Team of Teams or Team of Rivals.

I t is a pleasure and a great honor to be here, and thank you very much to the Eastern Association for the Surgery of Trauma (EAST) for this opportunity to share some thoughts with you today. In a little bit, you are going to hear two fantastic essays from two future leaders in trauma and very likely of this organization. I hope that the things that we talk about here today will put their essays and their thoughts into a bit of context. I have decided to talk about a couple of modern-day stories, one more modern than the other, to see how they potentially apply to what we do in our day-to-day lives. We are going to talk a little bit about leadership, philosophy, some definitions, some practical points, and then do a little bit of a comparison of leadership challenges and maybe impart some of the secrets to the recipe for success in leadership. Jago said ‘‘good leaders are made and not born’’ and if you have the desire and the willpower, you can become an effective leader. Good leaders develop through a never-ending process of self-study. ‘‘The real leader has no need to lead,’’ wrote HenryMiller. ‘‘They are content merely to point the way.’’ Jerry McClain says, ‘‘The best example of leadership is leadership by example.’’ For writer Lewis Lapham, ‘‘Leadership consists not in degrees of technique, but in traits of character and it requires moral rather than athletic or intellectual effort and it imposes on both leader and follower alike the burdens of self-restraint.’’ The quality of leadership, more than any other single factor, determines the success or failure of an organization. ‘‘When the effective leader is finished with the work,’’ wrote Lao-tse, ‘‘the people will say it happened naturally.’’ I start with the premise that the function of leadership is to produce more leaders and not followers. Abraham Lincoln himself said, ‘‘Nearly all men can stand adversity, but if you want to test a man’s character, give him power.’’ Ross Perot said that to lead and inspire people, ‘‘don’t try to manage and manipulate people. Inventories can be managed and people must be led.’’ Andrew Carnegie presaged this sentiment more than a century ago with his observation that ‘‘No man will make a great leader who wants to do it all himself or to get all the credit for doing it.’’ Thomas Jefferson has been attributed as saying, ‘‘In the matters of style, swim with the current. In matters of principle, stand like a rock.’’ Admiral Arleigh Burke said, ‘‘Leadership is understanding people and involving them to help you do a job. That takes all the good characteristics like integrity, dedication of purpose, selflessness, knowledge, skill, implacability, as well as determination not to accept failure.’’ From the Mayo Clinic, we learn that as ‘‘Iwe leaders deal with tomorrow, our task is not to try to make perfect plans. Our task is to create organizations that are sufficiently flexible and versatile that they can take our imperfect plans and make them work in execution. That is the essential character of a learning organization.’’ As surgeons, we have a tendency to have natural leadership ability. Surgeons have been touted as guiding, supporting, communicating, and coordinating. We lead in the operating room, during trauma resuscitations, and during rounds. We are typically the head of a multidisciplinary team, and we are leaders in the education of students, residents, and fellows as well as our multidisciplinary teammembers.We are involved in research to improve treatments and outcomes.We are good at task management, but we are surgeons, and the leadership skills used in the aforementioned aspects of what we do on a daily basis do not necessarily translate into the skills necessary to run an organization, especially in shaping the future of health care delivery. Surgeons hold key leadership roles in