Thank you all for coming to our session today, Leaders, Myth, and Reality. My name is Melissa Sallikverk, and I am a Policy Analyst with New America's International Security Program. For those of you new to New America, we are a think-and-action tank, a civic platform that connects a research institute, technology lab, solutions network, media hub, and public forum. The International Security Program aims to provide evidence-based analysis of some of the toughest security challenges facing American policymakers and the public. Our research has addressed homegrown American terrorism, the United States drone wars abroad, and the proliferation of drones around the world, and the profound changes in warfare wrought by new technology and societal changes. I'd like to introduce you to our two panelists today, Geoffrey Eggers and Tresha Mabio. Geoff Eggers is the Executive Director of the McChrystal Group Leadership, where he leads research and advises private and public sector clients on leadership behavior and organizational performance. With Stan McChrystal, he recently co-authored the book, Leaders, Myth, and Reality, and Geoff is also an executive leadership coach, a senior fellow at New America researching the behavioral and cognitive science of decision making, and an advisor to the Geneva Bay Center for Humanitarian Dialogue, where he assists with international conflict mediation efforts. In government, Geoff served as a special assistant to the President for National Security Affairs and worked as the White House in 2006 and 2007, and again from 2010 through early 2015. In 2014, President Obama presented Geoff with a Samuel Nelson drew award for Distinguished Contribution and Pursuit of Global Peace, and his role in mediating a solution to the political crisis following the 2014 presidential elections in Afghanistan. Geoff retired from the Navy in 2013, serving over 20 years as a combat veteran Navy SEAL. Geoff served in the military as special assistant to Chairman of the Joint Chiefs, Branch Chief for Combating Terrorism on the Joint Staff, and White House Fellow and Director for Combating Terrorism at the National Security Council. Geoff's operational tours included several SEAL teams, Commander of the Special Operations Task Unit in Western Iraq, and Operations Officer and Mission Commander for the U.S. Navy's Undersea Special Operations Command. Geoff currently serves on the board of a nonprofit that cares for and assists the families of veterans killed in action. Geoff is also a member of the Nation's Swell Council, a forum for advancing innovative solutions to America's most pressing challenges. He holds an MA from Oxford University and a BS from the United States Naval Academy. Tresha Mabiel is the producer of the 2018 Emmy-nominated CNN film, Legion of Brothers. The film is about the U.S. Special Forces, who were the first on the ground in Afghanistan after 9-11, and it premiered at the 2017 Sundance Film Festival. Mabiel produced and directed her first military documentary in 2000, based on the book Blind Man's Bluff by Chris Drew and Sherry Sontag. For this two-hour film, Mabiel interviewed U.S. submariners and their Russian counterparts about spying on each other under the oceans during the Cold War. In the decade-and-a-half following 9-11, Mabiel produced multiple documentaries in Iraq, Afghanistan, and Pakistan. In Iraq, Mabiel documented in 2003 as the U.S. efforts to install a democratic government gave way to an insurgency for a film called After Saddam. And in 2004, she documented as a team of U.S. attorneys helped Iraqis build a legal case against Saddam Hussein for a film called The Case Against Saddam. In 2005, she produced and directed Saddam's Reign of Terror for National Geographic. In Afghanistan in 2007 for CNN, Mabiel produced Narco State in which she showed how poppy farmers were joining the ranks of the Taliban because U.S. promises for replacement crops had failed. In Talibanistan, Mabiel documented for National Geographic the resurgence of the Taliban. And in Pakistan, she embedded with the Pakistani military in the tribal areas which straddle Afghanistan on the front lines of their war against the Taliban. The Talibanistan was nominated for an Emmy in 2011. In 2014, Mabiel produced and directed a film for National Geographic, American War Generals. The film tells the story of the top generals who led America's wars in Iraq and Afghanistan. And they had joined the army as America's war in Vietnam was winding down and they had vowed never to make the mistakes their generals had made in Vietnam. Nonetheless, these post 9-11 generals found themselves and their army bogged down again in Vietnam-like insurgencies in both Iraq and Afghanistan. So this afternoon we will begin with an introduction to Jeff's new book, Leaders, Myth, and Reality, which will be followed by an exciting discussion between Jeff and Trisha. And then we'll say the last 30 minutes or so for audience questions and books will be for sale after the event and please consider joining our social media conversation with hashtag Leaders, Myth, Reality. And with that said, we'll begin with Jeff. Thank you, Melissa, and welcome in. Thanks for coming today to those in the room and those out in the webcast. Let me start by first thanking New America, but in particular Ann Marie Slaughter and Peter Bergen, not only for their mentorship of me personally, but for their leadership of this great institution and all it does here. I've been honored and privileged to be a fellow. For the most part, that has involved me writing a book for the last two years. When I walked in this morning, the gentleman downstairs stopped me and almost asked for my ID because he just doesn't recognize me because I've been squirreled away writing a book. But it's great to be back and it's great to be part of this group and I couldn't be here without their support. Important time to be discussing leadership. When we set out on this project two years ago, we honestly didn't know that this book would land with this relevance at this point in time. I say that both in a specific way that we're, yeah, weak out from midterms. So there's a particular relevance, I think, in terms of political leadership and what people are experiencing and thinking about on that front, but just broadly. Where are we on the leadership spectrum? So what I'd like to do is just run you through some of, not the book's conclusions, but really some of where the book came from in the first instance. Why did we set out on this project and where did it come from? And then we can get into some of the conclusions when we get into the Q&A and the discussion. The title of this is mythology of leadership in large part because that's what we ended up concluding. So I will give you that snippet of the bottom line here is that much of what we believe about leadership is a mythology. In other words, there is a profound disconnect between how we talk about it, how we've been trained, and how we actually experience it. That's not what we set out to write about, but that's where we ended up in the end. So let me also thank my two co-authors. Obviously, the headline co-author, Stan, who was my once former boss and now is, again, my current boss, and as well, J. M. Ngone, who we brought out of a public sector job up in New York for this book project and was instrumental to getting it across the line. So they can't be with me today. They're actually doing their own version of book talks and so forth today, but very much a team effort across the three. There's a separate story in how you write a book with three co-authors. In some ways, that's the more interesting story, but we'll save that for another day. I train leaders and research leadership, and in some ways I've been doing this my entire career, but it's now my day job. The institute that I run is literally in the business of researching leadership principles and behaviors for the 21st century. We believe that we don't have this right and that we could do better. That's why we built this institute. So I'm just going to give you a couple examples of how we encounter this both in our business practice, but also in our book research, starting with this one. If you've been exposed to any leadership training at all, you'll be very familiar with the idea that humility and leadership is a good thing. We really kind of hold up and honor humility among our leaders. We talk about humble leadership. There's an entire genre of leadership theory devoted to this called servant leadership. It's been around for 30-ish years. And you can literally come to our institute and sit down with our PhDs and they will stack up literature from the floor to the ceiling talking about humble leadership and all its virtues and why it's so effective. And I've been talking about this for a number of years. And one of the most recurring questions I get is if humble leadership is so great, how do you explain that guy? In large part because there's a striking contradiction here, probably one of the most high-performing organizations in American corporate history and one of the most confident, almost arrogant leadership styles that people know of and CEOs at this level. There's a longer story to Steve Jobs, but it's a great example of the fact that, and this is a statistical truth, narcissists are over-represented in senior leader positions. So I mentioned that just to say, how could it be that humble leadership is so good and yet we tend to gravitate towards narcissistic leadership styles? And if that is true, what does that suggest about the ways we misunderstand this thing we call leadership? Let me give you another example. This one's a little closer to the book. It's a little bit of a quiz. So Winston Churchill here was speaking of an American leader, one of the noblest Americans who ever lived. FDR said we recognize him as one of our greatest American Christians and one of our greatest American gentlemen. Any guesses? Sorry? Truman? Billy Graham? Okay. Any others? So neither of those two are correct. If you guessed Ulysses S. Grant, it would be a good guess because he was an American president and he won the Civil War. But you'd be wrong. It was actually the guy at the other table in the foreground in this picture, Robert E. Lee. And what's so interesting about this picture is the guy who lost the war is in the foreground. The painting is really centered on the guy who lost the war. And in fact, Lee's legacy and leadership, particularly in military circles where Stan and I and Jay all kind of grew up, so to speak, is much larger than Grant's in many ways. The reverence and lionization of Lee far outpaced what Grant enjoyed. And yet, Lee lost the war and he betrayed his country. So if leadership is about achieving results by organizing a group or an organization toward a well-defined goal, and for Lee that was to win the Civil War, how is it that Lee came out as a quote-unquote great leader for so long? And it was only recently that we started taking down monuments and statues of Lee, very recently in relative terms. So this was one of the other questions that we started the book with. And so Robert E. Lee was going to be in the book one way or another from the very beginning. Stan went to Washington Lee High School. He grew up in Robert E. Lee's neighborhood. And he went to West Point where many buildings, roads, fields are named after Lee. So Lee was going to be in the book. And then we went out and we found 12 other historical leaders that we wanted to profile all deceased for a very simple reason. They couldn't argue with us after we wrote about them. So being deceased was a prerequisite for making our list. And we organized them by pairs. And we did that because we actually got an original idea from a colleague to write a book in the model of Plutarch's Lives. If that doesn't mean anything to you, you're also forgiven. It didn't mean much to us either at the time. Plutarch is a today relatively obscure Greek classicist, but the father of modern biography. He used to be a big deal. Used to be one of the top-selling books in America, Plutarch's Lives, second to the Bible no longer. But he wrote about Greeks and Romans in pairs. And he used a specific approach where he would profile one, profile the other, and then compare the two. And we decided to take a similar approach. So we put together pairs of leaders in genres. The first genre we came up with was the geniuses. Not your typical leaders, Leonard Bernstein and Albert Einstein in this case. But we felt that it was important to get as broad a spectrum