11

COLOR OUTSIDE THE RED AND BLUE LINES

Despite political polarization, individuals of different beliefs can still work together to solve common problems. Leaders must point the way and inspire by example.

Ivy League–trained experts who harbor strong, progressive beliefs and hail from the Northeast generally don’t befriend conservative pro-gun activists in the Intermountain West. They certainly don’t visit gun ranges and learn to shoot automatic weapons. But that’s precisely what Morissa Henn, former community health director at Intermountain, did during the summer of 2017.

As a graduate student in public health at Harvard, Henn wanted to do something about the plague of suicides afflicting the United States. Visiting Intermountain on an academic fellowship, she learned that youth suicide was an especially urgent problem in Utah and that guns figured prominently in these deaths, much more so than in states with low gun ownership rates.

Guns are part of the fabric of life in Utah. Almost half the population owns them, even more in some rural areas.¹ Many in our state are avid hunters and outdoorsmen, and with relatively nonrestrictive gun laws on the books, many also keep guns for self-defense, target sports, or to exercise their Second Amendment rights. I have deep respect for Utah’s gun culture and its emphasis on responsible gun ownership. But as gun advocates themselves acknowledge, the presence of so many guns makes it easier for people to accidentally or intentionally injure or kill themselves. More than other common means of self-harm, guns are lethal, and their effects on the body are often irreversible. When people experience a bad breakup, when they get fired from a job, or when they suffer some other setbacks, access to guns can turn what might otherwise be a passing moment of extreme distress into a catastrophe.

Mindful of these facts, Henn had an idea. Instead of approaching suicide solely as a mental health issue, as healthcare systems typically do, what if our efforts at prevention went further and specifically addressed the role played by firearms? Rather than simply hire more counselors and psychiatrists, we could engage with gun owners to help prevent distressed people from accessing weapons to harm themselves. Henn recognized that gun enthusiasts opposed laws that restricted gun access or that increased government’s role in their lives. But she envisioned many potential interventions that gun enthusiasts might accept and even embrace, ranging from better training of clinicians working with families to the distribution of gun locks and safes to new messaging in suicide prevention awareness campaigns.

When Henn brought her ideas to leaders at Intermountain, we greeted them enthusiastically. Not only was she focusing on prevention—she was looking farther upstream than health systems traditionally had. We also liked that Henn took a deeper, humanistic approach to this work. In her view, collaboration on new programs would yield better results if it were grounded in real, human relationships. She felt it vital to build bridges between healthcare and gun enthusiasts, two worlds that often didn’t mingle. By reaching out to gun enthusiasts and getting to know them, she thought she could build mutual trust and respect. As she says, “It’s really hard, if not impossible, to convince people who do not trust you to change their behavior.”²

Henn reached out to Clark Aposhian, Utah’s most prominent gun-rights advocate and chairman of the Utah Shooting Sports Council (USSC). The two became acquainted and began to discuss a collaboration. As Henn and Aposhian both realized, this was an unusual move, to say the least. Henn had never fired a gun and was utterly unfamiliar with the culture that surrounded these weapons. She had never personally known someone harboring Aposhian’s strong pro-gun beliefs. Still, she had learned that Aposhian, although opposed to restrictions on Second Amendment rights, was deeply concerned about the problem of gun-related suicides. If little else, she and Aposhian had this in common.

In their early conversations, the two openly discussed their motivations, values, and beliefs while also respecting their differences. “I asked as many silly questions as I could,” Henn said. “He was willing to walk me through in a way that didn’t assume I would subscribe to his politics or his beliefs.”³ Each sought to go beyond stereotypes and political talking points to understand what made the other tick. “Here’s a guy who thinks about guns all the time,” Henn recalls. “It’s his job, his mission, his identity. And I’m like the alien from outer space who has never had any connection to that. I think he was super curious about what I thought. And I was super curious about what he thought.”⁴

Such curiosity led Henn to make a surprising request: would Aposhian be willing to take her to a gun range and introduce her to shooting? Aposhian looked at her in disbelief—he couldn’t believe this doctoral student from Harvard really wanted to go shooting. But indeed she did. As she saw it, learning to handle and shoot firearms would help her to understand and relate with gun-rights activists like Aposhian. She would become a better advocate for gun safety and suicide prevention if she had at least some firsthand knowledge about firearms and gun culture.

