WHOOP VP of Performance Kristen Holmes sits down with Arena Labs Founder and CEO Brian Ferguson for this discussion. Arena Labs is a cutting-edge organization that is pioneering the field of high-performance medicine. It was born out of Brian’s experience in the military. He served in the Navy, special operations, and the Pentagon and is now using that experience to improve modern-day healthcare.
Brian and Kristen discuss why military personnel and healthcare workers are cut some the same cloth, the effect COVID-19 has had on doctors, nurses, and frontline staff, and the burnout so many doctors and nurses experience and why that sets a dangerous precedent in the field.
Thank you to all those who have served our country! Stay healthy and stay in the green.
3:05 – Transitioning from Special Operations to Medicine. “I saw how a large government organization like the Pentagon or the White House was thinking about decisions of magnitude at scale in a world full of information. … I often say that when you look at people, the archetype of individuals who go into the military, particularly the special operations community, they’re individuals who want to do hard things. They want to save lives and impact the world. As it turns out, that’s really the same archetype you see in most of medicine.”
6:41 – Complexity of Healthcare. “I believed that [the Pentagon] was the most complex institution in the world, the U.S National Security architecture, meaning defense and intelligence and diplomacy. I have since evolved on that thinking and I really have come to believe that modern healthcare is the most complex ecosystem there is, at least in the United States.”
7:12 – Teamwork in Medicine. “I believe that the future of world-class care is not in the regulatory environment, it’s not in policy or technology, it’s in building high-performing teams. … There is a massive focus, for good reason, on technical skill and on the technical side of medicine, whether that’s in surgery or in diagnosis. But at the end of the day it’s a team endeavor and it’s an endeavor where people come together in high-pressure circumstances to take care of people. One of my humble critiques is that medicine doesn’t focus on developing that team.”
11:06 – Burnout in Healthcare. “One of the many crises that’s happening right now in healthcare, and frankly that has been massively elevated by the COVID pandemic, is that of burnout. … The concern that brings to healthcare is, number one, turnover. People who frankly just no longer want to do this work and want to go do something else. And the second equally important thing, if not more, is patient safety.”
14:20 – Measuring Burnout. “One of the things I realized is that until someone has data, their own data that they can look at and see where they’re deficient, the fact that they haven’t slept or they’re chronically under-rested, it’s really hard to convince them [that changes need to be made].”
17:39 – Studying Stress During the Pandemic. “If we just look at the way the world is evolving, no matter where we work, whether we’re in business or in medicine or the military, the world feels more dynamic and more stressful. If we can start to understand what stress looks like, particularly in a time of crisis, in this case a pandemic, it can give us far better insights, particularly hospitals, in how to resource and how to train people and how to give folks a release valve.”
19:40 – Toll on Healthcare Workers. “For people who have a true sense of service in the world and want to help, there’s a psychosomatic toll that takes on your body from feeling that stress. … The data right now would suggest that it’s increasingly hard for [healthcare workers to lead a long, healthy life].”
21:34 – Sacred World of Medicine. Brian mentions the 1987 National Geographic Photograph of the Year, depicting an exhausted doctor and nurse after the first heart transplant in Poland. “I ask folks to look at the eyes of the surgeon. When you look in his eyes, you can see him almost willing that patient to stay alive.”
23:26 – Answering the Call. “At the end of the day, what people in medicine are motivated by is an ethos that transcends their own being. They come to work because they believe in something bigger than themselves. That is incredibly powerful. But as leaders, if you don’t protect against that and offer those people resources to project against their own inclination to overwork and to go too hard because they believe so much, we see what happens.”
27:39 – Information Overload. “At what point is too much information not effective, or when does it become too much? How do we think about what really matters? As medicine continues to evolve, there’s no shortage of machines and technologies and platforms that can be put into an operating room or given to a team. So this is where, at the higher level, where we step back and say, ‘Okay, what are the first principles of high performance in the operating room? How do we make this team their best and think about the technology that can amplify the team in the right ways?’”
28:29 – Favorite Quote. Brian shares the self-written obituary of John Alexander Hottell, who was killed while serving in Vietnam, saying it “captures the spirit of service” in both the military and in healthcare.
“We all have but one death to spend, and insofar as it can have any meaning it finds it in the service of comrades-in-arms.
And yet, I deny that I died FOR anything – not my Country, not my Army, not my fellow man, none of these things. I LIVED for these things, and the manner in which I chose to do it involved the very real chance that I would die in the execution of my duties.
I knew this, and accepted it, but my love for West Point and the Army was great enough – and the promise that I would someday be able to serve all the ideals that meant anything to me through it was great enough – for me to accept this possibility as a part of a price which must be paid for all things of great value. If there is nothing worth dying for – in this sense – there is nothing worth living for.
I lived a full life in the Army, and it has exacted the price. It is only just.”