of leaders as possible. That if we were going to really lift up this idea, this very broad idea of leadership in its broadest, most general form, we wanted to go to the very ends of what people typically conceive of as leadership. Second genre were the zealots. Maximilian Robespierre and Abu Musab Zarqawi, the leader of al-Qaeda in Iraq. So to explore this idea of zealotry and leadership. Third, the reformers, MLK and his namesake, Martin Luther. We had a tough time nailing down this pairing. There were literally kind of near fistfights over who should make this list. And lots of great people didn't make the cut. The founders was really an important topic today because so much of business leadership is driven by this idea of entrepreneurialism. And these were two great iconic century old brand founders, Walt Disney and Coco Chanel, that were high on the list just for those reasons alone. But then the more we actually dug into their biographical history, the more we realized that they were just fascinating characters in their own right. Power brokers were Margaret Thatcher and Boss Tweed. Boss Tweed was a corrupt New York politician of Tammany Hall days. We wanted to include, cuz we wanted to bring in people who had tarnished or kind of adverse experiences with leadership. We briefly played with the idea of Adolf Hitler and decided that it's just too controversial that that historical record was too well trodden, too familiar. And that Boss Tweed, a lesser known but very corrupt politician, would do better in part because he was highly affected despite being intensely corrupt. And then lastly, the heroes. And here we again tried to get some diversity, not just in gender but in culture and in its era. The gentleman on the bottom right is probably the least familiar to you on this list. Most of these are recognizable, if not by their image, by their name. But the gentleman on the bottom right is the Chinese admiral Zhang He, who's a big deal in China, not so much in the United States. But was a leader worthy of inclusion, given what he did in terms of his expeditionary exploits in China. And then lastly, Harriet Tubman, for her leadership really as a symbol of the abolition movement over and above her operational efforts to free slaves in the south. So those were the six genres, 13 people we profiled. I'm not going to go into any further depth but I'm happy to discuss any of those that are particularly interesting to you in the Q&A. Let me give you another example that was a little closer to home for me and this is actually how the book opens, is with a vignette of Washington Cross and the Delaware. And I won't totally spoil it for you, but you'll be familiar with this painting if only because it's one of America's most recognizable paintings. And I have to confess every time I talk about this that while I know a lot about this painting I know nothing about American history and I know almost nothing about American art. I only know anything about this one painting and the only reason I know anything about this painting is because I used to sit on that couch right underneath the painting. This is a reproduction of Washington Cross and Delaware. This is the Upper West Wing Lobby in the White House. I worked there for six years under Bush and Obama total. And meetings in the White House don't always run on schedule. That might not surprise you. And so you end up sitting on these couches waiting for meetings that are running over. And on this particular couch, if you're sitting there, you will hear a tour guide come through and talk about all of the stuff in the waiting room, the lobby. And so because I sat on that couch, I got an in-depth education on that one painting that was always hanging above my head. The tour guides would just cycle through and it was the same spiel every time. So I got a first rate education on this painting. Here it is, Washington Cross and the Delaware. And before I tell you what I learned about the painting, just look at Washington and to yourself for now, pick the word that comes to mind when you look at Washington. Just one word, and then I'll tell you what's wrong with the painting. Cuz that's what the tour guides would always tell me. Okay, we'll come back, hold it, we got one resolve. What the tour guides would say on this particular piece in the lobby was everything that was factually inaccurate about the painting, which is interesting given how prominent it became. Delaware River never had icebergs like that, apparently. Even worse, the flag is apparently wrong for the period. I'm not an expert in the course of American flag design, but apparently that's the wrong flag for that particular point in American history. If you know your geography of the Delaware River, the boat's going the wrong way. It's depicted actually going the wrong way. The most interesting fun fact that I kept hearing was that it wasn't a little 12 foot whaling boat. And they never said what it was. They just said it wasn't a little rowboat like that. And so then later when I started digging into what was it, I came across something and said it was a 60 foot flat bottom barge. And then I did some more digging and I found that more recently, an artist was commissioned to do a more accurate depiction. And sure enough, it depicts a 60 foot flat bottom barge. So this is the more accurate depiction of Washington crossing the Delaware. You can see lots of things are different. Which way he's going, the river itself and so forth. But look at Washington again, just zero in on Washington again. And what do you notice is different? What's his right hand doing? His left arm's kind of doing that weird thing generals do. What's his right hand doing? Everybody thinks he's steering. It's actually not a steering wheel. That's the wheel of a cannon. Which is why they had this 60 foot flat bottom barge is, if you're going to war, bring your artillery. Basic rule of warfare. So Washington had a barge so that he could bring his artillery with him. That's a cannon. Why is he grabbing it with his hand? Just steady himself, thank you. Cuz that's what real people do in a boat at night at war, right? Real people don't do that. Why don't they do that?  But when I asked you to pick a word, be honest, how many of you picked something like ridiculous, right? What was your word again, sir? Resolve. Which is more typical because that's how we think of leaders. And it's very natural. It's very natural that we think of leaders with these exaggerated expectations of what they're capable of. And by the way, leaders want us to think of them like this, right? Because there's something very powerful if you can portray yourself as this capable, in large part because it's what we hope delivers us from the challenges we face and gives us a better future. One of the more interesting things about humans as a species of animals is our cognitive wiring gives us a unique ability to think about the future in ways most animals don't. And because we can imagine the future, we typically imagine it as better. And who else to help us with that, but people that are this good, right? But that's a myth. None of us is actually this good and nobody actually leads their army like this. So Washington Crossing the Delaware is the first vignette in the book. These problems abound. This is a survey that comes out from PwC every January. It's one of the best surveys of CEO attitudes you can come across. And we look at it just because CEOs are a good metric of how leaders are thinking about their organizations in their business. This particular question is a question about how do CEOs perceive risk and threat in their environment? And in 2018, the top rated risks and threats CEOs perceive are cyber threats over regulation, terrorism, geopolitical uncertainty. The first thing I usually point out is that we continue to see uncertainty as a risk rather than the reality, which is common but it's a flaw. But what's more interesting is what they never put on the list. And I've been looking at this list for five years running now and it hasn't been on the list in five years. What's missing from this list? Right. They never put their own leadership as a strategic risk. And they should, because if you go back and you catalog corporate risk events, a lot of them are self-inflicted problems with leadership or employee conduct. So we tend to think of leadership in highly distorted terms. When it's going well, it's us, when things are going bad, it's the environment. This is one depiction of how I've come to speak about leadership. It's about where the science of medicine was when we were still doing lobotomies on people. I think that's about where our understanding of leadership is today. Just to give you another more popular reflection of this, this is a screenshot of a Google search of the word leadership, just sorted by images. And to me, this is a reflection of how we think of leadership. And it's not a very good reflection. This is my favorite, if only because it looks like my six-year-old son going to kindergarten. But I don't think it's an accurate portrayal of how we should be thinking about leadership. Across the course of our research, we had the opportunity to interview lots of very knowledgeable people about leadership. One of the first questions was always, how do you define leadership? It's not a simple question. There's actually a lot of disagreement about this. But the general consensus was something along these lines, that leadership starts with the leader, it's a process, and it's driven towards some well-defined result. You're trying to achieve something, usually through a system of followers. Leadership doesn't make much sense in a context of one person. And so this is how we came to depict the general notion of how people think about leadership if you just ask them, what does leadership mean to you? The other thing we had an opportunity to do is talk to some very prominent leaders about their experience with leadership, to include interviews with both Presidents Bush and Obama, which was an extraordinary opportunity. Literally, after eight years as president to ask, how has your perception of leadership changed and how do you think about it now? And I'll give you a vignette just in the interest of time from one of the two, and this one's from President Obama. In part because I was with him when this episode happened on his staff, and that was the raid on Bin Laden. And about a week after the raid, I traveled with him down to Fort Campbell, Kentucky, when he went down to meet with the team that did the raid. And he did an award ceremony and then he had a debrief of the operation, then we flew home that night. And I won't go into the details of that, but on the flight home that night I asked him, really trying to make small talk and just kind of chitchat a bit, what were your reflections on the day? What struck you? And his answers were interesting. None of them spoke about the operational dynamic. And in fact, one of his first answers was nobody then talked about who shot who, which is striking in hindsight now because so many books have been written and so forth. But one of the other things that was really interesting was that he focused on the team leader's leadership style. And in particular what he said was I was struck by the way the team leader did his debrief. And what he meant was the team leader when the floor was kind of handed over and it was his turn to basically give the debrief. All he did was say, Mr. President, my team will now debrief you. And that was it. And you can imagine why that's striking because who does that? Who doesn't own that accomplishment at least for 30 seconds or longer? Because you don't get an opportunity like that, but once in a lifetime if that. And that's why it was so striking is because it was an example of what we started with humble leadership or servant leadership. And leaders who lead like that we know are, as we've already said, rare. But they're very effective. They're effective because they celebrate the success of others. They put their team first, always. But if you catch up with that team leader, which I have done now, and you ask him, why did you lead like that? Why did you pick that as your leadership style? He doesn't say, oh, I read a book or I took a course or anything like that. What he says is, what choice did I have? How else do you lead a team like that? And I like that example because that along with countless others started to point us towards the reality of leadership, which is that it's often not in the leader, despite that that's how we think about it. Leadership is actually driven as much by the followers or the context, the surrounding context, as it is a choice the leader makes. And in this particular example, that leadership style was not selected by the leader, really, so much as it was selected by the system of followers. Because that system of followers demanded a certain style of leadership that was particular to them. In a different system of followers would have probably something different that they would demand. So, and this is kind of getting to the punchline of the book. This way we typically define leadership, we ended up calling a myth. That how we think of leadership or how we define leadership is basically wrong. And that we need to redefine leadership, not just now, but always, as something that's more a system. It's not a process driven by a leader, it's a property of a system. And that system includes leaders, but also followers in context. And that it is driven as much by the followers in the context as it is by the leader. And this is one of the fundamental conclusions of our book. We're not in the business of theorizing about leadership so much as practicing it, so very often we get asked, well, what does this mean when you're trying to do leadership? If you're an actual leader with an actual organization. And one of the ways we've come to speak of this is to stop doing this. In the 20th century, the metaphor for leadership could be analogous to being a grand chess master.  