One summer morning, the two met up at a shooting range outside Salt Lake City. “This was very outside my comfort zone,” Henn recalls. “This is beyond showing up in a country where you don’t speak the language, beyond eating at a restaurant where you’ve never eaten the cuisine. I literally didn’t even know what to wear.” Aposhian had brought a number of weapons from his own collection for her to try out, including a Glock pistol, a fully automatic machine gun, and an AR-15 rifle.⁵ For the next hour, Henn fired them off, with Aposhian providing expert instruction. Afterward, the two debriefed over lunch at a nearby restaurant.

As Henn recalls, shooting a gun took some getting used to. She was surprised at how loud it was; as she fired she “physically jumped an inch off the ground every single time for the first several minutes.”⁶ Although she wasn’t instantly transformed into a gun lover, she did find the experience agreeable enough, acknowledging that, “There was a fun, exhilarating aspect to it.”⁷ More broadly, her efforts to enter Aposhian’s world, and his willingness to serve as her guide, confirmed that it was possible to engage in a more meaningful way with people on the other side of issues. “I think what we seemed to see was that we don’t have to focus on our differences, that there’s a way of engaging that’s based more on shared human values, and that this can be our focus. We don’t need to obsess over a sense of blame or a sense of what policy or regulation is necessary. We can look for common ground and start from there.”⁸

In the months and years that followed, Henn collaborated with Aposhian and other gun-rights activists as part of a suicide prevention coalition. She and gun-rights advocates developed training that healthcare practitioners could use to interact with patients at risk of using a gun against themselves,⁹ a public health campaign that talked about guns and suicide, and a voluntary “no buy” law that allows people to give up their right to buy guns on a temporary basis if they feel they might face a future suicidal crisis.¹⁰ Testifying before Congress, Henn described the effort this way: “By moving outside of our comfort zones we’ve been able to find a common denominator: We’re all universally horrified there are so many gun deaths, and we all want our loved ones to be safe. We’ve found a level of trust with different groups, including gun owners, because neither side has a monopoly on grief from losing a loved one.”¹¹ Although it’s too early to gauge the full impact of Henn’s collaboration with gun-rights advocates, they believe their efforts will eventually help to lower suicide rates in Utah.

The polarization that grips the United States and other countries today stymies us by locking us into the same old assumptions and limiting our understanding of potential solutions. But well-intentioned individuals of different beliefs can break free of this trap, working together to solve big important problems. By building relationships with our perceived opponents and exploring common ground, we can arrive at compromises that might not perfectly address a given issue, but that yield important progress. As we at Intermountain have found, leaders can unleash organizations to drive that progress by encouraging approaches like Henn’s. Leaders can also set an example for others, entering their own discomfort zones and building personal relationships across political lines. This is some of the most difficult work leaders undertake, but it’s also some of the most essential, meaningful, and rewarding. Fertile ground for collaboration and comity still exists. We just need to look for it.

ONCE YOU KNOW PEOPLE, IT’S HARD NOT TO LIKE THEM

In May 2021, I was saddened to learn that a favorite restaurant of mine in Salt Lake City, the Blue Plate Diner, was closing.¹² The diner was nothing fancy, and that’s why I liked it. You could sit on stools at the counter and enjoy a cheap breakfast of bacon, eggs, and home fries. But what really made the place special was spending time there with former Utah governor and health and human services secretary Mike Leavitt. Before the pandemic, we would meet there every couple of weeks on weekend mornings to talk about our lives, healthcare, and the challenges of leadership. I would describe situations I was facing in my role as Intermountain’s CEO, and Leavitt would offer the benefit of his wise counsel.

