The Mosaic Principle

PART 1

WHY BUILD A BROADER LIFE AND CAREER?

1

THE SAINT AND THE SINNER

The Six Dimensions of the Mosaic Principle

Our age reveres the specialist, but humans are natural polymaths at our best when we turn our minds to many things. We can’t all be geniuses. But we can and still do all indulge in polymathic activity. Life itself is various—you may need many skills to live it.

—Robert Twigger, “Master of Many Trades”

Toussaint Louverture Airport, Port-au-Prince, Haiti—July 12, 2010 Once you get past the jury-rigged check-in desks and the security screens that seem to be held together by chewing gum and string, this could be any regional airport in the United States or Europe. The departures terminal is in fairly good condition—and the sight of a couple of American Airlines 757s waiting to be boarded adds to the impression of familiar normality. Several times a month I travel through airports much like this one in various places around the world.

The passengers, waiting patiently for their flights, also look quite normal—although there seems to be an especially high proportion of travelers very obviously in organized groups, wearing the same customized and colorful T-shirts that announce their affiliation with the South Western Louisiana Volunteers or St. Thomas’ Episcopal Church, Tampa. The agonizingly slow late-afternoon journey to the airport, through streets crammed with rush-hour traffic and bustling pedestrians, was also tediously familiar—the kind of physical and emotional endurance test you have to put up with in most major cities these days.

It’s only when you look out beyond the departures terminal that you see this airport is very different. The tarmac on the airport apron has large gaping cracks and craters, around which arriving and departing planes are forced to navigate. Although the departures terminal is in fairly good shape, the arrivals terminal certainly is not. Indeed the building where passengers used to disembark is now reduced to a barely organized heap of rubble. In its place, arriving passengers are shepherded into a makeshift warehouse on the outer edges of the airport. There—in the absence of any meaningful ventilation—they endure one-hundred-degree heat and 90 percent humidity as they wait to be processed through slow-moving immigration lines and to reclaim their luggage from barely functional conveyor belts. Then, already bathed in sweat and gasping for fresh air, they are funneled out through a narrow walkway and into the clamoring hordes of awaiting family members, cab drivers, and insistent hustlers.

I have been traveling to this airport—the main entry point to the island nation of Haiti—with a few of my colleagues every week or so since February. The conditions have perceptibly improved on each visit—but it is still very evident that this is a major disaster zone. Exactly six months ago, on January 12, 2010, Haiti suffered one of the most catastrophic earthquakes in history—7.0 on the Richter scale, with an epicenter near the town of Leogane, approximately sixteen miles west of the capital, Port-au-Prince. Nobody knows the exact death toll—but estimates range between 150,000 and 250,000. Everywhere you go in Port-au-Prince, you see piles of rubble and wholly or partially destroyed buildings—including the National Assembly building, the National Cathedral, and the UN Mission. This morning I attended the six-month anniversary ceremony on the grounds of the Presidential Palace, which looks like a pulverized wedding cake, quickly becoming the iconic visual image of the 2010 earthquake all around the world.

I am making slow progress walking through the departures lounge—and the reason is the person with whom I am walking. Dressed in an unremarkable jacket, black jeans, and black T-shirt, he nevertheless seems to be instantly recognizable to all the Haitian citizens packed into the airport buildings. Every few steps he stops to greet somebody he knows, sometimes modestly to accept their gratitude, sometimes to respond to a request or suggestion. One person wants him to take a letter with him to the United States; another has just seen his own doctor and wants a second opinion; yet another wants to discuss how to transform this ailing nation’s infrastructure and social services. Each of them wants the attention of the man they call “Dokte Paul.” He listens to each of them patiently and cheerfully, and then heads quietly toward our plane.