And a lot of us were raised with that idea of leadership. This is how we like to think about it, gardening. Because gardeners don't make plants grow, plants grow all by themselves. What the gardener does is cultivate that ecosystem so that they provide a place where plants can grow. So the bottom line idea here is, one, you can't make leadership prescriptive because it's contextual. But to the extent you're looking for a way to improve leadership, the first idea is to stop thinking of it as a process, directed by the leader. And start thinking of it as a system that the leader is a part of. So with that, we'll stop. I will thank you again for being here. But mostly I will thank Tresha for agreeing to moderate. And then ask her to join me on stage here, and we'll have a discussion, and then look forward to your Q&A. Thank you. Thank you again for being here and doing this, yeah. What a magnificent book I've read it. And I hope it sparks a national conversation about leadership. I do, too. We very much see that as one of the things that is now a great opportunity given where we sit. And given that the book is so broad and so general in thinking about kind of this institution of leadership. And that many of us are frankly, whether it's in our corporate lives, our organizational, professional lives, our political observations, a bit frustrated with leadership, that we actually hope it does elevate something of a conversation. And all you have to do is turn on the news and everything is about leadership, right? What are the metrics? Because if I watch Fox, I leave thinking Trump is a great leader. He's mobilized people. They feel very happy. He's very effective and he's not very humble. But if I turn on CNN, I feel like the world is about to end. So what would be the metrics and what would you say about the tone of today's leadership? Is it inspiring? Is it? Okay, okay. Sorry, there's a lot to add. Yeah, we gotta unpack that a little bit. So on the first question about the metrics, it is the holy grail of leadership studies. It really is. The brightest minds in leadership studies are all thinking about what is a real viable metric of leadership? How do you measure it? And what do we mean by effective? And how do we know who's going to be effective as a leader? Or when and why, more importantly, a leader is effective? And in some ways, that's why we think it's important to start with the definition, because your metric is going to come from how you define it. And in some ways, that's the point of the Lee example, is if you define leadership effectiveness as what a leader achieves or whether they achieve what they set out to achieve, we call many leaders great or effective who were well short of the mark, like Lee. So whether or not a leader achieves something really isn't a good metric. In many ways, and given the way we've defined leadership, we think of leadership as the ability to motivate, use the word inspire. And you do that by giving a group a sense of purpose, a sense of meaning, a sense of identity. And when we're really honest with ourselves about the history of quote unquote effective leaders, leaders who have been held up by history as being great or notable or sometimes popular, it isn't because they achieve something so much as they've made us feel a certain way about ourselves. They gave us a sense of identity. They gave us a sense of meaning. And for good reason, it's a very powerful force in leadership because it's very primal and it's very useful. Universal, all of us is walking around with that thing in us that wants to find that sense of purpose, that sense of identity. Political leadership's no different. And the real challenge is we talk about both a leader's values, but we also talk about the issues, right? And when we talk about the issues, we're talking about what we want done. We want a leader to do. We want them to raise taxes or lower taxes. And there's all sorts of leaders who say one thing and then do another. And a lot of the debate is focused on the metric of the issues and what the leader is going to do. I'm for this or I'm against that. I think a better metric is to get to the values. And what metric that is will be different in political leadership for every single one of us because it's going to be a reflection of what we decide we want in a leader. And it won't be issue-based because we actually don't know what the issue of tomorrow will be. We can say it's taxes, but it may be China or it may be the Middle East. We don't know what's around the corner. So the better hedge is to base the metric on values. Because that's got a better shelf life, really. And it's a better judge of how that leader will behave, even if we don't know what the issue is that they will be deciding on. And that's both very individual, very personal. And then as a collective, we can come together and have a discussion. Before we look at the leader or turn on the TV, we can just come together and have a discussion. What do we want in a leader? Can we come to agreement on who we are and therefore what we would want in a leader and make that the metric? And then go out and start watching TV and thinking about the leaders. Does the civilian world grow good leaders? I think you can say it's obvious that the military does. But do we do this in the civilian world? Well, your point that it's obvious that the military does is an interesting one. Because the military, I was at Gallup yesterday and Gallup's been doing polling on how Americans perceive credible institutions. And there's been a collapse in trust or perceived credibility of institutions across the American population. With one exception, a couple, but mostly the military. Firefighters are still pretty high, bankers are all time low, Congress is- But the military focuses on it as a point of education. You have to constantly train to be a leader, right? Right, and for that reason and other reasons that are just more fundamental. The military's often occasionally asked to go put themselves in harm's way in service to this country for a lot of good reasons we hold the military up in the pedestal. My point was only that it doesn't, because someone comes from the military, doesn't necessarily mean they're going to be a good leader. The three of us wrote an editorial in the Wall Street Journal a few weekends ago on this question of whether or not you should instinctively vote for a veteran and not surprisingly, we come down saying, a veteran has certain advantages in the realm of leadership. But again, vote for a veteran, if you will, as you would anybody else, right? That it's not the breed, it's the person and look at the values or whatever you're going to look at in that person and don't instinctively go to a veteran as a leader. Sorry, there's a little bit of a- Just remember, if somebody picks up the book, are they going to get a sense of how I become a great leader if I just read this book? Well, the book actually says it can't work that way. And books that do that sell very well. But there are traits in these leaders that you can glean. Right, but they won't transfer. Because you find a leader and you study them to death and you say, this leader had these seven things, these five things. And then you say, okay, therefore, and let's do this across, let's do this longitudinally across 20 or 80 or 100 leaders. Let's crunch the numbers and we'll say, I'm gonna write a book on the seven secrets or whatever of leadership, you will be proven wrong. Jim Collins is good to great was that kind of a book. And if you go back and you look at Jim Collins's organizations, they were great then, not all of them are so great now. Same problem with leadership. If you find the leader who has really, whether it's Steve Jobs at Apple, who failed at Apple the first time and didn't do so well at Pixar in between. And you, unfortunately, we don't have the ability to do this. But you were to lift up a leader like Steve Jobs that's high performing in this one place and time. And you say, this is a great CEO. We wanna turn around this company and you drop them in over here. Because it's a different company, it's a different context. They may not do as well. Particularly if they're gonna rely on what made them successful over here. And you see this in professional sports, winning coaches that have a great record here and they get transferred and can't replicate the formula of success. So it's the context, the charisma, the followers, the leader, everybody like one big family operating. It has to be a systems approach and that's the problem with it is that's not appealing. If you agree that that's the reality, it's not appealing to us because we like this to be simple and formulaic. One, because it's important, right? Leadership, none of this diminishes the importance of leadership. And because it's so important and because we have trouble keeping track of complex systems-based things, just because we're human, we want it to be simple, distilled, and formulaic. And that's why if I write a book that says these are the five things that make for a great leader, it will sell really well cuz that's what people want. But we're not convinced that that approach will work. And so to answer your question, if there's one thing a leader can do to be better as a leader to flip that around, it is to start to pay attention to the system and start to learn to modulate your approach as a leader based off the contextual realities of the system. And that's something you can do. That's a real skill. So it's not to say that leadership can't be taught. It's not to say leadership can't be learned. But it is to say we need to rethink how we teach and learn and practice leadership. Do you have a favorite character in the book? I do, this is one where the co-authors definitely disagree, which is a good thing. I was very partial to Albert Einstein, which is tough because who thinks of Albert Einstein as a leader? I mean, you think of him as a physicist, a genius, but if you think of a leader, particularly a thought leader, as being someone who fundamentally changes the way we think and has an impact on our lives, Albert Einstein is a leader by those measures. Cuz he, one, he revolutionized the field of physics in many ways. But two, he made a practical difference in our lives. Whether it's the GPS, all of us are carrying around on our phones, which is dependent upon much of his achievements or anything else. He really did have a big dent on a lot of our lives. And he did it in this very non-traditional way. He was literally the leader of almost nothing his whole life. In fact, when he was offered the presidency of Israel, he turned it down famously because he said, I'm not qualified for that. I think he just didn't want the job cuz he liked being a thinker, not a manager. So in some ways he defines the stereotype of a leader cuz he never led anything. He didn't really lead a big organization, never managed a huge group of people. And yet he still had this influence over this huge swath of us somehow. And so to think about where that influence came from and what it means for