The Value of Vulnerability

The Value of Vulnerability: An excerpt from Unleashed

This story, as told by Dr. Julian Kim in our book, Unleashed: Harnessing the Power of Liminal Space, shows the value of vulnerability, and that in order to harness the power of liminal space: ask for help, lean on others and be open to things outside of what you thought your path would be.

Dr. Julian Kim, a surgical oncologist, was at the top of his game. When Rick met him, he was participating in a physician leadership engagement with telos at University Hospitals in Cleveland, a cohort-driven experience with twenty-five of his colleagues. telos runs a number of these leadership engagements, helping highly competent technicians, whether they be in law, finance, technology, healthcare, or other domains, increase their effectiveness as leaders. That’s what Dr. Kim was there to do. He had earned an international reputation for his skill as a physician and had taken on significant leadership responsibilities, helping to build University Hospitals’ new Seidman Cancer Center, the only freestanding cancer hospital in the region, a 375,000-square-foot, state-of-the-art space centralizing all the hospital’s cancer services under one roof. And then he had a stroke.

I was in the middle of surgery when the resident next to me noticed something. “You’re dragging your foot a little,” he said. “Do you think you could be having a stroke?” When I looked down, I noticed that he was right—my foot was tilted at a strange angle, kind of sideways. I was rushed to the neuro-intensive-care unit. I had had undiagnosed high blood pressure, which set off an intracranial bleed.


Afterward, I was in bed for a while. I couldn’t move my left side, and I was entirely dependent on nurses to turn me, to get me up to go to the bathroom. Then, for eight weeks, I was in a wheelchair. I went through inpatient and outpatient therapy to start walking again. When you’re a patient, a lot of people come and wish you well. They spend time by your bedside. But eventually, everyone leaves your room, and you’re left there, staring at the ceiling, wondering what’s going to happen to your life. That was something I had never really experienced before. There had been times personally and professionally when I had dealt with challenges, of course, when I had to pause, take inventory, and make decisions, but this was the first time I’d ever really felt helpless, plagued by fear and doubt.


From a professional standpoint, I had reached the pinnacle of my career. I had far exceeded the expectations I had set for myself professionally. I had built a beautiful freestanding cancer hospital in Cleveland, where I served as chief medical officer. I had assembled a group of cancer surgeons who were some of the highest performers in our department. Everything was clicking, and in an instant, it was all in jeopardy.


Initially, my thoughts were about my family. Would they be okay? Then, I thought about how I would fare. I knew I wasn’t going to be able to go back to surgery right away because I couldn’t do much with my left side. But I was doing well cognitively, and I felt like I still had a lot to offer. I was staring down my current situation—just learning to walk—but my professional future also hung in the balance.


While I was out, I’d gotten a new supervisor. The first day I came back, my new boss told me, “You can’t lead your surgical group if you can’t operate.” It was a punch to the gut. I had wanted them to tell me that they’d work to rehabilitate me and get me back in the operating room. Of course, I understood the business side of medicine, too, though that didn’t make it any easier.


Instead of making the offer I had been hoping for, the hospital agreed to take me back as chief medical officer of the cancer hospital, an administrator. At the time, I was fifty-six, going on fifty-seven. I could have taken disability and retired. It certainly would have been justified. But the feeling that I still had more to give lingered. So, I decided to go back to work as chief medical officer and gave up the opportunity to stay on disability.


Even though I was happy in my role leading the cancer hospital, the fact that I wasn’t doing surgery—which had been a big part of my life and my role there—made me feel as if I didn’t have a long-term future with the organization. It certainly was no fault of the hospital’s. The leadership team saw value in me; it was just a different value than the one I used to provide.


Things began to feel awkward. I’d go to work, do my job. But there were long periods of time when I would have been seeing patients—something I was not allowed to do until I recovered—or operating. They became hours that didn’t quite have purpose. During that time, I had a lot of conversations with my wife. Our daughter was in Cleveland,and she had just had a baby. We were going to have to decide whether we’d stay there—with me in my limited role—and continue on with our family life or whether we would open ourselves up to new opportunities, other situations elsewhere that might be a better fit for me.


As it turned out, I was offered an opportunity in South Carolina. The head of surgery at Prisma Health had been a friend of mine for many years, and the organization needed someone to help lead cancer surgery services in the region. He had hinted about me coming down there several times prior to my stroke, but I had always brushed it off. “I’m at the top of the world here; why would I go to South Carolina and start something new?” I’d tease. But now that I was looking at the world through a different lens, it seemed like a promising option.


I saw the opportunity as a chance to put a capstone on my career. I could work to change the way healthcare was delivered to an underserved patient population. In South Carolina, medicine hasn’t quite reached the same level as it has in Cleveland. I thought I could make an impact.


When I came to South Carolina, the first person I met was the CEO. At that point, I was barely able to walk without a cane. “I have a great resume,” I said, “but I’m a surgeon who can’t operate. With all due respect, why are you even talking to me?”


His answer stuck with me. He was focused on my value as a leader, a visionary, someone who could change the way healthcare is being delivered to a large population of patients. None of it had anything to do with me performing an individual operation on a patient. I gave it a lot of thought and decided that it was the right next step. I’m here in South Carolina today. I never would have expected to leave where I was and be where I am now. It’s all a result of what I went through.


I came to a few powerful realizations through this experience. I recognized my own vulnerability. That’s something I didn’t feel much at all before my stroke. I was extremely confident—I felt like I could handle any situation that presented itself. But after my stroke, I realized I wasn’t as infallible as I had thought and neither was anyone else. Organizations restructure, telling their senior leaders that they’re simply going in a different direction. People get sick and can’t work the way they used to. I also began to see the value in those experiences.


I had been at the top of the mountain, but when I got knocked down, I had the opportunity to recreate myself. The stroke I had was the most terrifying, humbling, and brutal experience I’d ever been through. I see everything differently now. I appreciate things I never would have noticed in the past.


People see me differently, too. I’m more accessible than I was before, with my suit and tie and perfect posture. During my recovery, total strangers would come up to me. “I see you every day, and I can see your progress. You just keep working,” they’d tell me. My vulnerability opened the door for those interactions.


That vulnerability was bolstered by my experience working in high-functioning organizations in a different part of the country—Cleveland Clinic, Case Western Reserve University, University Hospitals—and it meant I had seen and experienced a lot of things that just haven’t happened in this region yet. I would share my ideas, and they really seemed to resonate with people. Nine months after I arrived, the chief clinical officer for the local healthcare system departed. Soon after, I got a call from the CEO. He wanted me to consider taking on the role. At first, I didn’t think I was the right choice. I had been there for less than a year. There were people who had been there for their entire careers, who knew the health system inside and out. When I asked him why he wanted me, he said, “Well, people like what you have to say.”


It was a simple answer, but I think I’ve come to understand what he meant: they appreciated my humility, my willingness to listen.


Today, I still feel vulnerable; the organization is going through a restructuring. I’ve seen people who have been here for twenty years be relieved of their duties. What I’ve come to realize is that it’s never over—you get over one hurdle, and the next one is standing right there, staring you in the face. Life is a continuous process of trying to overcome, to manage. But instead of panicking, I focus on what I can control, on getting through.


My stroke gave me perspective about my role on this earth. Having that perspective helps me realize that there’s more to the world than my office, than trying to cut my budget or meet my bottom line. Right now, I’m sitting in an office with plaques all over the walls. Looking over them, I realize that life is what happens in between all that stuff.


To learn more about liminal space, purchase the full copy of Unleashed: Harnessing the Power of Liminal Space here. Also available as an audiobook at the following locations: