The 2019 Joseph W. St. Geme, Jr Leadership Award Address: Ubuntu: The Power of Social Connections - American Academy of Pediatrics
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The 2019 Joseph W. St. Geme, Jr
Leadership Award Address: Ubuntu:
The Power of Social Connections
F. Bruder Stapleton, MD
The following is an address given by the author in receipt of the Joseph W. St. abstract
Geme, Jr Leadership Award, presented by the Federation of Pediatric
Organizations at the Pediatric Academic Societies Meeting in Baltimore,
Maryland, on April 27, 2019.
Receiving the Joseph W. St. Geme Ubuntu is a South African philosophy
Jr Award is the greatest honor of my espoused by Nelson Mandela and
career. Unfortunately, I never knew Bishop Desmond Tutu. There are
Dr St. Geme. In a conversation numerous interpretations of the
with a fellow faculty member who meaning of Ubuntu and the philosophy
knew Dr St. Geme, he spoke of perhaps may not translate exactly into
Dr St. Geme’s passion, optimism, and English. Ubuntu has special meaning to
drive for excellence. Over the years, I many Africans. Department of Pediatrics, School of Medicine, University of
have had the privilege of knowing Washington and Seattle Children’s Research Institute,
and working with his son, Dr Joseph In general, Ubuntu refers to “shared Seattle, Washington
St. Geme, Chair at CHOP [Children’s humanity.” It believes that we are DOI: https://doi.org/10.1542/peds.2019-1887
Hospital of Philadelphia], as well bound together in invisible ways.
Accepted for publication Jul 12, 2019
as meeting other members of the Nelson Mandela describes what Ubuntu
meant to him with the following words: Address correspondence to F. Bruder Stapleton, MD,
St. Geme family at previous Pediatric Department of Pediatrics, Seattle Children’s
Academic Society meetings. Knowing A traveler through a country would stop at Research Institute, 818 Stewart St, Suite 603, Seattle,
them gives a sense of the qualities a village and he didn’t have to ask for food WA 98101. E-mail: bruder.stapleton@
or for water. Once he stops, the people give sseattlechildrens.org
that made Dr St. Geme such a special him food and attend him. That is one
leader. PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online,
aspect of Ubuntu, but it will have various
1098-4275).
aspects. Ubuntu does not mean that people
should not enrich themselves. The question Copyright © 2019 by the American Academy of
therefore is: Are you going to do so in Pediatrics
UBUNTU order to enable the community around you FINANCIAL DISCLOSURE: The author has indicated
to be able to improve?1 he has no financial relationships relevant to this
In reflecting on what I believe is
especially important to a group of article to disclose.
Ubuntu aligns with an African proverb:
academic leaders at a time when the FUNDING: No external funding.
“I am because you are. You are because
world and medicine seem particularly we are.” POTENTIAL CONFLICT OF INTEREST: The author has
stressed and distressed, I harkened to indicated he has no potential conflicts of interest to
an African concept that was explained It is a term for humanity, a shared disclose.
to me by one of our former residents, humanity: in how we connect to each
Dr Vivian Leuche. She explained the other, how we grow together, how we To cite: Stapleton FB. The 2019 Joseph W. St.
concept of Ubuntu to me in one of our accept each other, and how we can lead. Geme, Jr Leadership Award Address: Ubuntu:
The Power of Social Connections. Pediatrics.
discussions during her pediatric Bishop Desmond Tutu described
2019;144(4):e20191887
residency. Ubuntu in his statement, “We achieve
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PEDIATRICS Volume 144, number 4, October 2019:e20191887 SPECIAL ARTICLEourselves in how much we share with We in medicine are not unique. Other often accused of replacing social
others.”2 careers, while less than physicians, interaction showed that spending
are similarly finding burnout 20 minutes a day learning
burdensome. Twenty-eight percent of mindfulness improved the number of
WHY IS UBUNTU IMPORTANT?
nonphysician professionals with social interactions over a short period
Recently, after stepping down as graduate degrees are described as of follow-up. What a contradiction.
Chair of Pediatrics at the University of burned out.5 In one recent survey of
Washington and previously serving physicians, a control group of diverse
after a total of 29 years as Chair there HUMAN CONNECTIONS AND JOY
working Americans found that 28%
and at the State University of Buffalo, of the general public also reported A former Howland award winner, Dr
I have repeatedly described my burnout symptoms.4 Phillip Pizzo, a renowned pediatrician
experience of being a department and former Dean of Stanford School
chair as a great joy. Joy can be Clearly, we live in a stressful world. of Medicine, describes three
described as an attitude of the heart Perhaps you, like me, even become ingredients that are essential for joy
and spirit. It doesn’t mean the distressed each morning when we in life. Purpose, personal health and
absence of problems, stresses or read the newspapers. What we as community or human connections.9
failures….Believe me, as a chair, each physicians and academicians do as Purpose is very important. In studies
of these happened to me. our life’s work is incredibly of physician burnout, the highest
demanding. However, if so many odds for burnout were found in those
In reflection, I have come to realize others in society are dealing with
that my joy from the years as who spent less than 20% of their time
burnout, something in addition to our in work that they found most
department chair came from my repressive regulatory and medical
human connections, connections with meaningful. Meaningful work (which
system processes as well as our I perceive as a surrogate for purpose)
faculty, residents, students, friends excessive time demands must be
and family. From them, I received the included patient care, teaching,
contributing. research, and volunteering.10 Human
gift of shared humanity espoused in
the concept of Ubuntu. What is missing to create so much connections are a powerful
stress, exhaustion, and depression in component of joy. Connectivity can
My joy stands in marked contrast to provide both purpose and better
our world? I believe that the absence
the scourge of “burnout.” But without mental and physical health. Lack of
of the values of Ubuntu and the
doubt, excessive stress, mental social connections has been
paucity of human interactions may be
exhaustion, and depression certainly associated with increased mortality,
an important element contributing to
do exist in our profession as well as in increased depression, cardiovascular
“burnout.”