leadership with him and then his counterpart, Leonard Bernstein. To me, it was very interesting. And why is it that geniuses are so influential or captivating to us? The great leaders get a free pass or do we want them to be moral? And do we bring baggage in terms of our expectations of them? I mean, they definitely don't get a free pass. They get a lot of scrutiny, which is one reason people self-select from leadership is cuz they don't look forward to the scrutiny, particularly in this day and age where the digital environment, where the scrutiny and the intensity of the scrutiny has just gone way up. But in some ways they do get a free pass because we will look past leaders, some leaders with some in discretion for a variety of reasons. And the history of leadership is famous for this. And you can encounter all these leaders who actually had really good behavior, but really bad decisions and really bad results, like Lee. Cuz Lee was, it's hard to find instances in Lee's personal behavior, demeanor, disposition, that wasn't anything short of impeccable. Which is partly why he had such an amazing legacy. As Stan likes to say, if you were in this room, all of us would find him to be the most impression of forming person in the room. Like all of us would be struck by his demeanor. But at the same time, what he fought for and his record of results and frankly how he made decisions, the most important decision he made of his life was whether to accept Lincoln's offer to fight for the union or whether to stay with Virginia and fight for the Army of Northern Virginia. And he actually didn't make that decision. He said, before Virginia decided which way it was gonna go, he said, I will go whichever way Virginia goes. So he actually deferred the decision. And in some ways, we say leadership is all about making decisions. Well, Lee never made the most important decision of his life. But history has been so kind to him. Right, right. And in part, I think that's because of a historical explanation. The lost cause narrative and the reconciliation process after the war. That's a huge factor that's very particular to Lee's legacy. But beyond that, the fact that he had this kind of sterling reputation just because of the way he held himself and the way people looked at him, even physically. And that's one of the things that's really bewildering about how we perceive leaders is that physical appearances matter. And Lee benefited from that, I think. Good leaders, how do they make a difference just in day to day life? I mean, I live here in DC and I sometimes think like I wish the roads were nicer. The schools, it's 2018, the schools are horrible. I mean, why is leadership so important? Well, I think you touch on part of it. I think good leadership has to affect the day to day lives of the people in that system. And that should be part of the deal. And in fact, that in kind of modern Western leadership, that is the deal. Because all of us, particularly in political leadership, give up small amounts of either personal liberties or certain amount of our wealth and form of taxes. So that our leaders can do something with that, do some good. And the quid pro quo is that the potholes will go away, right? And if the potholes don't go away, we say, bad leader, throw them out. Get a new one who will promise to fill in the potholes and give them a chance to fill in the potholes. So I think at one level, there is this quid pro quo, particularly in politics, of the day to day lives of that system. Get better in whatever way that becomes aggregated and so forth. But at another level, particularly outside of politics, it's not about our day to day lives in the potholes. It's really about, and you mentioned it earlier as a form of inspiration. But it's about whether each one of us feels like we're part of something bigger than ourselves. Whether there is something in us that is awakened, either in terms of what we're a part of or why we are here. That feels bigger than us. And really effective leaders don't just fill in the potholes. They get their followers to feel one of those emotions, right? And it is an emotional thing. They do it in various ways. Not all of them good, frankly. But that's, I think, a better and a higher level definition of what we should expect and what they do. Is there a difference between leaders in government and leaders trying to make a profit in a business? Do you need different traits or is it? There is, of course, mostly in the constellation of stakeholders. So in fact, you can start to categorize it much further than that between privately held companies, publicly traded companies, non-governmental organizations, public sector organizations, and so forth. I think that one of the critical differences between private and public is much simpler. Many of the leadership ideas, I think, hold and transfer. The one that's very different is whether you're operating off of a budget or whether you're operating off of profit, right? And that's actually tough for private sector leaders, because while they're shareholders in a publicly traded example, demand profit. Most of us aren't motivated by how profitable our organizations are. We are, to some extent, because that's where our bonus comes from or that's where our compensation comes from. But a lot of the research suggests that while that stuff's important to us, it doesn't actually move mountains inside of us. And where public sector has an advantage is the fact that it's public service. And if you tap into a sense of service, like you have in a lot of government work, and non-governmental work as well, but like the work that's done here, you're tapping into something that's more fundamental than profit. And that's a key difference. And a lot of either nonprofit or public sector organizations struggle because they are operating off of a smaller budget and people aren't compensated as well and so forth. But what they have going for them that they can really leverage to their advantage is this sense of service that's kind of always in the background somewhere. What do you think is the most important takeaway of the book? What do you hope that people take from this? A fair question. Some ways we should either start or end there. The most important idea in the book is that we've misunderstood leadership in terms of what it is in the first instance as I covered in the slides. That our typical definition of way of thinking about leadership is misguided. And based off of the myth. And that it may be appealing to think of leadership in this kind of inaccurate way. But it's misguided in that it leads to a lot of frustration. And a lot of the frustration that we feel today is because we've bought into this inaccurate notion of what leadership is in the first instance. And that part of the solution of being less frustrated. And being more successful with the quote unquote practice of leadership. Is to reframe it as something that is about a system. And to create space in that system for the rest of the system, i.e. the followers, the context, everything other than the leader themselves. Excellent. Shall we open it up for questions? So if you would, we'll just wait for the mic so that everybody here will hear each other. But so that the folks out on the webcast can hear you as well. Yes, ma'am? My name is Jenna Rousseau. I'm a research associate at the Public International Law and Policy Group. I was wondering in your discussion of leadership whether you considered like the way that men and women have been socialized to understand leadership. And specifically in changing thinking towards more systems thinking. Personally, I feel like women have been more introduced to that idea earlier on in their personal education. So I was just curious about your thoughts on that. Yeah, that's a great question. It's an incredibly important question. And we actually do touch upon that in the book. Not just in our thinking about the canon of leadership being a patriarchal one, which it is, and our 13 leaders reflects that. I mean, it reflects the fact that historical record of leadership is imbalanced in that way. But more importantly, in a forward looking way, we talk about the fact that one of the very interesting findings in leadership studies is that companies or organizations with a better, less gender inequity, and i.e., a better gender balance, are higher performing. Just period. Is that because women are more humble? Well, that's the million dollar question, is why is that true? No, it's fairly well established that that is the case. So the more interesting debate and where it's less clear is why is that the case? What's the causal explanation for that? The most humorous slash cynical explanation I've heard for that is the bar for women is higher. So women have to be better to get to the same point. Therefore, organizations with more female leaders are gonna be do better because the bar is just higher, right? That's a very like direct straightforward explanation. More of the explanations or theories go to your point about the ways in which women, and I'm not gonna speculate on why women would lead differently, but that the way in which women have been either conditioned or taught or disposed to lead does lend itself to thinking more about the system. Whether it's having, the term it's frequently used is a sense of emotional intelligence, i.e., being sensitive to the needs of the system, needs of the followers, and whether that's something that conveys and manifests in that result where you get higher performance. So that's just the beginning of the discussion because how the two genders approach leadership is a whole bunch of different ways before you actually get to the leaders themselves. Before you get to that, you have to talk about how does the rest of the system think about them? And one of the classic examples there is that there are different standards and that what systems of followers expect and tolerate among male leaders is different than, broadly speaking, than it is for female leaders. And I'm not making a judgment on that. I'm just making a statement of an observation or I would say fact. And if that's a reality, then what does that say about either how men or women should lead differently? What does it say about which way you would approach it from either side? And then it gets into much more complex issues like how do male-dominated industries do with female leaders and vice versa and so forth. There's a million questions within just the gender aspect of leadership alone that would make for lifetimes of study and are well worth that effort because it's important to all of us. Great question. Thank you. Yes, sir. Thank you. My name is Adizafat. I'm working with the United Nations Development Program. I like the system approach that you said where the followers in the context is as important as the leaders drive. But I come from Pakistan and well, if you start following what the followers want and what the context requires, you will end up having populist leaders who will probably, in that part of the world, it's not too good to follow what the followers want and the context requires from you. Most of the unpopular leaders in our country are people who do not follow people's demands. So I just wanted to know if it's universal, this approach, or it's for the more evolved societies and culture. Yeah, fair question. I wouldn't make a huge distinction between the political leadership implications for Pakistan versus Western democracy. I mean, Imran Khan was just elected in Pakistan and hardly a career politician. For those of you who don't know who Imran Khan is, professional cricket, celebrity now. I mean, he's the Michael Jordan of cricket in Pakistan. And that's very telling, right, that we can elect or Pakistanis can elect a professional athlete or in the American context, a Hollywood movie star, Ronald Reagan, as an elected official is a very interesting statement about leadership. And the Pakistanis aren't nearly as subject to kind of the populist sentiment that's going through Europe and the US right now. And it's not just in the US. It's pretty widespread in Brexit and the UK and so forth. So populism is, yes, a form of thinking about giving more weight to the followers. But it doesn't have to be that way, right? And one could argue that the populism engine is being driven as much by the leaders as it is by the followers, right? There's a feedback loop there. And it's incumbent on both sides of that loop, I think, to step out of it and say, let's not define this about what we are not, what we are against, but