Leavitt and I continue to meet, and I count him as my good friend and valued mentor. By most measures, our friendship seems as unlikely as the one that emerged between Henn and Aposhian. Leavitt is a Republican who served in the administration of George W. Bush. I don’t identify as a Republican and have voted for Democrats. Leavitt is a member of the Church of Jesus Christ of Latter-day Saints. My background is Jewish. Leavitt is a Utah native. I was born and raised in Pittsburgh. Leavitt had a successful business career before becoming a political leader. I worked as a frontline clinician.

Despite these differences, Leavitt and I have forged a strong personal connection and friendship. I first met him years ago when I was working at Cleveland Clinic and he came to visit with our executive team. Later, when I arrived at Intermountain, I sought him out, primarily because I admired his track record of success and wanted to see what I might learn from him. This is a longstanding practice of mine: whenever I encounter successful people in any domain, whether it’s sports, the arts, politics, or business, I try to understand how they came to excel, and I apply their wisdom or tactics to my own work in healthcare. I don’t worry too much about how different their backgrounds might be from mine. My curiosity and desire to learn win the day.

As Leavitt and I became acquainted, we discovered that we actually shared quite a bit in common. We might have played on different teams, but our political inclinations were both centrist. I can sum up my own politics as follows: I want a clean environment. I don’t care who sleeps with whom, as long as they’re adults. And I think the free market is very effective at solving many problems, so long as we regulate it properly. If you asked Leavitt, I believe a good deal of this would resonate with him. Do we agree on every specific policy issue? Not at all. But our general outlooks on the world and on politics are remarkably congruent.

Thanks to our conversations, I also realized that liberals and conservatives often have a strikingly similar commitment to health-care. Liberals tend to talk about healthcare as a right, not a privilege. They sympathize with the underserved in society and feel obliged to help them. But Leavitt, too, speaks in very sincere and meaningful ways about caring for the frail and vulnerable in the community. A strong sense of social responsibility is core to his values and undergirds his belief that Intermountain should function as a model healthcare system and provide care for those who can’t afford to pay. Other conservatives I’ve become friendly with, including several on Intermountain’s board and leadership team, feel similarly. Again, we might not agree on specific policies, but we share a vision of a world in which people of all backgrounds suffer less and access the care that they need.

As it turns out, my common ground with Leavitt runs even deeper than this. Like me, he doesn’t see himself as having reached some final state of intellectual maturity. He’s not finished learning and retains an openness to hearing alternative interpretations or new facts that might change his approach to problems. To that end, he’s always reading, thinking, and engaging with people across a wide range of backgrounds. More than anything else, it’s his openness and desire to learn that makes it fun to spend time with him. Because I never know what new idea or perspective he’ll share with me, he sparks me to question my own beliefs and push my thinking further.

I believe Morissa Henn has it right: in making forays across political lines, personal relationships really do matter. We can make the most progress if we take time to get to know people, opening up to them and inviting them to express their cherished beliefs and values. Personal relationships allow us to identify common ground that might otherwise go unnoticed in the context of partisan rancor. We come to see political adversaries in more nuanced ways, and we come to trust them. It’s hard to hate people if you spend time with them and get to know them as human beings.

I’ve been privileged as well to form a strong friendship with Brad Wilson, Republican speaker of the Utah House of Representatives. I first met Wilson early in my tenure during a visit to the House floor, but we became better acquainted during the pandemic, dining together on multiple occasions with our wives. I found that I liked Wilson very much and that he shared my own values around family and service to the community. Although his politics are considerably to the right of mine, we’ve been able to build a great friendship that transcends those differences. Once again, far more connects us than divides us.

Our relationship in turn allows us to bring balance and perspective to others in our respective camps who might disparage their opponents. When I hear people complaining about “those crazy legislators,” I assure them there are good folks in government who are working their hardest to make the world a better place. I suspect Wilson at times has gently deflected people on his side who have tried to vilify me. Wilson and I know and trust one another’s deeper motivations. That allows us to lower the temperature in political debates and to collaborate effectively to solve problems. Of course, I intercede with critics directly as well to lower the political temperature. Even in situations of overt conflict, I’ve found that reaching out and attempting to make a personal connection can enable more productive interactions.