Dokte Paul’s full name is Dr. Paul Farmer—and he is the primary reason I am in Haiti, along with the earthquake and former president Bill Clinton. Officially, Farmer is Clinton’s deputy as UN special envoy to Haiti; informally he is Haiti’s de facto surgeon general, as he has been for much of the past twenty-five years. Clinton and Farmer are the pro bono clients who have engaged my colleagues and me on a program of institutional reconstruction and recovery, as Haiti seeks haltingly to deal with yet another catastrophe in its two-hundred-year history of social, political, and economic strife—interspersed with unpredictable natural disasters. It is one of the most challenging and exhausting professional experiences of my career—and also quite nerve-wracking, because the seismic aftershocks have only just begun to fade, and our team is required to travel everywhere with armed security, because Port-au-Prince is still essentially lawless. But somehow none of this matters when you’re working with Paul Farmer.

Farmer is one of those people who has made broad and imaginative choices about how he wants to live his life and affect those of others—choices that have taken him well beyond the conventional tramlines of his chosen profession. By doing so, he has built a remarkable life and career—a broad life, fully lived; a life of meaning, consequence, and profound fulfilment.

He started along this path of breadth and diversity in college when he chose to study both medicine and anthropology. He is now a professor of both disciplines at Harvard Medical School, as well as an attending physician at Brigham & Women’s Hospital in Boston. But that is what he does for only half the year. The rest he spends with the nonprofit organization Partners in Health (PIH), which he and some friends founded in 1987 when he graduated from medical school; and he spends a high proportion of that time here in Haiti.

When he was accepted by the Brigham & Women’s Hospital, he learned that a Brigham resident could get permission to pursue another interest. So he split his residency with a colleague, so that he could spend half his time in Boston and half his time in Haiti. And throughout his increasingly distinctive career, he has continued this practice of splitting his time across a broad and complex portfolio of interests.

PIH has enabled him to pursue the obsession he has had with Haiti since his undergraduate days at Duke University, where he started working with Haitian immigrants in the North Carolina tobacco plantations. That was also when he began studying liberation theology, whose foundational concept is “the preferential option for the poor”—choosing to focus his medical studies on epidemic diseases because as he later observed, “any serious examination of epidemic diseases has always shown that microbes also make a preferential option for the poor.” PIH has focused on creating community-focused health-care programs—first in Haiti, and then in eleven other countries including Peru, Rwanda, and Russia. It is now a substantial social enterprise, which, with the backing of the Clinton Foundation and other philanthropists, employs more than 13,000 people and caters to many more patients.

Farmer and his team started PIH with a simple objective: “Let’s see what we can do in one little place.” As they got started in that one little place—the rural enclave of Cange in Haiti—Paul told his colleagues, “We have to think of public health in the broadest terms possible.” The single health-care clinic—called Zanmi Lasante—that Paul and his friends started in Cange more than twenty years ago now plays a much broader role in its community. It is a freestanding system of public health and social services that sends more than 9,000 students to school each year, employs more than 3,000 Haitians, and feeds many thousands of people every day.

That is a lot of work for a community organization to do—but it’s not all that Zanmi Lasante has done. It has also built hundreds of houses for the poorest patients, cleaned up water supplies, and installed water filters in some people’s homes. And PIH’s influence now spreads well beyond Haiti. It has played an influential role in how AIDS is treated in sub-Saharan Africa. Its recommended approach to the treatment of multidrug-resistant tuberculosis, based upon practical experience in the field, has now been adopted by more than one hundred countries. These and other public health crises have taken PIH—and specifically Paul Farmer—all over the world, accumulating millions of miles on planes like the one he will fly in this evening.

You would think that all of this would require Paul Farmer to spread himself quite thin—to make numerous trade-offs and sacrifices—and there’s certainly some truth to that. But he learned early on that there were at least as many benefits as costs to taking such a broad and imaginative approach to his life and career. As a student, for instance, he learned that Haiti was a much better site than Boston for his graduate work in anthropology, given the practical insights he could gain there. He had very high grades in medical school, in part because he also worked for large portions of each year as a rural doctor in Cange, dealing with more varieties of illnesses than most American physicians see in a lifetime. And in Haiti he also learned firsthand how to design a clinic and a public health system, building them from scratch in the most difficult of circumstances.