let's define this in terms of what we are for or what we want for ourselves or how we define ourselves. And it is important for both sides to do that. But if it's driven from the leader down, then you're much more vulnerable to the misguided notions of one single individual, right? That system is much more vulnerable to imperfection when it comes down from the leader than it is if it's a system approach, because that's going to be more resilient, because now you're allowing for the fact that there can be a reverse form of accountability, where the followers will hold that leader accountable. So it's a fair point that a system-based approach can run ahead of itself in an adverse populist way, which isn't always good. But I don't know that it has to be that way. And frankly, there's a lot of that that's almost inherent in politics, because politics is as much a de-selective system as it is a selective system. In other words, we run against the status quo in hopes for something better that will replace it. And it's really hard to get out of that cycle when it starts running ahead of itself, because that's how in a system that becomes hugely populist, that's how people win, as they compete against the other side and then it just gets into a bad back and forth. Other questions? Yes, please. Thank you. Niza Farzakh, I'm a leadership trainer. Myself was at the Kennedy School. Right. I'm fascinated by your talk. And there are two themes I'm interested in your thoughts on. One is leadership, of course, in the service of others, but as enabling the others in dealing with uncertainty. Because definitely, if we're certain, then that's management, that's not leadership. Leadership is required when there is uncertainty. So how much of what you've seen has been in the context, that is, that the leader was a leader because they helped the group get better at dealing with uncertainty. The second prong or the second theme is distinguishing authority from leadership. That is, people could be in a position of authority, but that doesn't necessarily make them leaders. And sometimes the best leadership comes from people who are outside of their authority and they take on an active leadership role as an activity. So if you could speak to both of these themes. Thank you. Both great questions. Obviously, coming from someone who trains leadership at the Kennedy School, I would expect as much. Let me just take the second one first. Having influence without authority, as you suggested, is quite powerful. In many ways, it's more inspirational. Harriet Tubman, when she started rescuing slaves in the South, had no authority. And yet she made her list of leaders. And to the extent she ever gained any real authority, it was because she had done enough of these kind of audacious slave rescues that she became a symbolic leader of the abolition movement, which was looking for something that it could hold up as a symbol of that movement and galvanize and motivate and unify that movement. So a lot of influence without authority comes from appealing to those non-authoritative forms of influence, like being a symbol for something. And the best way to become a symbol for something is through your personal example and personal behavior, particularly if it's really far outlying and exceptional, like the case of a short African-American former slave by herself going south, risking enslavement to rescue first her relatives and then slaves. So you can have a lot of influence without authority just by capturing people's imagination through your personal example, i.e. becoming a symbol of something. How you transcend from personal example to being a symbol of something is a longer conversation. But it does generally involve some degree of exceptional behavior, either in terms of its consistency or its magnitude. For Lee, it was consistency. Like he never wavered from that impeccable demeanor. He got nicknamed the Marvel Man at West Point because everybody joked around that he was like a statue. He just was impeccable. And for him, it was the consistency that made him a personal example for others to try and emulate. Remind me the first part of the question. So the dealing with uncertainty. Oh, right. Uncertainty. It's more about name than other. So one of the truths that we find in leadership, which I find most fascinating and is very practical, even though it's complicated, is that effective leadership manifests in paradoxes. And the answer to the first discussion we had about the juxtaposition of humility versus confidence is to take both of them. And that truly effective leaders know how to be both humble and confident. Your question about uncertainty falls into the same paradox model, which is that really effective leaders can both be quite certain about the vision for their organization and quite open to where that organization is going to go. And that sounds like a contradiction or a paradox. It sounds like I said two things that were in contradiction. But that's precisely what a good leader does, is they are crystal clear about where that North Star is, but that they are very open to the idea that how you get there, or even maybe the need to change course, is going to be subject to where that organization needs to go. So there's a lot of, I think, particularly in this day and age, where competitiveness is more about your ability to face on certain environments than it is about crystal clear and prescriptive about what we need to do and where we need to go. And so in some ways it's about having that clear vision but then kind of keeping your hands off the system and letting the system respond to the dynamics of how it senses where that organization needs to go. And getting those both in balance and right is a tough needle to thread, but critical to being an effective leader. Holly in the back, right behind you. Hi, my name's Holly Fussell. My question is about nature versus nurture in terms of charisma and whether or not that you tackle that in the book and the features of the different personalities and whether you think those leaders had innate traits that got them to opportunities that developed further opportunities and drew more people or whether that charisma can be cultivated out of less raw natural resources in a given person. Yeah, great question. And the book does go into that. The really kind of generic version of that question is the born versus made debate. And in some ways that's supposed to be settled. If you go back through all of the twists and turns of leadership theory, it was more the case that we believe leaders were born and then about World War II era, mid 20th century, we shifted to saying no, no, no, leaders are made. And in some ways it's swung back to be about in the middle. And the reason it swung back to being in the middle is there's an indisputable dimension of leadership emergence. And I won't say effectiveness. And I say emergence because most of the research on this can't really talk about whether leaders are effective because that's highly subjective and difficult to measure to go to your metrics question. It's more about whether leaders emerge. And in the studies of leader, which is much easier to measure, in the studies of leader emergence, one of the things that's most striking is how a lot of the principal factors are innate. And something that most of us can't do much about. Number one predictor of whether someone's going to emerge as a leader. We've already covered it. Gender. Number two predictor of whether someone will emerge as a leader. This is harder to guess. Introvert or extrovert? Nope. Height. L. Yeah. So, why is it that people of, but you're- What about being an introvert or an extrovert? We've always heard that extrovert. You're right. And loosely associated in a lot of people's minds with quote unquote charisma. And all of us know the answer to this question because if I asked you to go find someone with charisma, you'd all be able to do it.  So there is something that we don't understand about why we're drawn to certain people. And it goes beyond height, of course. To your question about introversion versus extroversion. In some sense, we touched upon that when we said narcissists are overrepresented in senior leader positions. Extroverts do better in terms of leader emergence. Introverts tend to have higher performing organizations, but they're less well represented. The answer for the first part of that's obvious. Extroverts promote themselves. They stand up and say, give me the job. I'll take the promotion. You should promote me. Introverts don't do that as much. So extroverts tend to rise up and emerge as leaders for some ways, direct reasons related to them being extroverts or narcissists. But then once you compare not leader emergence, but leader effectiveness, you actually find that introverts, and to some extent organizations with more female leadership, do better because they're less authoritarian and they're better able to listen and process the needs of their system and their organization. That's one of the explanations among many. So it's a bit split on extroverts versus introverts, but lots of great introverts are super high achieving in this regard, but they have a harder time getting there, I guess. Great question, Holland. Yes, sir. I thank you very much, Ian for you at the Close Up Foundation. You mentioned earlier that when you were doing your own talk that you were considering Hitler as one of the leaders and Zarkowis up there and there are other people who you definitely, we would consider to be doing the wrong thing or leading in the wrong direction or maybe even evil, but can't deny that they are leaders. So I'm sort of interested in, when you look at leaders who, obviously no one themselves thinks of themselves as evil, but when you think of leaders that are leading people in a zealot cause or down a dark path, what is similar to other leaders they have and is there anything different about them? Yeah. In some ways, that's a difficult question to judge except in hindsight. And if you think about the examples that we tend to work with, their legacy has changed over time, right? I mean, when we were in the thick of it, a lot of Americans wanted to make peace with Hitler. They did not want to go to war with Hitler. And the political momentum in this country was actually what those who thought we should fight, Hitler would negatively call appeasement. And there's a complicated explanation, World War I and the reasons we got into World War I and the fatigue with that and so forth. But it took some course of history before Hitler became who Hitler is today. One, because we got the facts and the dust settled and we could see more clearly. But two, attitudes changed. And if you take today's notion of who Hitler is and how effective or ineffective Hitler was as a leader, even though we're all agreed about how good or bad he was, which is more of a moral judgment, we would have an interesting debate about whether he was effective or not because he did galvanize his country and then achieved some military progress after that galvanization, clearly marks of effectiveness in the way we typically define leadership. And we could have a more interesting debate about whether he was effective because he was pathological. And by the way, many very effective senior leaders, if we could give them a clinical diagnosis, which is hard, many of them would show up as pathological. In fact, there was a great study that suggests many former heads of state in the West have tendencies that are more outlying rather than more moderate and central. So there's a correlation between effectiveness and emergence and that as well. But really, your question's about the moral judgment. And that's why I think, you know, an intrusion I were discussing this a bit before we started, we can say effective leader, but that's not the same thing as good leader or even popular leader. Boss Tweed, who was corrupt as hell, right? A bad leader, he was immoral. He stole from the city a lot of money.  