When I first arrived at Intermountain, I managed to alienate an influential political figure in the state. I’m not sure exactly what I said or did, but I heard that this individual, a very conservative Republican, had concluded that I was irredeemably “woke” and too radical for Utah, and that he wanted me gone. Before long, it became apparent that this person was indeed planning to take action that could hurt Intermountain.

I was mortified that I had hurt the organization by making a powerful opponent. I was also angry. Although I felt tempted to dig into my corner and fight back, I chose to do the opposite. With the help of an intermediary, I arranged a meeting with this person and offered up a genuine apology. He affirmed his mistrust, telling me to my face that he thought I was wrong for Utah. Maintaining a respectful tone, I made it clear that I would not allow him to run me out of town. I asked him to give me a chance and take some time to get to know me. I also conveyed the respect I had for him as a political leader.

My overtures didn’t automatically repair our relationship, but they did at least help to stabilize the situation. About a year later, I invited this individual out to lunch, and we had quite a good time, coming away with more respect for one another. We’ve since seen one another socially on a number of occasions. Although we’re not necessarily friends, we’re always civil and cordial. With a bit of outreach across the political divide, we were able to avoid some of the acrimony that riles so many communities and that could have proven distracting or worse to Intermountain.

Many leaders talk about mutual respect, but how many of us practice it? More often, we surround ourselves with like-minded folks who reinforce our own points of view. We feel safe and protected in our certainty, and we might even feel superior to those who think differently. But feelings of superiority don’t help us solve problems. They only make collaboration more difficult. What does help is rediscovering our shared humanity, whether by extending an outstretched hand to those who attack us or building friendships with those who think differently than we do. It really is hard to hate people—or even just dislike them—once you’ve gotten to know them. And it’s a heck of a lot easier and more productive to work with them.

STAY PRAGMATIC

Although Morissa Henn made progress working with Clark Aposhian and other gun-rights advocates on measures to help reduce gun suicide, it wasn’t long before she discovered the limits of their collaboration. Initially, she recalls, she harbored the somewhat naive belief that if she could convince gun-rights advocates to embrace nonregulatory measures like voluntarily using gun locks or undergoing training in gun safety, they could eventually find ways to collaborate on government regulations designed to help keep guns out of the hands of people at risk of suicide. In particular, Henn sought to obtain the support of Aposhian and others for “red flag” laws that would allow people to petition judges to remove guns from those who posed an imminent threat to themselves or others.

Collaboration on policy proved quite difficult. “I tried so hard to bring Clark and others together,” she says, “not to convince them that it was the answer, but just to have a really robust dialogue around, ‘What are the possibilities? What does the data tell us? How does that relate to what we’re doing in Utah?’” As she came to realize, gun-rights advocates just couldn’t go there—anything involving government regulation was a nonstarter for them. Having built a collegial relationship with Aposhian, Henn found it jarring to see him take what she regarded as hard-line positions on policy matters. “It did feel a little disorienting in that I was like, ‘Well, this is the same person who’s working with me on something productive,’ but also refusing to be open-minded about what I thought were some policy areas we could explore together.”

At one point, Aposhian’s organization compared gun rules and gun control to Jim Crow segregation, a move that Henn found overtly racist and unacceptable. On another occasion, Henn attended a meeting with gun-rights advocates at the state capitol only to find them sharing information she regarded as factually incorrect about a particular policy issue. Such episodes taught Henn an important lesson about coloring outside the red and blue lines. As important as it is to pursue collaboration, political differences will remain that we cannot fully bridge—and that’s OK. Even if we show flexibility when we’re working across political lines, many of us still have core values from which we won’t stray.