society. A quick search in PubMed in events, and other health problems.11
late March found a list of 1480 We are called a connected society, but
articles in the medical literature since are we? We are a society connected Bishop Tutu says it is impossible to
January 2018 under the search word through technology, not through be “human” without interacting with
“burnout.” Sadly, 40% to 50% of human social connections. We are other humans.2 Interacting with other
physicians express symptoms of increasingly connected to technology humans gives us purpose, the ability
burnout in recent surveys.3–5 in a world where time for ourselves to grow together, to work and
Especially discouraging are data that and others appears to be shrinking. accomplish as teams, to provide
show 40% of physicians also screen Work and our devices follow us home mentoring and also to have the
positive for depression.3 and on vacation. In our technology- privilege of receiving mentoring, the
connected world, many people are opportunity to develop friendships,
When physicians are queried and ultimately to enjoy
lonely. In a recent survey, over 33% of
concerning what is responsible for healthier lives.
adults say that they are lonely and do
their unhappiness, often the greatest
not have daily personal interactions.7
focus is on system issues such as the
electronic health record, the loss of
Worse, 25% say that they have no UBUNTU LEADERSHIP
one with whom to confide when they
autonomy, requirements for As leaders, we should consider
are in distress. Similarly, half of
productivity, the lack of time with Ubuntu in our leadership philosophy.
physicians say that they do not have
their patients. The cost of individual The values of Ubuntu can be
a trusted advisor.4
burnout or depression or personal a component of transformational
pain isn’t trivial. Four hundred Ironically a recent article reported leadership. We all have opportunities
physicians in the United States a study testing a newly developed for both transactional and
committed suicide last year, more smartphone mindfulness app to transformational leadership.
than one a day.6 reduce loneliness.8 The very tool Transactional leadership is often
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2 STAPLETONmore managerial and asks, “What love: staying in love with leading, together to discuss and advocate for
time and how much?” Physicians with the people with whom you work, pediatric subspecialties and
often feel pressured by requirements with what their organizations especially to address fellowship
for productivity, lack of scholarly produce, and by honoring those who programs. Later, we were joined by Dr
time, requirements for grant funding, honor the organization by using its William Schnaper and Dr Richard
and multiple directives sent by work.” I think that this view is very Behrman. Together we were able to
e-mails without an opportunity to applicable to academic leadership. He create the organization the Council
discuss or understand the genesis of finishes the thought by saying, for Pediatric Subspecialties (COPS),
policy decisions. “Leadership is not an affair of the which continues to be an important
head. Leadership is an affair of the voice for pediatric specialists.14 Work
Transformational leadership creates
heart.” by COPS ultimately has led to the
a vision and inspires.
current postgraduate level 3
Transformational leadership offers an
universal fellowship match, which we
opportunity to share the spirit of EXAMPLES OF UBUNTU FROM FELLOW championed back in 2006 as one of
Ubuntu. It encourages pursuing PEDIATRICIANS
the reasons to create COPS.15
a common mission, it listens and
In receiving this award, I owe much to
respects the team, the leader When I had the privilege of being
colleagues who have demonstrated
demonstrates humility, she shows president of the American Pediatric
the values of Ubuntu and shared their
compassion, he treats colleagues as if Society (APS), I realized the absence
passions with me. One of the first
they were family, they coach and of a focus on diversity and inclusion
faculty colleagues to greatly influence
support others, they articulate the in our strategic plan. In consideration
me in my career was Dr Fred Rivara
culture of Ubuntu or shared of how the APS might address
when we were both assistant
humanity. diversity and inclusion in academic
professors at the University of
pediatrics, Dr Elena Fuentes-Afflick
Transactional leadership and Tennessee in Memphis. Fred, who is
joined me and chaired a task force
transformational leadership can and Vice Chair of Pediatrics at the
and later a standing committee on
should coexist. I would like to offer an University of Washington, among
diversity and inclusion that has led to
example of a leader in Seattle who other national leadership posts, has
a significant and, I believe,
articulates the spirit of Ubuntu and been one of my closest friends,
a wonderful evolution of this meeting
also is a highly transactional and advisors, and a role model for
and the APS and all our societies.16 Dr
goals-oriented leader, Satya Nadella, integrity, excellence, and advocacy. He
Fuentes-Afflick is past-president of
CEO of Microsoft. In his book Hit is one of the most accomplished
the APS.
