Pulling your donkey

I passed her by rather quickly but the glimpse was enough to convey the entire situation.  Her cart was loaded with things she needed to take to town, but the donkey had led her down into a gulley off the side of the road.  The stupid beast stood contentedly, eating grass, and hardly noticing the pulling at his bridle.  At possibly 10 years old and very slender of frame, she stood two yards ahead of him, pulling with all her might on his lead in the hopes of bringing him and the cart back onto the road.  Pull as she might, she was, frankly, no match for the donkey.

I was on my way home from the hospital this morning, and as I saw her, the scene gave perfect expression to my weary feelings.  I had just spent the morning doing wound care for several patients, and though I had worked hard, and I was losing my entire Sunday morning, that wasn’t really the source of my fatigue.  Rather, I sensed that I had spent a good portion of my weekend trying to make broken systems work. 

I have, much like that little girl, been pulling against something for which I am no match.  The very thing that should be pulling the load with a little guidance from me seems to have left the path, and try as I might, I’m not succeeding in getting it back on track.  And these efforts are exhausting.

Now, please don’t misunderstand, our hospital is doing amazing things.  In just the past 48 hours we’ve cared for several high risk pregnancies, safely delivering baby and keeping mom alive and unharmed through emergency surgery.  I could go on, but suffice it to say that despite the fatigue and discouragement, I still believe very much in what we are doing.  And though we have systems that are broken, we manage to do many things right.  (I say this as much to remind myself as to inform you.) 

The reality is that a hospital is a very complicated system and there are bound to be breakdowns.  I just wish we didn’t have so many.  Because my role at the hospital gives me broad exposure to the entirety of our system and because I’m charged with training the staff, I know that I’m especially sensitive to the things that go wrong.  All day long, I’m jotting things down on my post-it notes—which look very much like the pages out of a mad-man’s journal—trying to address the areas where the system is weak, breaking, or simply non-functioning.  And it feels very much like I’m pulling my donkey and the cart, instead of guiding him as he pulls the load.

It seems to me, when you’ve exhausted yourself pulling on your donkey, you have three options.  The first is to unhook the donkey, abandon him, and continue on with just the cart.  Second, you find the biggest stick possible and beat that donkey with all the strength you have left (this is always such a tempting option).  In third place, usually the last to arrive to our thoughts, you work to find better and smarter ways to lead the donkey.

On more occasions than I’d like to admit, I try to abandon the donkey.  Unfortunately, dad has given us a responsibility, and part of that is getting the donkey and the cart safely back home.  Doing the job and losing the donkey isn’t considered a success in dad’s eyes.  It would seem that our Father has commissioned us to this job, and part of the responsibility is bringing the donkey along with us.  So, on those many occasions that I want to work alone, instead of training and teaching others, because it feels so much more efficient, I must try to remind myself that I’m missing a hugely important part of my job.  When I want to plunge ahead without communicating with my team and understanding their perspectives; when I want to ignore important considerations in my host culture; and when I play blame games, I am effectively leaving my donkey behind.  Furthermore, I usually end up more tired from having carried the load alone.

The immediate gratification from beating your donkey is—quite unfortunately—short-lived.  In addition, you seem, to everyone but yourself, to be quite the unreasonable, irritable as…errr, I mean, donkey.  It also does you no favors in your relationship with the donkey.  Lastly, and possibly the greatest risk, if you beat the donkey enough, he will become so conditioned to those hits that he will refuse to move unless beat.  You will have created a system that only starts and continues in response to your vicious thudding.  The gratification will disappear entirely, and you will grow tired from delivering repeated blows.  So when frustration rises, I must avoid resorting to harsh words and aggression.  Though everything in me feels that the donkey is the problem, I must remember that the real problems lie elsewhere.  

This leaves the third option, better donkey leadership, which frankly, has its own set of problems.  Most notably, this method takes time—hours, days, weeks, months, and years—to truly develop and implement.  Trying to negotiate your donkey and cart out of a gully in a crunch without resorting to other methods takes enormous presence of mind and patience, not to mention creativity.  But if successful pastors, professionals in business, and leadership specialists are to believed, then this is exactly what we must do—if for no other reason than that we too, participate in someone else’s donkey. (Think: Golden Rule)

When I was working in the States, I was appointed as a representative to the regional ICU safety committee.  Our job was to review every error made in the area ICUs and devise ways to prevent them from reoccurring.  One thing that has always stuck with me from this job is that you must focus on systems and not on individuals.  Most people think that medical malpractice results from deliberate neglect or just sheer incompetence on the part of an individual.  However, that is rarely the case.  Sure, an individual commits the act that is considered an error, but in the vast majority of cases, this is an error that would have been made by many other competent people in the same position.  Expecting fallible human beings to perform perfectly 100% of the time in high stress situations is foolish.  So a system of safety nets and checks are put in place to prevent the possibilities of errors in the first place.  Thus, most of the time, when we see problems and errors, they represent a system that isn’t well designed or honed, not an incompetent individual.  (This is often hard to remember in the moment.)

Coming back to Mali this year, I was committed to spending more of my efforts learning to lead our donkey better.  I vowed to see individuals in light of the systems that surround them—education, culture, practical training, models available to them, systems of safety nets and checks, general systems of hospital functioning.  I want to make creative and wise changes to our systems in order to prevent us from being derailed.  All of this is, of course, very difficult to really put into practice.   And in the face of daily emergencies, time for reflection is short. 

After a busy week and weekend, I find myself guilty (and tired) of having tried the other methods more than I should have.  Not sure how many times I’ll get it wrong before I even learn to do it right.  So while I’m busy reflecting on how to get my donkey to go forward, I can’t resist that nagging thought:  how God must feel about me, His constantly wandering ass.