DON’T GREAT LEADERS CREATE MORE LEADERS? It’s not lost on me, that the mark of all great leaders is less about their individual success— and more about their significance—the imprint they leave on others—and ultimately haven’t the “greatest leaders in history created more leaders?” On September 13, 2023, a number of McMaster University leaders in the Faculty of Health Sciences, hosted by our Dean, Professor Paul O'Byrne gathered to celebrate the career and impact of William Orovan—a Surgeon, a Chair, a Dean and most recently a Vice President. For me, it was particularly special—because I was one of many recipients of his mentorship over the years—and indeed has opened many doors for hundreds —if not thousands of trainees, faculty, and administrators alike: Anthony Adili, Vice Chair in Surgery wrote “Dr. Orovan’s visionary leadership, mentorship, and strategic recruitment of faculty have been critically instrumental in creating the foundation upon which the department of surgery has become internationally renowned.” “His wise counsel and support helped shape my surgical career” says Dr. Stephen Kelly, Surgeon in Chief, HHS. Devin Peterson, Surgeon-in-Chief, Children’s Hospital notes “Dr. Orovan has been an inspirational leader to many of us privileged to have worked under his Bobby Shayegan, Surgeon-in-Chief, SJH says “If I were to best describe Dr. Orovan, it would be Commander in Chief. We have all had the privilege of Dr. Orovan’s sound advice in times of need--his calm but resolute voice in times of chaos--and his leadership and foresight when most needed” What could our Department of Surgery possibly give someone who has it all? How about something that is “free” but “priceless”; something so valuable that once you’ve lost it, you can never get it back. Indeed, the answer was time-- Time I had spent over the prior few weeks working on a painting for him. [Winston Churchill, sketch and watercolour]. [Photo Credits: Mike Lalich• edited from original versions to black and white]. @mcmasteru @mcmastersurgery @mcmasteralumni1887

STRUCTURED SERENDIPITY • “1 hour of face to face is worth about 6.6 hours of Zoom” researchers say. Collaboration, Innovation, Acculturation and Dedication are hard to build on zoom.[Hooijberg and Watkins]. What is structured serendipity? The effect of stumbling onto something truly wonderful while looking for something entirely unrelated. Bob Ross, artist and educator, used to encourage “happy mistakes” as a way of discovering something entirely special from what seemed, at first, to be a mistake. But you can’t fully experience this on zoom! SURVIVING CAMP CHRISTIE LAKE• Our team of programmers, data scientists, and writers at OrthoEvidence came together at Christie Conservational Lake for a micro-adventure (2.5 hour experience) –“Friday the 13th, Conquer Camp Christie Lake”. The experience designed by two of our team members, Ellen Scholl and Robin Ozolins, included –by design, challenging intellectual activities, moderated throughout by clues from Snoop Dogg [A.I. powered]. High performance teams are unified in culture, celebrate their diverse talents, and believe they are more innovative and creative together —than alone. Evidence suggests that “a well-designed immersive experience consists of a balance of formal and informal elements that create fertile ground for such a moment. This structuring can include elements such as the selection of a diverse set of participants, the pedagogical variety of the program, the opportunities to connect with different colleagues, the choice of locations that foster formal and informal connections, and the spaces that are conducive to reflection and sharing.” [Harvard Business Review, 2021].

OPENING DOORS• I’ve been recipient of so many acts of kindness —many deliberate and probably even more that have been random • These stories seem to come when I’ve slowed down enough to think about where I’ve been —and where I’m going to go. In these quiet moments —I’m overwhelmed with gratitude to all those who have opened these doors and given me so many opportunities—and making sure that I take seriously whatever privilege these open doors have afforded to do the same for others.

