Stand up for leaders

It’s August and, ever since my days as a student in Edinburgh, for me that has meant one thing – the Edinburgh Festival. To be more precise, the Fringe, and to be even more exact, comedy shows. In my younger days I saw many cheap (or free) productions, and the occasional gem. I’ve witnessed Stewart Lee being grumpy, Jenny Eclair being rude and Jo Brand dealing with hecklers in the way that possibly only a former psychiatric nurse can.

This year, looking through the programme, I started to reflect on the question: why is an NHS leader like a stand-up comedian? My train of thought was partly inspired by health care leader Caroline Shaw, Chief Executive at The Christie, who is raising funds for cancer patients by performing a set at The Comedy Store in Manchester. So do health care leaders and stand up comedians have more in common than meets the eye?

The good ones in both professions work incredibly hard. Comedian Louis CK has talked about the years of practice he put in before he became an overnight sensation: the hours of rehearsal, writing and honing his material, reviewing what worked and what didn't, watching and learning from his role models and pushing himself with a punishing work schedule. All this could equally apply to health care leaders. While nobody would claim that a workload so heavy that it negatively impacts one’s life is to be emulated (Louis slept in a car for a year), it's true of almost everyone who is good at what they do – they got there largely by dint of hard work.

Then there’s the desire and ability to connect with people. Many comedians have told of the incredible buzz from ‘the first time I got a laugh’ and how that connection with their audience spurred them on to do it again. The desire to engage people, connect, and communicate with them – bringing them together around a common purpose – is also something good health care leaders know how to do.

Finally, there's courage. It takes some nerve to stand on a stage in front of a crowd of people – or even in front of two men and a whippet – and try to make them laugh. But arguably it takes even more courage to be a leader in the NHS. Day after day, health care leaders make decisions that directly affect the lives of patients and their families. They work in organisations of huge complexity, in a constantly-changing environment, in a service that is held up to public opprobrium when things go wrong but rarely lauded for the thousand and one successes every day. Leaders in the NHS come into the health service because they want to make a difference, and doing that takes a huge amount of courage.

So, to answer the question – why is a good health care leader like a good stand-up comedian? One response might be that they share the ability to connect, the courage to stand up and the commitment to deliver. It is probably also no coincidence that the very best NHS leaders I've had the pleasure to work with over the years have all shared a wicked sense of humour... which is not to say they make light of their work, but simply that they recognise that sometimes laughter really is the best medicine.

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