He won that election because he was so popular with his base and he had so much momentum in that popular support, they kind of looked past it, right? And so there's all these cases kind of with examples that are much milder than Hitler's, right? Where we have a very skewed view of leader-effective versus leader-morality. And we will side with leaders in our own interest in the past, in discursions. More common than I think we think we do. And it takes a long time for, generally for everybody who was involved to be dead plus about another 20 or 30 years before we have good perspective on that. And we can have an honest conversation about whether that was a good leader or not. This is one of the most difficult questions we're dealing with. Why leaders that we think are morally borderline can have popular support, whether it's, in whatever context you wanna approach that, is a very, very difficult but fascinating question. And that's probably an unsatisfying answer, but that's probably the best I can do given how difficult it is. Yeah, thanks for your question. Okay, time for maybe one more? One more, and then hopefully you can leave us on a happy note about leaders. Yeah, yeah, yeah, yeah, yeah. Yes, sir. Thanks a lot for this very broad discussion about leadership. My name's Dennis Willie. I'm an active duty army colonel and a military fellow here at New America this year. My question and comments are about the systemic or systems approach you took and that you effectively have elevated followers to be co-equal in the system. And I'd like for your thoughts, whether you had them or not, previous to publishing and writing, or if you have them now about the topic focusing on leaders and propagating this myth of leaders are more important than followers, even though the approach you take is that they're now co-equal. And whether or not you should see some future study about studying followers and characterizing followers in ways that help us understand the overall approach. Yeah, no, it's, there's a bit of irony because the Institute that I run has a number of, we have trainers, facilitators, PhDs in academics and so forth. Several of our people are very interested in this question of followership. There's books been written about it. I mean, it's an active question. And in many ways it's the question that emerges or is begged by the model. To go back a little bit, we say co-equal deliberately, right? It's actually a good start for leaders to think of themselves at the bottom and put followers at the top. That's what servant leadership says, right? Is that the leader's job is to serve and enable the followers and the followers are really the ones who make great things happen. That's servant leadership. The reason we did kind of a melding and put it as co-equal is because the thing servant leadership gets wrong is that we are drawn to models of heroic leadership. And that confident leaders, there is a place for confident leaders or even directed leaders, but not always, right? And so we wanted to create a model that would be more in sync with the reality that servant leadership is a great aspiration, but none of us actually shows up that way to take the Washington Cross and the Delaware example. Like there's something in us that really does want our leaders to be good and not put them at the bottom, but sometimes we want them to be at the top, but sometimes we want them to be at the bottom. And since we can't really make it one or the other, we tried to create a model that allows for that to be in balance. You know, the great thing about this idea of followership, which is probably not a great term because it, to know it's something I think it doesn't help with, is that it gives every single one of us agency, which is extraordinary when you think about it, right? That each one of us is a miracle waiting to happen. Really. That's our happy note. Yeah. I mean, and that's something for all of us to celebrate, whether it's the leader who gets it and goes, wow, I can move mountains with that, or whether it's us who just goes, man, what am I gonna do with that today? Recognizing individual level agency is a great place to start, and maybe a great place to end. Thank you for your question. Thank you. Thank you. Let me thank Tresha again and all of you for coming. And if you would like, I'd be happy to stick around and sign books if any of you have one or buy one. Thank you again.


Hello everybody, I'm Dr. Bohini Preeti. I'm doing my radiology residency from Babbar Mahavi Jane Hospital. My topic for presentation is Chromatic Spectrum of MRA CT imaging findings in Rhino-Arbiter Cerebral Mucor Microsis and post-COVID-19 patients. Co-authors are Dr. Praveen Kumar and Dr. Gnana Prakash. Mucor Microsis is a severe opportunistic fungal infection that results from a fungus of order mucarils. During second wave of COVID-19, significantly increased number of Rhino-Arbiter Cerebral Mucor Microsis were encountered. Because of its rapid spread and angiotinvasion, it has varied presentation among patients. Cross-sectional imaging has an important role in diagnosing cases of ROCM and also helps in assessing the spread of infection, staging of disease, prognostication and follow-up. With different clinical presentation, we reported various imaging findings from 37 patients with COVID-19 infection and invasive ROCM from our hospital. Risk factors, immunosuppression, corticosteroid administration and uncontrolled diabetes, pathogenesis, COVID-19 is a pro-coarchable state and there is incidence of thrombotic events. This pro-coarchable state forms ground for angiotinvasion leading to vessel thrombosis and dissemination of infection. Pathway of spread of ROCM can be direct spread or through pteripopalatin, FOSA, or through sphenoid sinus from mycelary sinus into the adjacent soft tissue or from the ithomoid sinus into the orbital apex and into the cavernous sinus. We have categorized our patients based on the following classification. On average, SG proposed four state system to determine the anatomical extent and severity of ROCM. Stage one, disease was limited to nasal mucosa, stage two, extended into para nasal sinuses, stage three, involving the orbit and stage four, involvement of the central nervous system. We have retrospectively reviewed the cases of ROCM with the history of COVID-19 infection in the recent past. Most of the patients presented with facial pain and facial numbness, orbital pain and periorbital swelling, conjunctival suffusion, diminution of vision to complete of Thalmuclecia blindness, headache and stroke like features.  CT imaging were performed using 16 slice GE Optima 540 CT scanner.  Coming to imaging interpretation in our patients, coronal and axial stir sequences showed polyporeal mucosal thickening of the right maxillary sinus and there was involvement of the right terbynate.  Another patient showed polyporeal mucosal thickening involving the right maxillary sinus and there was involvement of the right cheek showing edematous changes. And on post contrast there was non enhancement of the mucosal of the right maxillary sinus with the peri sinus fat strand. This patient showed the imaging findings of polyporeal mucosal thickening involving the bilateral maxillary sinus and on post drop there was peripheral enhancement with the central non-enhancing area. And on corresponding CT image showed bony erosions of the maxillary sinus, walls of the maxillary sinus involving the posterior wall, medial wall and edges in nasal veins. This was a post drop patient on the left side with a recurrence of infection on the right side showing polyporeal mucosal thickening in the right maxillary sinus and the disease was seen extending into the bilateral etymol sinus. On post contrast there was peripheral enhancement with the central non-enhancing area. This was also a post drop patient came with recurrence of infection on the right side. On imaging there was polyporeal mucosal thickening of the right maxillary sinus. On post contrast there was evidence of involvement of the extracellular compartment of the inferior wall of the orbit and inferior rectus muscle. A corresponding section of the CT image showed the areas of bony erosion involving the walls of the maxillary sinus. This patient showed involvement of all the sinuses and there was a fat stranding noted in the retro orbital region of the left, retro orbital region of left orbit. On post contrast there was heterogeneous enhancement seen on the left orbit. This was also a stage 3 where orbital involvement was seen. This patient showed involvement of all the sinuses and left maxillary sinus showed areas of necrosis and areas of non enhancement seen in the mucosal of the left maxillary sinus. And there was area of necrosis noted in the medial wall of the orbit. Areas of bony erosion noted involving the orbital walls and facial bones involving the frontal psychomatic rib reform. Coming to stage 4 intrapranial extension. This was a post-op patient presented with the post-op patient now presented with recurrence of symptoms involving the involvement of residual sinuses. And now the disease was seen extending into the basic frontal region bilaterally. On post contrast there was peripheral enhancement of the lesion and similar lesion was also seen in the right ganglia capsular region. This patient had undergone stereotactic brain biopsy and abscess drainage was done which showed the fungal elements and following the procedure there was resolution of the lesion. And this was the first patient encountered at a hospital with the muper microsus now presented with left sided symptoms. Now on imaging there was extensive debulking done on the left side and DWI showed peripheral diffusion restriction and on post contrast there was peripheral enhancement indicating left temporal lobe abscess. This patient was also a post-op case came with recurrence of infection involving the spinoid sinus and the disease was seen extending into the cavernous sinus. There was a non-visualization of cavernous segment of the right internal carotid artery indicating internal carotid artery thrombosis. The same patient had also involvement of the skull base showing areas of bony erosions involving the clivus part foramen of skull base and most like mostly involving the right midiscranial fossa. This was also a post-op case came with recurrence of recurrence in the spinoid sinus and disease was also seen extending involving the roof of the right orbit and adjacent temporal and infertile temporal fossa. And disease was also seen involving the meninges there was meninges thickening and there was an axis in the right temporal lobe. On CT there was involvement of the frontal bone and spinoid sinus. This was also showing intracranial extension. This patient presented with stroke-like symptoms. She presented with a weakness on the right side. On T2 image there was hyperintensilation seen in the left thalamid area which showed blooming on GRE and peripheral diffusion restriction on DWI. Mild peripheral enhancement was noted in the post-contrast images. She had undergone stereotactic brain biopsy which turned out to be an abscess and that abscess was drained and specimens showed the elements of fungal hyphae. Following a post-procedure showed the resolution of the lesion. And another patient showed involvement of the skull base where the glibus was involved and most of the skull base including the middle cranial fossa was involved. In post-contrast there was heterogeneous enhancement of the glibus region. This patient showed evidence of an sinus involvement and there was involvement of the right orbit with the mild proctorosis and right cheek was also involved. And there was an area of infarct noted in the right middle cerebral artery territory with a mild mid-lineship noted. On microscopy, KOH Mountain HNA staining showed broad aseptic fungal hyphae that is a muper microsus. Now, Sino-Nezer involvement, maxillary sinus was involved in 32 patients, etymor sinus 19, frontal sinus 13, sphenoid sinus 8 patients showed the involvement of sphenoid sinus. Orbital involvement, orbital wall involvement was seen in 13 patients, extraconal intraconal compartment was seen in 8 patients, proctosis was seen in 9 patients. Roof and floor of the maxilla was seen in 8 patients, alveolar process of the maxilla was seen in 8 patients, ibomactic bone involved in 5 patients, clivus was involved in 3 patients. Meningial thickening, bilateral frontotemporal area was involved in 4 patients, bilateral frontotemporal, sylvian fissure was involved in 2 patients, thalamic lesion was involved in 2 patients and frontal lobesion was seen in 3 patients, cavernous sinus involvement was seen in 4 patients. I would like to conclude by saying that most of our patients presented with involvement of the paramesal sinuses extending to orbits and cranial cavity in few cases. While evaluating post-COVID-19 patients, high index of suspicion must be made for muper microsus and relevant MRD protocol should be followed. Therefore, it plays a major role in the earlier diagnosis of infection and extent of involvement. These are my references. Thank you.


