Is There a House in the Doctor? – Diagnosis and the Work of Business Coaches/Consultants


Last night was the end – Everybody Dies.  I have been a fan of Dr. Gregory House for a long time, and the series ended very well.  It felt “right.”

If you’ve never watched House, you won’t know that he was driven by the challenge of “solving the puzzle.”  He was the preeminent puzzle solver.  As fictional head of Diagnostic Medicine at Princeton-Plainsboro Teaching Hospital, he got the cases that no one else could solve.  He would only take the case if it was “interesting.”  If the case was too easy to solve, he would just cast it off to another, “lesser” doctor.  (And, yes, he cared more about the puzzle than the actual patientMaybe).  He constantly worked in collaboration with his team — and, a time or two when the team was not available, he would recruit anyone, including the janitor, to listen to him think out loud.  And though he was something of a world class jerk (“ass” is what Wilson called him in his last episode), he was also a world-class observer, and listener.  Not necessarily an empathetic listener, just a thorough listener.

The show was prompted by Lisa Sanders, the doctor/author who inspired the series.  Here is a key paragraph as she reflected on  the experience (from the Daily Beast, ‘House’ Finale: Interview With Doctor Lisa Sanders):

There’s this meeting that happens every day in every teaching hospital in the country. It’s either called “resident report” or “morning report” and in it, internists in training and experienced internists go to this one room every day, and one or two patients are presented, and you walk your way through this mystery. When I went to that meeting, in my third year of medical school, I don’t even remember what the case was, but I remember thinking, My god, these are doctors acting like Sherlock Holmes, doctors as detectives. I recognized this and it changed my understanding of medicine profoundly.

The important task is this:  Finding the problem.  It really does come before you can find a solution.  (And, sometimes, there is no solution to be found).

One business consultant/coach that I know boils his approach down to this:  “I find the point of the most pain in a company, and then I go to work.”  In other words, diagnosis before solution.  He works like Dr.. House.

I have read a lot of business books.  And plenty of them say that there are a lot of “broken” companies out there, a lot of “sick” companies.  They are sick from what they don’t do, as well as what they do.

And so many are in denial!

“let’s think about what you can do to become an enemy of entropy. First, you have to protect yourself against denial.”  (Gary Hamel, What Matters Now).

Dr. Gregory House, hard at work

Many of the minutes in many of the House episodes showed Dr. House just sitting, staring into space, throwing his ball against the wall, tapping or twirling his cane, as he thought.  I think it was the best job I have ever seen in a movie or tv show capturing the “work” of thinking.  Make no mistake: thinking, done by the right thinker, is incredibly valuable work.

Here’s my thought for your company, and mine.  You may be very sick.  Or, you may be in good health, but there could be troubles coming your way.  You may be too close to see your own illness, or your own vulnerabilities.  But if you don’t diagnose the problem, you may not survive when it hits with full force.  So, make sure that someone will spend some time doing the very needed, critical diagnostic work.  You may have to hire the right, brilliant doctor — not every doctor loves the “puzzle.”  But unless your case is an easy one, you may have to find someone who loves the complexity of your puzzle, someone who loves the challenge.

You may have to find a doctor with a House inside of him/her.

Oh – and I’m really going to miss Dr. Gregory House.

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