HIGH IMPACT RESEARCH • Dubai • The next generation of innovators will “be able to think critically and creatively, while embracing collaboration and diversity” • In lieu of virtual meetings, we’ve embraced face to face engagement with our surgeon peers all over the world • We are all united in wanting to work together —share experiences and most of all, ensure our best ideas are disseminated widely• Because as Paul Romer puts it —“ Great advances have always come from Great ideas”. ABOUT THE COURSE • We have modeled a highly interactive course with small group sessions to engage all surgeons in research —building collaborations one person at a time• Our first Dubai program was made possible by the leadership of colleagues in the region- Sameh Abolfotouh, Waleed Awwad—and those from abroad, Jeffrey Wang, and Jason Busse. With great thanks to Drs Khattab and El-Sharkawi—and Tim Pohlemann.

THE FALDO• 18 hole championship course, Dubai • Emirates Golf Club• As the only fully floodlit 18-hole course in Dubai, it lit up the night sky enabling a pretty amazing round in the heart of the city Amid 75% humidity and night temps of 90 degrees —the silence of playing the back 9 with nobody in front ( or behind me) to near midnight was something I’ll remember for a lifetime• Big thanks to the course management team for facilitating a private night golf experience. I played some of my best golf—sadly nobody was there to see it! A happy trade off.

MAYBE LESS IS MORE• Everybody should be able to aspire to anything —-but everybody shouldn’t aspire to do everything• The cornerstone of my guest lecture today at the Hockey Hall of Fame TSN Room • Speaking to a group entrepreneurs managing surgery devices, I shared a personal story of mistakes and milestones along the way —with an epiphany that doing more doesn’t get you more —it actually gets you less. Jack Welch, for instance, who was dubbed Manager of the Century in 1999 by Fortune—decidedly focused GE’s corporate structure on those business units that were either top 1 or 2 in their markets• Everything else —was either fixed or sold. The massive reorganization and focus on strengths led GE from 50 billion to 500 billion market cap—during his tenure. [caveat-the short term focus was crucial to the company’s success during a slow economic period ] Decluttering your “busy-ness” is not a weakness —it’s a strength• How we choose to use this extra time is the differentiator.

HIGH IMPACT • High impact teams are masterful storytellers, diverse in their skillsets and views, idea-factories, and above all, individually aligned such that their personal skills and passions strengthen the team • “Everybody should be able to aspire to anything —but not everybody should aspire to everything”• Each of us working where our strengths meet our purpose makes our team stronger. The keynote message for research delivered to the members of the American Foot and Ankle Society• Reconnecting face to face with many friends. A moment of quiet before the beginning of the session —thinking about what I might say —and what I might just leave for another day. @aofas1

RESPECT YOUR IDEAS • “You never know where a breakthrough might occur. You may not see results as quickly as you wish, but always remember to respect your ideas when you research” [Makoto Kobayashi, Nobel Prize 2008] PATIENCE • Dr. Kobayashi theorized the presence of particles (quarks) in 1972 and ultimately waited 27 years (or so) until a high energy accelerator was built to test their theory. FRIENDSHIP• He did this nobel prize-winning research during post doctoral studies in Kyoto University. Together, with his colleague Toshihide Maskawa, he conducted research and published the seminal paper. MENTORSHIP• At his 2008 Nobel Prize award ceremony he said, “Both Maskawa and I graduated from and earned our PhDs at Nagoya University. At that time, the theoretical particle physics group of Nagoya University was conducting unique research under the mentorship of Professor Shoichi Sakata. Both of us learned a great many things from Prof. Sakata” REFLECTION• How often do we dismiss our ideas as “being wrong” in our youth ? The story of Kobayashi demonstrate the power of 1. trusting our ideas-especially in our youth, 2. having a meaningful collaborative partnership, and 3. the lifelong guidance of a mentor(s)—especially one who encouraged them to pursue their ideas. BACKGROUND• Makoto Kobayashi—a particle physicist —was awarded the 2008 Nobel Prize in Physics. After completing his doctoral research at Nagoya University in 1972, Kobayashi worked as a research associate on particle physics at Kyoto University. Together, with his colleague Toshihide Maskawa, he worked on explaining CP-violation within the Standard Model of particle physics. Some 27 years later, his theories were proven by the “Belle Experiment” conducted by the Belle Collaboration-an international collaboration of more than 400 physicists and engineers, at the High Energy Accelerator Research Organisation (KEK) in Tsukuba, Ibaraki Prefecture, Japan. The experiment ran from 1999 to 2010. [Sketch and watercolour of Kobayashi] #kobayashi #nobelprize #sketch #watercolor #ideas