Refresh,12 Mr Nadella describes his researchers and advocates for safety
efforts to transform the “soul” of and accident prevention in the Mentorship is a value of Ubuntu.
Microsoft and to position Microsoft world today. Several wonderful role models for
for leadership in the future world. In mentorship have enriched my career.
Dr Doug Jones, former Chair of the
his book, he states in various Dr Susan Marshall, Professor of
Department of Pediatrics at the
excerpts, “Culture is everything.” “We Pediatrics and Vice Chair of Medical
University of Colorado and former St.
will grow a company if everyone, Education in Seattle, is a leader in
Geme Awardee, asked me to join him
individually, grows in their roles and student education. She is a tireless
in the late 1990s when we were on
in their lives.” “We are a family of advocate for education and well-being
the American Board of Pediatrics to
individuals united by a single, shared of medical students at the University
colead a reexamination of fellowship
mission.” “It is our ability to work of Washington and in the Council on
requirements. That effort led to the
together that makes our dreams Medical Student Education in
current expectations for a robust
believable and ultimately achievable.” Pediatrics (COMSEP). Another leader
curriculum and academic oversight of
in career development is Dr Nancy
And transform Microsoft, he has. fellowship programs.
Spector, Professor of Pediatrics at
Another perspective on personal During the effort to reexamine Drexel University and head of
leadership based on human fellowship training, Dr Ted Sectish, Executive Leadership in Academic
connectivity is offered in the well- then president of the Association of Medicine (ELAM). Dr Spector is
known leadership book by Kouzes Pediatric Program Directors (APPD) a leader in faculty and leadership
and Posner13 from the distinguished and I, president of the Association of development, particularly promoting
General John Stanford, who was Medical School Pediatric Department opportunities for women faculty. Dr
a Seattle resident prior to his death. Chairs (AMSPDC), realized that there Richard Shugerman, Professor of
To quote General Stanford, “The best- was no mechanism at that time to Pediatrics and Vice Chair of Faculty
kept secret of successful leaders is bring all pediatric subspecialists Development in the Department of
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PEDIATRICS Volume 144, number 4, October 2019 3Pediatrics in Seattle, is a national intolerance, partisanship, economic can lean on your shoulder. Self-care
leader in resident well-being and has disparities, gender and religious is a form of compassion.
supported countless residents as they disagreements, and other conflicts, • We all feel overwhelmed at times.
transitioned into pediatricians. These this is an especially fitting time to Reach out to others for support
three individuals have an abundance embrace the values of Ubuntu and when you need it. Or perhaps in the
of the Ubuntu qualities of compassion expand our human interactions. future, we will look for that app for
and empathy. They each expanded my loneliness.
vision of how important it is to In the epilogue of the 1993 Interim
Constitution of South Africa, it is In receiving this award, I reflect on
support the careers of others.
stated, “There is a need for Ubuntu and its potential for making
Ubuntu also allows for personal understanding but not for vengeance, our lives, workplaces, and
growth as a result of others sharing a need for reparation but not communities more rewarding and
their innovative passions. Individuals retaliation, a need for ubuntu but not joyful. “I am because we are.” My
who have shared their remarkable for victimization.”18 Could there be accomplishments have been gifts
passion for innovation with me a better message for us today? shared with me by many others. As I
include Dr Bonnie Ramsey, Professor receive the honor of receiving the
of Pediatrics and Vice Chair for I hope that we academic and clinical Joseph W. St. Geme Jr Award, I
Research in Seattle, who has changed pediatricians might consider bringing thank them.
the world for children with cystic Nelson Mandela’s Ubuntu values into
fibrosis with her development of our daily lives. I offer the following
inhaled tobramycin (Tobi) and her suggestions: ABBREVIATIONS
leadership in the development of each • As individuals and leaders, we can APS: American Pediatric Society
of the current and emerging CFTR model humility, kindness, COPS: Council for Pediatric
(Cystic Fibrosis Transmembrane compassion, generosity, and Subspecialties
Conductance Regulator gene) forgiveness.
modulators. Another great mentor
• We can expand our repertoire of
was the late Dr Russell Chesney, who
social connections. Introduce
also received the St. Geme Award.
yourself to fellow academic
Russell always asked the most REFERENCES
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PEDIATRICS Volume 144, number 4, October 2019 5The 2019 Joseph W. St. Geme, Jr Leadership Award Address: Ubuntu: The
Power of Social Connections
F. Bruder Stapleton
Pediatrics 2019;144;
DOI: 10.1542/peds.2019-1887 originally published online September 30, 2019;
Updated Information & including high resolution figures, can be found at:
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Downloaded from www.aappublications.org/news by guest on August 31, 2021The 2019 Joseph W. St. Geme, Jr Leadership Award Address: Ubuntu: The
Power of Social Connections
F. Bruder Stapleton
Pediatrics 2019;144;
DOI: 10.1542/peds.2019-1887 originally published online September 30, 2019;
The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/144/4/e20191887
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