How do we sustain progress in the face of strong, persisting differences? The answer is to adopt a pragmatic posture, respecting boundaries, adopting realistic goals, and notching gains where we can. Henn describes her years of work with the gun-rights lobby as an ongoing process of “disagreeing on a lot of things until we found that alignedness.” She tried repeatedly to engage Aposhian and other activists around policy issues, with little to show for it. But rather than throw up her hands, she accepted this boundary on their work and pushed ahead in the areas where they could make headway. It was important, Henn relates, “to just constantly return to the common goal. It really keeps people focused and keeps them realizing that they want to be part of the solution.”

Gun violence prevention advocates criticized Henn, claiming that by continuing to engage with the gun-rights lobby, she was capitulating to gun owners and giving them political cover. Henn pushed back, arguing that addressing gun violence required “engaging on every different level, on so many different levels, to affect change.” Working with gun-rights advocates was one path to progress, but it didn’t mean that people with her beliefs couldn’t pursue change in other ways, too. Instead of judging people as “good” or “bad,” we could appreciate and accept their complexities and “really look for the nuggets of productive engagement we can tease out.” Doing so could invite them to do the same. Such an approach is messy, and it might not satisfy our need for certainty and clarity. But over time, it allows us to make headway on otherwise intractable problems.

As we at Intermountain have repeatedly seen, leaning pragmatically into the complexity really does yield results. In Chapter 1, I described our decision to delay mandating Covid-19 vaccination for our workforce. We focused on encouraging voluntary vaccination by offering incentives and sharing information about vaccines’ safety and health benefits. We implemented a mandate only in October 2021, when the Biden administration required it. In making this decision, we listened to the concerns of caregivers opposed to vaccines and recognized that the removal of personal choice via a mandate represented an important boundary. We knew that in general these caregivers could accept that we favored vaccines and encouraged their use, but the moment we made vaccination a requirement for employment, we would be crossing a line. Studying the experience of other health systems that implemented mandates, we anticipated that turmoil would erupt and a significant number of caregivers would quit, worsening a staffing shortage wrought by the Covid-19 pandemic. We also doubted a mandate would increase vaccination rates enough to warrant such a disruption to our organization.

In avoiding a mandate for as long as possible, we made strong progress vaccinating our workforce while retaining the staff required to care for a surge in Covid-related hospitalizations. Prior to our mandate, the vast majority of our caregivers—about 82 percent—were either fully or partially vaccinated.¹³ We did anger some doctors who supported a mandate, but overall, our approach allowed us to ease tensions inside of our organization. When we did finally issue a mandate, we won over at least some vaccine opponents by tying our decision to our mission. Intermountain exists to keep people healthy, and that means actually providing healthcare. Since at least 40 percent of our business was funded by the government, failing to issue a mandate meant we wouldn’t be able to care for all of those patients. Forget about the financial implications for us—we simply couldn’t abandon millions of patients over a vaccine mandate.

At the same time, we assured our workforce that we were going to make a mandate as palatable as we possibly could. We would respect the Biden administration’s regulations, but we also would do our best to ensure that our caregivers knew all of their options when it came to obtaining exemptions. Meanwhile, we would continue to be diligent about providing personal protective equipment (PPE) to caregivers and mandating its use, ensuring that any caregivers who remained unvaccinated wouldn’t compromise the safety of our patients. (By the way, PPE really works: as of this writing in 2022, we aren’t aware of a single case in which one of our caregivers has transmitted Covid-19 to a patient.)

As we implemented the mandate, we worked very closely with individual caregivers who were wary of vaccination. In some cases, after speaking with others and reviewing data, caregivers decided that vaccination was the right choice for them. One of our nurses had suffered a series of miscarriages and finally managed to get pregnant. Unfortunately, she had encountered information about vaccines online and believed that they would harm both her and her unborn child. She was quite frustrated that she would lose her job if she didn’t get the vaccine. In truth, vaccines aren’t harmful to pregnant women, but Covid-19 is—pregnant women have a much higher death rate from the virus than the general population. When one of our caregivers sat down and explained the evidence to her, she decided to get vaccinated.