As Tracy Kidder observes in his extraordinary book Mountains Beyond Mountains: The Quest of Paul Farmer, a Man Who Would Cure the World, “It was impossible to spend any time with Farmer and not wonder how he happened to choose this life.” When he is asked, Farmer responds that many things coalesced into a vision of his life’s work. But “this happened in stages, not all at once. For me, it was a process, not an event. A slow awakening, as opposed to an epiphany.”

One commentator has described Farmer as “the world’s most well-known doctor who advocates for the poor.” But in all honesty, he is far from a household name—and here in Haiti he mostly seems like just an unheralded rural doctor tending to his patients one at a time. The contrast is striking and evokes a complex set of emotions—one of them being moral envy. As Tracy Kidder notes about readers’ reaction to his own book, “Some people have read Mountains Beyond Mountains and said, in effect, ‘Damn, I wasted my life. I should have done what Paul Farmer’s done.’”

But Farmer himself never conveys a sense of moral superiority—indeed he is always generous about the work of others, including our own. When it comes to our mission, which is focused on setting up the government’s recovery administration with a clear set of management goals, processes, and procedures, he thinks that he has as much to learn from us as we do from him about Haiti, public health, and social welfare. Kidder eventually concludes, “I think of him simply as a friend. I don’t idolize him, but I’m grateful that he is living on this planet.”

As we approach the gate, there is no interruption in the flow of people who want to speak to him—a former patient reporting on his recovery, an aid worker who wants his advice on her restoration project in a nearby village, and two or three people who just want to say hello. Only once on board can he settle back in his seat and become just another passenger on American Airlines flight 201, which will take less than two hours to cover the six hundred miles to Miami, the first stop on his journey back home to Boston.

Hotel Arts, Barcelona—October 11, 2000

“If you don’t get it, then I am sorry—that’s too bad. I can tell you with certainty that this is the way business will be conducted in the future.”

The speaker holds his audience in rapt attention. He goes on: “We are on the brink of a broadband revolution—unleashing the power of the Internet and digital technology to transform the business world. Every kind of business is going to be disrupted—not just traditional media and bricks-and-mortar retailing, but also so-called utilities like gas, electricity, water and transportation. This will enable us to break up outdated industry structures, and minimize the burden of redundant assets sitting on our balance sheets.”

This is a great time to be an attacker in business. The monolithic and bureaucratic companies of the past are just sitting ducks. Using the custom-designed modeling algorithms we have developed and the digital trading capability we have built, we can already capture much of the premium value in our businesses—and we are just getting started. Our asset-light business model is perfectly suited to today’s world.

To make all of this happen, we are focusing most of our attention on human capital—on creating the most powerful talent machine in the business world. We are hiring the best-of-breed technical specialists in every category—the top business modelers and analysts, MIT and Stanford PhDs, the ultimate quant jocks, who can develop the most powerful algorithms for our businesses. We want people with deep, specialist expertise and obsessive focus. Some of them are pretty crazy people—the kind of people who think they can model anything. But that’s OK—that’s what we want. It’s up to people like me to integrate all that talent and convert it into a powerful business. And that’s what I’m doing. I invite you to come along for the ride.

When he finishes, the charismatic speaker gets a prolonged standing ovation from his enraptured audience, punctuated with enthusiastic whoops and hollers. On his way out of the room, he is high-fived by audience members, many of whom know him personally and view him as a much-admired friend. And as the audience filters out into the surrounding coffee stations and bars, all the talk is of how this is indeed the way of the future, and the most frequently asked question is, how can we be part of it?

The speaker is Jeff Skilling, the highly respected chief executive officer of the Enron Corporation, and the audience comprises the senior partners of McKinsey & Company from around the world. I am one of them, sitting in this audience along with 250 of my most distinguished colleagues. We have gathered here at the Hotel Arts in Barcelona for our annual senior partners’ conference to celebrate our achievements over the past year and set the direction for our firm in the year ahead.

In recent years, it has become our custom and practice to invite high-profile external speakers—either important clients or conspicuously successful alumni of our firm. Jeff Skilling meets both criteria—only a few years ago he was sitting among this same group as a senior partner of McKinsey, where he spent thirteen years of his career; and since he joined Enron, he has continued to employ the firm on a series of strategic and organizational engagements. Among the proudest people in the audience for Skilling’s speech are the current partners who lead the firm’s relationship with Enron. When Rajat Gupta, the firm’s worldwide managing director, speaks later in the day, he calls them out for special acclaim, and they too are applauded.

