) came over the intercom: "Ladies and gentlemen, this is probably a minor little thing, but we have some fuel leaking from the right wing fuel tank. This kind of thing happens sometimes on hot days. So we have done a li'l emergency engine shutdown and have some folks coming out to look."

A peek out the window showed fuel flowing from the wing onto the ground. I wondered if that engine shutdown was to prevent the fuel from igniting, turning the 747 into a fireball. The captain's calm, almost lackadaisical tone, made it seem impossible to imagine anything major could be amiss. The plane was quickly towed back to the terminal, and we were told to deplane promptly by some serious-looking firefighters. After an hour or so, the plane was declared "broken." We were told to go to another gate and wait.

It was a hot, humid summer night in Chicago, and the pilot said the plane would get warm while the engines were turned off and the maintenance people investigated the problem. Many passengers dozed. Some time after midnight, increasing numbers of tired, sweaty, and disappointed travelers began to stand up and scream, yelling that they were angry and "too hot to breathe." Flight attendants gathered near the front of the plane, talking to each other. They looked frightened, and it seemed that matters might get out of hand. The pilot, who had been outside checking with the maintenance workers, entered the plane and was rushed by the attendants, who described what was happening. The captain listened, calmly glanced about the cabin, then quickly gave instructions.

The attendants now seemed confident and disbursed to perform their assigned tasks. The pilot spoke on the intercom, calmly telling us he knew we were warm, that he had ordered auxiliary air conditioners to be hooked up to the plane, and that he would do everything he could to address the problem as rapidly as possible. One flight attendant promptly appeared with two Chicago police officers who strolled the aisles. Immediately, the situation became calm.

They never fixed the engine; at 4 a.m. they gave up and we deplaned. To my regret, I missed the special meeting. But I did get to see some effective leadership. In the first situation, the pilot acted quickly (pulling over, killing the jet engines), while communicating the situation in a way that reassured all the passengers. The calm voice, dispassionately describing the fuel leak, probably prevented people from panicking as fire trucks raced toward us.

The second pilot dealt with a tense situation by calmly taking control, immediately acknowledging and addressing the problem, guiding a confused and frightened staff, and ordering onto the jumbo jet some smiling and empathic (but visibly armed) police officers whose presence made it clear that unacceptable behavior would not be tolerated.

Physicians sometimes need similar skills. When your staff is anxious and looking for clear-headed decision-making, do you supply it? Do you hide your own stress and maintain equanimity when things don't go smoothly in the OR or office? If things aren't going well, can you take control, listen respectfully, be decisive, reassure and guide your staff, coolly acknowledge and address problems, and set the limits for acceptable behavior?

When it's hitting the fan, do the people you lead get reassurance/strength from your calm outward demeanor and level-headedness? If so, your employees and patients are fortunate to have you.