In other cases, working through an individual’s concerns led us to help them to apply for a religious or medical exemption if they met the relevant criteria. One nurse had been experiencing strange and unexplained neurological symptoms, including muscle weakness and cognitive deficits. These symptoms were impacting her life and causing her distress, and she worried that the vaccine might exacerbate them, given its effects on her immune system. Although strictly speaking, she didn’t meet the criteria for a healthcare-related exemption, we explored other ways that she might qualify. This caregiver knew she was subjecting herself to some level of risk by forgoing vaccination and continuing to work for us, but she was willing to accept that. She had legitimate concerns and just couldn’t bring herself to get vaccinated. Since her presence on the job wouldn’t harm patients, we wanted to work with her as best we could to help her stay employed with us.

Life isn’t perfect. We usually can’t achieve all our goals and still hope to win the support of a diverse coalition. That’s just reality. Over the long term, working pragmatically and collaboratively can allow us to have the greatest impact, but only if we’re willing to respect boundaries, make accommodations, and at times sacrifice some of our ambitions while still remaining true to our core principles. In building relationships with our partners across the political aisle, we must accept that they will need to disagree with us and uphold core principles of their own. Rather than cut off the conversation, we should keep it going and collaborate when possible. It’s easy to grandstand, much harder to actually make progress. I’ll take progress over grandstanding any day.

BE A CONVENER OF STATURE

Like other states across the nation, Utah has a homelessness problem. It also has a homelessness policy problem. Between 2016 and 2020, state government spending to address homelessness skyrocketed by 600 percent. Despite all that money flowing into shelters and other service organizations, the number of homeless people in Utah rose by 12 percent, and the number of those who lacked shelter tripled.¹⁴ As it turns out, those numbers reflected underlying political tensions. While leaders in recent years managed to build new facilities to help the homeless, they couldn’t agree on ways to increase the homelessness system’s overall capacity. Clark Ivory, a prominent philanthropist focused on the homelessness issue, observes that differences of opinion “led to dysfunction and impacted, in the end, what we could accomplish.”¹⁵

As a successful homebuilder with a strong sense of civic responsibility, Ivory took pride in his local business community’s pragmatic, nonpartisan approach to important issues like immigration and transportation. “We just want to get stuff done,” he says. “We’ve been able to bring a lot of like-minded, solution-oriented business leaders together, and we haven’t really cared about politics. We’re able to do things that some people would maybe call progressive. I just call it common sense.” In recent years, Ivory and other prominent business leaders sought to apply this pragmatic, nonpartisan approach to overcome divisiveness and spur progress on homelessness.

In 2020, Ivory and Intermountain board member Gail Miller funded a study to assess the state’s approach to homelessness and recommend how better to organize it. As part of the data-gathering process, the researchers convened an array of groups and individuals with a stake in the homelessness issue, including businesses, philanthropists, elected officials, service providers, mental health practitioners, and law enforcement. Members of the group held diverse political views, but with the support of prominent philanthropists and the business community, they were able to put aside traditional disputes and hold productive conversations. In a final report issued to the Utah legislature, the group aligned behind a number of measures to improve the formulation and execution of homelessness-related policy. These included the creation of a Homeless Service Officer who would serve as the state’s “chief policy officer and advisor for homelessness” and of a Utah Homeless Council composed of key public and private sector leaders to drive homelessness strategy.¹⁶

In 2021, the Utah legislature put these and other recommendations into law, resetting homelessness policymaking in the state and spurring new projects and strategies. Bringing diverse stakeholders to the table was critical, as was keeping the dialogue nonpartisan. “They’re listening to people who are out there in the trenches,” Ivory says, “and getting everyone engaged so that they understand the issues and are responding.” Two projects have kicked off with a mixture of public and private support, one designed to help preserve affordable housing and the other to help homeless people with substance abuse issues. “But more importantly, the group is intact, they’re collaborative, they’re moving forward. That’s something we hadn’t seen happening on this issue.”