At the end of a memorable day, we gather for a celebratory gala dinner, and reflect upon how fortunate we are to have such clients, alumni, and colleagues. Not a few of us are probably thinking that one day we’d like to be invited back as senior executives and clients, having completed a similarly successful transition to the highest bastions of corporate leadership.

LESS THAN A YEAR LATER, Jeff Skilling’s career was crashing around him—and within a few years he was on his way to jail. On August 14, 2001—just ten months after his appearance at our partners’ conference—he unexpectedly resigned as CEO, citing “personal reasons,” and sold a large volume of shares in the company. Then-chair Kenneth Lay, who had previously led the company for fifteen years—and been advised by Skilling during his time as a McKinsey consultant—returned as CEO. Shortly afterward, in December 2001, the company declared bankruptcy. It had taken just fourteen months from the moment when Skilling declared Enron “the future of the business world” to corporate bankruptcy with the loss of 20,000 jobs—and as collateral damage, the collapse of Arthur Andersen, Enron’s auditors and at the time one of the world’s leading accountancy firms.

That was just the beginning of Skilling’s troubles. Early in 2004 he was indicted on thirty-five counts of fraud, insider trading, and other crimes relating to what was now routinely referred to as “the Enron scandal.” On May 25, 2006, he was convicted of all but the insider trading charges; and on October 23, 2006, he was sentenced to twenty-four years in prison and fined $45 million. Despite several appeals—including a case that went all the way to the Supreme Court of the United States in 2010—he remains in prison. According to the Bureau of Prisons, he is currently incarcerated in Federal Prison Camp Montgomery and is now eligible for release on February 21, 2019.

A story like this has many of the elements of a Shakespearean tragedy. Indeed some time later the British playwright Lucy Prebble did put the story on the stage—albeit in the form of a tragicomic musical entitled ENRON. The opening scene is set in Skilling’s office on January 30, 1992, as he and his colleagues hold a rambunctious party to celebrate the Securities and Exchange Commission’s approval of Enron’s very distinctive form of accounting for gas contracts. By Act 3 Skilling has become chief executive of the company and is being acknowledged as one of the most admired business leaders in America. In Act 5 he is sentenced to twenty-four years in jail.

SAINT AND SINNER—OR BROAD AND DEEP?

Paul Farmer and Jeff Skilling have quite a lot in common. They both went to elite universities in roughly the same era, distinguished themselves academically, worked extremely hard, applied their considerable natural talents, and reached the loftiest heights of their chosen professions—garnering along the way devoted followers and widespread acclaim. Until Skilling’s spectacular fall from grace, they were both widely viewed as role models of successful leadership in their respective fields. People wanted to be just like them, if only they could figure out how.

But given the differences in their respective fates since 2001, it seems more instructive to view them as a study in contrasts. The most obvious and straightforward of those contrasts is between good and bad—“saint” and “sinner.”

Paul Farmer has devoted his life to tending to the poor and downtrodden—often in the most hazardous and challenging of circumstances. He has forgone considerable opportunities for fame and fortune to do so—indeed, the first impression that he evokes in those who know and observe him is that of personal self-sacrifice. Jeff Skilling, in contrast, has focused his talents on generating enormous personal wealth for himself and a few people around him; abused the trust placed in him by shareholders and staff; led a large corporation into oblivion, wrecking the careers and pensions of thousands of employees; and broken the law of the land multiple times. His continued presence in a federal penitentiary tells its own story.

And yet the “saint and sinner” interpretation of these stories seems too simplistic—too morally neat and tidy. Paul Farmer is undoubtedly a very good man, but as his closest friends (and he himself) will attest, he is not perfect. Meanwhile, Jeff Skilling’s friends (including some of my former colleagues) still struggle to think of him as simply a “bad guy.” Clayton Christensen, the highly respected Harvard Business School professor, was a classmate of Skilling’s thirty years ago. He says of him, “The Jeffrey Skilling I knew from our years at HBS was a good man. He was smart, he loved his family . . . and yet when his career unraveled with his conviction on multiple federal felony charges relating to Enron’s financial collapse, it not only shocked me that he had gone wrong, but how spectacularly he had done so. Something had clearly set him off in the wrong direction.”