CHOOSING WISELY• If you have work to be done —who do you pick for the job? —the one who is already doing many things —or the one who seems to have lots of available time. Insights from a recent read by author Paulo Coehlo. I’ve tended to put higher value in the work one has already done than the one who continually talks about the work that will happen in the future. To quote a friend who always says “ show me, don’t tell me” from which I’ve edited to my own “saying isn’t doing —doing is doing” “The busiest people I have known in my life always have time enough to do everything…” [Paulo Coehlo, The Pilgrimage] “My grandfather once told me that there were two kinds of people; those who do the work and those who take the credit. He told me to try to be in the first group; there was much less competition” [Indira Gandhi]

IT’S WORTH THE WAIT! I’ve been privileged during my career to work with many talented surgical scientist trainees—who take time away amid their surgical training in pursuit of higher research degrees [MSc, PhD]• It’s the road less taken —accounting for less than 1.5% in some surgical specialties. But the evidence suggests surgeons with graduate degrees have more publications per year, higher citation scores, and more citations per article. Of particular interest--there is evidence supporting higher h-indices among with surgeons with graduate degrees compared to those without. HYPERBOLIC DISCOUNTING-The idea of choosing an immediate reward vs one that may be even greater in the future [that is, if we have the patience to wait] has been a great source of reflection —and an interesting psychological bias —called “Hyperbolic discounting”. I recall in 1995 contemplating the trade-off myself—I was about to leave orthopaedic residency to pursue a Master’s degree in Design, Measurement and Evaluation at McMaster University. I was warned by many-- “ You are needlessly delaying your career --and losing earning potential”. I was delaying the gratification of completing residency training and getting a job sooner for the potential [although not certain] of even greater career satisfaction in the future. The pull towards abandoning the longer, less travelled, PhD degree for the immediacy of job opportunities and earnings is a strong one—one that has led to a veritable decline in surgeon scientists. THE STANFORD MARSHMELLOW EXPERIMENT—Children were offered a choice between one small but immediate reward, or two small rewards if they waited for a period of time. The children who were willing to delay gratification and waited to receive the second marshmallow ended up [over 40 yrs of follow up] having higher SAT scores, lower levels of substance abuse, lower likelihood of obesity, better responses to stress, better social skills as reported by their parents, and generally better scores in a range of other life measures. WOULD I DO IT ALL AGAIN? Short answer: Yes. it was worth the wait.

INSIDE THE BOX • I spent the better part of my early career believing the path to success came from “outside the box” thinking• Yet, with time and experience (and many failures), I’ve come to embrace an “inside the box” approach to advancement • In fact, I developed a lecture series some 10 years ago entitled “Thinking Inside the Box”• Building incrementally on existing ideas has led to some of my proudest moments in research (and education) • Turns out , I’d rather be in the box ( than outside it). CONTEXT • “Thinking outside the box is a myth. It is based on flawed research from the 1970s. Research shows that simply telling people to think outside the box does not improve their creative output. It sends people on cognitive wild goose chases. [Box 3 Rogers Center] #Insidethebox

OPPENHEIMER • “Access to the Vedas is the greatest privilege this century may claim over all previous centuries.” Oppenheimer had a long and documented fascination with the Bhagavad Gita. He learned Sanskrit in the early 1930s while working at Berkeley, after befriending a professor of the language• “ Now I am become Death, the destroyer of worlds.” [from the Hindu Scriptures] is Oppenheimer’s most cited —and most debated quote—with scientific discovery comes great responsibility—morally and ethically. sketch and watercolour