Leaders can drive progress not just by forging relationships across political lines or enacting organizational policies with a nonpartisan lens but by creating opportunities for others to do so as well. My friend Mike Leavitt has thought deeply about how leaders can reverse political polarization and foster more comity and collaboration. The basis for engagement across political lines starts, he argues, with a common outcome that everyone can agree on, such as reduced homelessness or fewer people dying of gun-related suicide. Leaders of different political persuasions must then take time to understand one another’s points of view—what their concern or “pain point” is and how we might address it.

But as noble and difficult as this shared understanding is, it isn’t enough. Adversaries often require a gentle nudge to engage productively with one another. The people who can deliver those nudges are what Leavitt calls “conveners of stature,” respected leaders who possess enough status and influence to “bring people together and get them to operate in good faith.” In Leavitt’s telling, George Washington was precisely one such convener. After defeating the British, the American colonists were struggling to self-govern under the Articles of Confederation. Washington was the only person with enough gravitas to bring representatives from the various factions together and encourage them to make the compromises necessary to adopt a new constitution.¹⁷

Leaders today must follow Washington’s example, convening warring sides and establishing dialogue built on mutual respect. We can do it on a grand scale at the national or state levels, and we can also do it within our organizations. For over 15 years, our chief financial officer, Bert Zimmerli, has held meetings in local communities across Utah to gather input about financial needs related to healthcare and how our system can best mobilize its charity dollars to help the under-served. These meetings include a wide range of stakeholders—large and small business interests, government, community advocates— that collectively straddle the political divide. With their help, we can fine-tune our policies on financial assistance and foster healthy, productive discussions between those in our community who pay for healthcare and those advocating for healthcare consumers.¹⁸

Leaders also can convene others across political lines while managing their own teams. At Intermountain, our executive team includes leaders who harbor an array of views across the political spectrum. As convener, I’ve encouraged open debate and tried to help team members forge deeper, personal relationships with one another by arranging retreats, social events, group exercises, and the like. Although we tend to keep our individual political views in the background, they’ve crept in at times, prompting us to do the hard and messy work of muddling ahead toward common ground. Our challenge at these moments is to find a way to do what is right for the organization while also allowing each of us to walk away with our personal dignity intact.

During one episode of fairly intense conflict, I tried to rally our team by relaying an anecdote from when I was practicing medicine in the pediatric ICU. A sad but necessary part of our job was withdrawing life support from patients who had no hope of survival. One of our partners—I’ll call him Rich—held religious beliefs that made it extremely difficult for him to take patients off life support. Another partner and I were willing to perform the necessary procedures because we knew we had to and because we also understood that we were giving these patients a gift by sparing them from horrible and constant pain and suffering. We wound up creating a protocol whereby we would take Rich’s patients off life support ourselves when that was warranted, removing the burden from him. This arrangement allowed our team to serve patients and the organization as required while still leaving everyone’s dignity intact. As I told our team at Intermountain, we, too, could arrive at solutions together, so long as we were willing to persevere and work through painful issues. So far, we’ve always managed to do that, and our team has emerged even stronger.

All leaders have it in them to serve as conveners of stature, and more generally, to color outside the red and blue lines. It takes strength and focus as well as a number of other traits we’ve referenced in this book: empathy, courage, openness, pragmatism, and a tolerance for complexity. Is it sometimes scary to reach out to perceived enemies or antagonists? Absolutely. But the more we do it, the more we discover that it won’t kill us, it won’t rob us of our sense of identity, and it won’t erode the principles and values we hold dear.

Please don’t let the divisiveness of our times discourage or distract you. Push aside either-or thinking when you encounter it. Forge new, nontraditional partnerships of your own and help others to do the same. Remember, people who share your beliefs don’t have a monopoly on good ideas and noble intentions. Make it a priority to become friendly with those who disagree with you—to learn from them, to unleash their energies. We really can ease tensions and build a more harmonious, compassionate, and prosperous society. We can turn our organizations into agents of civility and comity, replacing extremism and dogmatism with a healthier pragmatism— all in the name of meaningful progress. But only if we’re willing to step up, work together as leaders, and make some good trouble across red and blue lines.