Report date
May 2018
Learning Log

Life appeared very confusing the very moment I became a Bush Fellow. There were more barriers to change the world than I expected. And possibly, just being a Bush Fellow was the main barrier. Why? Because I made a commitment to do something that it might as well, be impossible: make medicine more efficient, starting at Sanford Health, the place where I work. It is even published on the newspapers. Such a big mouth of mine! At least that was my own agenda. But it was not my workplace's, let alone the world's agenda. So I set myself out to get involved into the most challenging project Sanford could offer to help patients get better faster. Nonetheless, I could not find anything meaningful or impactful enough for 2 years. Sanford was too distracted building a 500-million hospital in Fargo, ND to pay attention to Yuri Nakasato. Meanwhile, I got a Master of Consulting and Coaching for Change, a Certificate for Gestalt Coaching, and half-way Master of Health Care Management at Harvard (I still have another year on my own). This training would give me enough structure and foundation with pillars, I thought, and decent exposure to figure out my next strategy to change the world. Yet, there was something missing: I was not doing what I said I was going to do.
Every single time I see a Bush Fellow I perceive a strong and contagious trait of resilience and ambition. A man/woman in search of meaning looking beyond what the eyes can see. There is this subjective norm that is fundamental about a Bush Fellow: somebody (that is to say, the Bush Foundation) not only believes but invest heavily in you. Wow, how beautiful could that be. So I set my standards high, feeling the emotional support of a motherly Foundation. Currently, day by day, I go out to meet people outside my comfort zone. When I am told "no," I hear "perhaps," or maybe "later," or "if you bring me more evidence before I tell you my final answer..." Although I have become more comfortable with rejection over the course of my fellowship, unavoidably, I am still get affected by the push back. I suspect many potential leaders are hidden like turtles inside their carapaces afraid of sticking their heads out and being rejected, for that matter. After all, rejection is as powerful as shame. Paradoxically, the more I try, the less the setback seems to dent my soul because I am so busy working on the next rejection. As a result, I am not only become better at asking or putting a case together but I am efficient at many, I mean, many cases simultaneously. In addition, I am able to anticipate better the timing and what and how to deliver the right message with enough energy to even persuade an elephant to move. After all, persuasion follows a mathematical ratio of no-to-yes answers. For every ten noes one yes get through.
Rather than becoming a dejected loser and enter the pathway of judgement and self-deprecation, I have developed a learning process pathway to learn from mistakes and failures. And then practice and practice on what works, because only good practice makes me better. Sometimes, the only way to know whether a door is locked is by trying it. I see life as an empty alley full of closed doors on both sides, where I must try every single one, always afraid of missing the real opportunity right before my eyes. I am afraid of missing the train. Thus, life is defined by the doors that are opened, and blurred by the doors that are closed. Thus, the faster I know about the right doors the quicker I can set my life trajectory. It is like Cybernetics, whereby a heat-seeking missile uses trial-and-error sensors, correcting its course second by second, to finally hit the target intended. And sometimes resilient and perseverant people are courageous enough to look silly and funny trying to accomplish apparently unrealistic things. They strongly believe in their ideas with an exuding passion that you cannot help it but say yes in rendition with both arms up in the air. I read somewhere that people must hear the same thing 7 times before they even listen and pay attention to it. In cognitive theory, intention is the most important predictor to change a behavior. Likewise I seem to be one of those silly people who keeps talking about Efficient Medicine even in my dreams. Surely, I don't want to go down in history as the Bush Fellow who didn't accomplish anything. It has to be a miracle then. Today, as I am finishing my Fellowship journey, I got accepted into a Sanford team, to help a big project at the new hospital. This launching pad project involves helping patients from the whole region of North Dakota, getting better faster by decreasing their unnecessary stay in the hospital. It is big enough, it is ambitious enough, it is impossible enough. Yet I have the gut feeling that I can finally make a difference in the Peace Garden State. This door was closed for a long time, until I did something that only a Bush Fellow could do: I got my foot in the door first and then I pried it open with my bare hands. Bleeding still, I can say at least to the Bush Foundation: Mission accomplished. Long Live the Bush Fellows! The rest is now up to me.