Difference between should, could, and would from espressoenglish.net Use should and shouldn't for advice and suggestions. For example, I have a really bad headache. You should go to the doctor. I need to lose some weight. Well, you shouldn't eat so much fast food. I had a fight with my best friend. What should I do? I think you should call her and say you're sorry. Could and couldn't are the past forms of can and can't. Use them for ability in the past. For example, when I was younger I could run a mile in seven minutes. Yesterday I couldn't find my wallet anywhere. This morning I found it on top of the fridge. Last year John couldn't speak English very well, but he's improved a lot recently. You can also use could for possibilities in the future. For example, how are we going to get from the airport to the hotel? Well, we could take the bus. If it's really late at night, we could take a taxi instead. Finally, you can use could to make polite requests. Could you open the window? Could you turn down the TV? Could you make ten copies of this report, please? Could you lend me your pen? Use would and wouldn't for unreal, unlikely or imaginary situations. For example, if I were president of the country I would make a lot of changes. If you had called me and told me you weren't coming I wouldn't have wasted an hour waiting for you. Would is often shortened to apostrophe D. If I were president I'd make a lot of changes. You can use the phrase would you like to make polite offers. Would you like anything to drink? We're going to the park this weekend. Would you like to join us? Finally, never use to after should, could or would. You shouldn't smoke. We could order pizza tonight. I would buy a car if I had the money. Visit www.espressoenglish.net for more English tips. If you like this video, please share.


What's up? How are you guys today? Some of you may have noticed the change in decor and a few unfortunate circumstances have led to me basically having to find an apartment within several days and move all my stuff out and You know that combined with the lawsuits the legal stuff me getting you know kicked out of my warehouse for my business It's just more work on top of more work on top of more work. So I'm still trying to Keep up with everything guys answer all your emails related to the businesses. I need to get back on some sort of track for the YouTube schedule because Really it seems like almost everyone is against me at this point But I'm here to show you guys how I am still attempting to stay healthy Despite everything going on and it's been difficult because I haven't had a kitchen haven't had my food So today is Wednesday on Monday and Tuesday Actually did like I didn't eat all day and I went down to some restaurants in the city and I just didn't feel well The first time the food was actually decent quality. I just had a little too much scotch and the second day I Until restaurant and the food wasn't that great, you know the rice was made with a lot of fluoride and stuff So I'm just trying to get back into like the quality organic Good water and just feeling better. So we have the fire roast prime rib from Frankie Strange meat on an organic baguette that I get from It's a bakery meal few they make organic. I'm sure the water is not high quality, but we've spoken about that before That's a big source of starch and protein. I have two organic Fuji apples that I chopped up We have the potato chips which will be delivered either this week or early next week on Frankies free-range foods. We sold a few dozen bags of this already But this is basically organic potatoes Organic coconut oil a little bit of salt nothing else highest quality chips that will ever exist on the market I'm sure Someone else is gonna come out with them in about two weeks after I start selling them We have some pineapple water kefir here. We have some water kefir grains Some of the dessert cookie bars, which we'll talk about later and I have my mastic gum now I would have probably been fine on Monday and yesterday if I was taking the mastic gum and some water Kiefer but I didn't I just like went down to the restaurants ate whatever I want drank whatever I wanted You know the mastic would have probably been enough to prevent it and the water kefir would have helped a lot as well But I haven't eaten all day today. It's already getting close to dinner time. So So for those of you that tried the first batch of chips, these are excellent But the new ones are gonna be even better. We're switching the type of potato and changing the cooking time and temperature So I guess I should explain each individual component and why I'm consuming it So the bread the starch is going to kind of soak toxins from the liver Feed the gut bacteria. It tastes good. It's calorically dense. So I can help kind of maintain my weight The red meat you guys know We've covered it basically in almost every video on this YouTube channel Lean grass-fed beef tends to be the healthiest option that really most people have access to once you start deviating to other sources of meat There's so many issues with it. Thank you Frank. You see range meat. We do have High-quality pork chicken and beef and eggs, but normally speaking like if you go into a supermarket Even with all those high-quality options beef is almost always the safest bet from an Allergen perspective from the B vitamins the protein and taste too.  They're using them, but These really help, you know me prevent getting migraine headaches because of my liver damage. I'm sensitive to Wi-Fi. I Think the electrolyte content really plays a big role here so you have similar starch profiles between the bread and the potatoes although they're pretty different and then the apples Cover the rest of the sugar profile. So your body can only produce so much of each enzyme and can only digest So much of each thing the sugar is adding another carbohydrate component that your body can then utilize To digest and it's high water high volume high gut motility The vegan cookies are just really really dense calories coconut milk based white flour based white sugar, so The banana rice crisp bars in some case. I'll have those instead or if I'm really hungry I'll have this but because these are high on sugar which the water keeper eats It's kind of an extra gut bacteria thing, but honestly, this meal could really do without these Mastic gum keeps food out of the stomach and and gets digestion moving and of course we have our water keeper grains and our water keeper Two most powerful and effective probiotics that you can really have I got the pineapple today It's not too carbonated because I haven't had the bottle sealed for a day or two, but it should still taste pretty good So we'll take maybe a tablespoon of the water keeper grains and although I've gone over it before I need to say it more often a Lot of you guys are really really against carbohydrates and sugar But in the context of liver damage and taking digestive stress off the body Carbohydrate and sugars are the main macro nutrient that your gut bacteria can eat the yeast can eat So when I look at this meal, I'm seeing okay potatoes Apples bread can all be digested by the bacteria in this water keeper turn it to be vitamins turn it to nutrients, but The protein has to be broken down by the body's enzyme system. So Little more stressful if you put a lot of protein in the meal, you know, this is a big meal So it's probably I'm gonna eat today mainly because of How much stuff I have to do? I've never moved before in my life and like Before I didn't have time to have fun or do things I wanted to do now I'm like all day. I have to be doing something between unpacking the stuff and organizing things and cleaning but Hopefully in a week or two it settles down a bit I'm a little worried though. Although I found a nice spot, you know, it is a little expensive and I Think they're trying to sell it. So hopefully I can stay here until I have to go to PA or something But because then if I have to move two times, I might actually disappear to a beach in Mexico Maybe if I stick this out long enough, they'll send me like an Amish princess And I'll just throw a potato sack on our head and film only fans or something That seems like a pretty good fucking plan So I'd maybe have the chips and most of the sandwich and I always go by my appetite so When I feel like I don't want any more of these sandwich or chips I just Move on to dessert some of the best apples I've tried whole foods is getting these organic Fuji apples from New Zealand and Most of them are pretty good. A few of them tasted like candy. It was crazy Maybe we'll do an apartment tour next week Although I don't have much to show you guys because I don't own furniture Anyway, we're wrapping up dessert here with Titomi's very vegan cookies and the reason for two names is because as soon as it told me sues me I can just switch to very vegan Anyway, these are minimally inflammatory chocolate chip cookies Pretty good. Very good as much as I like joking around guys every single product I make Is because it was something I was making for myself and didn't exist in the supermarket so So depending on how fast your metabolism is and how active you are That would dictate whether you want something like these vegan cookie bars or our organic banana rice crisp bar because When a food is super high quality You will always be healthy But if it's really really dense This is something that you could kind of use to put on healthy weight whereas if you you're prone to putting on weight easily then you want to stick to the more natural foods like the apples the potato chips the Organic rice crisp bars. Hey if you're trying to gain healthy weight Adding a few of these to your diet every day is 100% by far the healthiest healthy healthiest possible way to ever do that because People that typically can't gain weight need to use very dense foods like this like even our Organic banana rice crisp bar. It's dense, but it's very satiating. So you can't really eat a lot of it This is kind of hyper palatable is very calorically dense and You know four or five of these today a lot of calories now honestly, I wasn't super hungry, but These cookie bars are so good.  I will take a vitamin B1 supplement because Those specific carbohydrates can deplete B1 when they're digested That's also why I take Vitamin C and magnesium in the morning those are more nutrients that Required for processing large amounts of carbohydrates almost forgot We have our mastic um I'll take about half a teaspoon Anyway, thank you guys for joining me. Maybe if you continue to support my businesses I can afford to buy some furniture not a $20 table from Target, but Check out Frankie syringe meat calm or we have the fire roast ribeye and all high quality animal foods And a lot of the stuff you guys saw today will be on Frankie's free range foods calm potato chips Look towards the end of the week and early next week And we're also going to restock the water kefir and water key for grains So as usual if you guys could please drop a like on the video leave a comment down below Subscribe so that YouTube can unsubscribe you next week and we should check that notification But also they don't notify you of my videos. Thanks for joining guys, and I'll see you for tomorrow You


To me the core of the question goes into this, you know, how to reach God and I know there are many different methodologies in many ways including a lot of, we could say, new age or new thought ways which is called affirmations where you affirm, affirm, affirm, affirm. What I like about the course and what I've come to discover in my own life is the course is very much like the Eastern teachings and Eastern philosophies which is more of neti-neti, not this, not that. Or it's more like the thing of like you've got a beautiful piece of a big hunk of marble and then Michelangelo comes along and takes away a lot of the marble and everyone goes whoa to what's left. I think it's that way with truth that, you know, Jesus says you do not have to seek for what is true but you do have to seek for what is false, that it's about removing the obstacles to the awareness of love's presence. So we're not trying to teach love and we're not trying to teach light and we're not trying to teach, we could say, abstraction. What we're trying to do and the whole focus of curriculum on planet earth or we could say in awakening is removing everything that's not it. And that's where faith comes in because, you know, it's like to continue on towards something that is not, you know, people work with a course and they maybe don't have an experience of the vision of Christ. They see the words in the book, vision of Christ, they go oh that sounds really important and good but the book is really aimed at forgiveness, at removing everything else and just to even continue on on the journey where you're feeling things are being undone and dismantled and taken away but it's quite intense to the ego too as well. It takes faith to even continue on to have all the marble removed, so to speak, to see what's left. So I came to a point in my life where I thought wow truth is approached through negation. You basically negate everything that isn't truth and what you left with is the I am-ness of the purity of truth. Now reason is something that is very important in philosophy and very important in science and what I liked about the course was the course did not negate reason. In fact Jesus would even say reason would tell you. He would start off a sentence and use reason as synonymous to the Holy Spirit. So for anybody who's coming from a scientific or a philosophical thing he's actually using reason in the course as synonymous with the Holy Spirit. So he's not negating it at all but he's saying reason, logic, that anybody who knows logic if you know the basic premises that if the premise is true and this premise is true then this is true, basically that you have to have true premises to reach a true logical conclusion, a summation. And basically the ego has false premises and then your premises you reach in a logical manner from following these false premises is a false conclusion. Whereas the course is saying no, spirit is real, your reality is only spirit and hence when you wake up your final conclusion will be that you are one with God which is what Jesus said I and the Father are one. You will end up in a logically in the same place if your premises are correct. So the Holy Spirit operates from an entirely different set of premises and the ego's logic is consistent but its premises are false and the Holy Spirit's logic is consistent but its premises are true and you will get very different outcomes logically from different premises. So that's why when I talk to scientists and philosophers and they will say where does reason fit into spirituality? Where does reason fit into religion? I say it fits in perfectly, I've got a book here called The Course in Miracles that actually is a reflection that reason is part of this and reason and faith are not seen as opposites in that way. They both take you to the same experience and that's important I think to know. Now the other thing about faith is that faith is not something that's quantifiable so a lot of times when people talk about faith they talk about I wish I had more faith, wish I had more faith, not in the Course. The Course says you can be faithful or faithfulness or faithlessness but you do have faith make no mistake about that.  The question really is what have you invested your faith in just like with prayer, prayers are answered, be careful what you pray for you may get it, oh yeah it's be careful about what you're praying for because prayer, the power of prayer is undeniable and faith, the power of faith is undeniable but it's really what am I investing the faith in? So that can sound still kind of abstract so let's get more specific. Lesson 50, lesson 76, I'm 50 and I'm sustained by the love of God lesson 76 in the workbook I am under no laws but God's. In those two lessons he gets very specific about pills, money, protective clothing, being liked, knowing the right people, medicine, the laws of medicine, the laws of economics. He gets into very specific things and he would say all of these are things that are inventions of the ego so if you have your faith in all of these things you don't really know the love of God but it will sustain you in every circumstance if you tap into it so so that's a good example of when you have faith even in in medicine and the laws of friendship and the laws of economics and you know all those things that he mentions that's putting your faith in the thought system of the ego and when you see that that the love of God trusting in the Holy Spirit will say is the thing that you can put all of your investment in if you put all of your faith energy just in the Holy Spirit Jesus is saying that will take you home to the kingdom of heaven but it takes it it's a full investment you know they warned us don't put all your eggs in one basket it once says Jesus is saying you can put all of your eggs in the Holy Spirit's basket because the Holy Spirit is speaking for your true self and he will take you back to the kingdom of heaven so you see how it's just really starting to get really clear on what he's teaching us away from these old ideas of oh if I only had more faith my life would be a lot better as if it's a more or less thing and it's not really a more or less it's more of what is it for


The Institute's president, Ken Okbara, says the donation is to the School of Business Studies for the advancement of the study of banking and finance in the country. Members of the Chartered Institute of Bankers of Nigeria were in Nassarawa State on Wednesday to commission the 160-capacity state-in-hall. Present at the event were the governor of the state and officials of the state government, traditional rulers, members of state chapter on the Chartered Institute of Bankers of Nigeria as well as other dignitaries. President of the Institute, Ken Okbara, while commissioning the edifice, said the banking hall will serve as a meeting port, melting port for the training and development of future bankers on contemporary banking technique. This edifice will be known and called the CIBN Bankers Hall. It will serve as the melting port for the training and development of future ready bankers. The facility is a 160-seater lecture theater, fully furnished and equipped with ultra-modern facilities. I do not have doubt that this structure will serve as an important tool in delivery of high-quality education to young or coming bankers. I therefore would like to see this opportunity to urge the students who are the ultimate beneficiaries to use the facility responsibly so that it can serve successive generations. I also want to appeal to the management to give priority attention to maintenance of this beautiful edifice so that it can return its functional ability and aesthetic value. In his response, Director Alhassan Abdul-Lahi loaded initiative stressing that infrastructure has been a major challenge for the institution as he called on other professional bodies to follow suit. In other words, the infrastructure is among the major challenges in this institution due to continuous increase in staff and students' population. As such, this project will surely assist in addressing some of our major challenges. On behalf of the entire community of the federal protected missile, I therefore wish to wholeheartedly express our profound appreciation and grant you to the Council and management of CIBN for contributing generously towards the development of this great project, the great protagonist. This beautiful edifice is strategically located at the center of our campus to secure to the world what CIBN has done for us. It is our firm belief that this project will certainly caution the effect of our infrastructure needs and further provide conducive environment for teaching and learning especially in the areas of banking and finance. Responding to the gesture from CIBN, sub-dean in the department says the project is a necessity for the study of banking and finance, a position supported also by the representative of the students who said that the students have for long yearned for such a project. The School of Business saw the not doubt stand tall in the midst of other schools within the prestigious institution. The federal protected missile is an important project. Indeed, the project becomes a necessity as well as a plus, an instrument of efficiency to the staff and students of banking and finance department and the ATIA protected community in general. I want to say a big thank you to the CIBN for this laudable legacy project for the honor repeated on us. This project is one of its kind and it has been our yearning and aspiration to have a befitting lecture hall well equipped and free from distraction. Today, our yearning and aspiration has come to a realization through the donation of this bankers hall. We promise to handle these facilities with care and ensure proper maintenance from time to time. Hello, hope you enjoyed the news. Please do subscribe to our YouTube channel and don't forget to hit the notification button so you get notified about fresh news updates.