What was the “something” that had set him off in the wrong direction? What was the underlying reason for such a spectacular professional and personal collapse? The answer may lie in a different and potentially more revealing contrast between Skilling and Farmer. That is the contrast between breadth and depth—and it is the dominant theme throughout this book.

In his early years, there was no reason to think of Jeff Skilling as an intrinsically deep or narrow person. He had every reason and opportunity to live a broad life, given his education and eclectic early experiences—including his thirteen years as my colleague at McKinsey. But, when he joined the senior management of Enron, he chose to focus his leadership approach on a model of extreme specialization—in common with many in the modern era of financial and technological sophistication. In his Barcelona speech to the McKinsey partners, he boasted that Enron was “cornering the market in MIT and CalTech PhDs with sophisticated algorithms and mathematical models.” He made it clear that he expected these technical specialists—these “quant jocks”—to revolutionize, and to a large extent automate, the company so that it could transform the world of business. Indeed, Enron under Skilling’s leadership exemplified the increasingly pervasive belief that highly talented people, working in narrowly defined specialist silos, can achieve miracles.

But when Skilling resigned and when soon afterward the company he had led unraveled so quickly, it became apparent that he and his board colleagues had been sucked in by the mythical virtues of deep specialization—and that that approach had led the company down the road to self-destruction. The Powers Commission, set up to investigate the causes of the Enron collapse, concluded that the management and board of Enron—and especially Jeff Skilling—completely failed to understand the operational risks of the company’s mark-to-market business model. They did so because they lacked (or had lost) the breadth of perspective to see how it could go so badly wrong—and how to react when it started to do so. The consequence of this false confidence in the benefits of deep specialization was catastrophic for Enron and its employees and shareholders, not to mention those of Arthur Andersen.

Paul Farmer has shaped his life in a very different way; he has consciously and explicitly chosen breadth and diversity at every stage. At college, he chose to study both medicine and anthropology; as a medical resident he chose to divide his time between a renowned Boston hospital and a rural clinic in Haiti; while continuing to practice as a physician in multiple locations, he chose to create a nonprofit enterprise to further his model of community medicine; he chose to expand the reach of this nonprofit to more than a dozen countries; he chose to become a prolific writer so that he could spread his ideas about Haiti, medicine, and even theology; and he chose to help formulate public policy through the United Nations and his association with Bill Clinton.

As a consequence of his intrinsic personality, but especially as a consequence of the choices he made, today Paul Farmer is a physician–anthropologist–professor–social entrepreneur–author–activist–philosopher–policy adviser—and probably a few things beyond. If you ask him why, he says simply, “I needed to operate on a broader canvass. I didn’t want to be bounded by a single specialty.”

Farmer does in fact have a distinct specialty—the treatment of epidemic infectious diseases—which he has developed, honed, and applied to treat patients and influence policy choices all over the world. But he has not let that specialty exclusively define or constrain him, nor has he allowed himself to go so deep into that specialty that it has obscured his vision of everything else. Rather, he has shaped his life around the belief that his specialist knowledge will be more useful, more likely to do good than harm, if he takes as many opportunities as possible to broaden and extend his experience and perspective.

The pressure on each of us to specialize and focus reflects the marketplace at work, operating as we do in a modern economy that is dominated by human and technological services. As citizens and consumers, we all want to receive the services we need from fully credentialed experts—especially when technical expertise and experience are evidently required. When we get on a plane, we want to hear that our pilot has flown thousands of hours and learned how to deal with any manner of possible in-flight emergencies. When we decide to build a house, we want to be assured that our architect has designed lots of beautiful and safe buildings and that our contractor has built them so that they will withstand the elements for decades to come. And, of course, when we go to the hospital, we want to hear that our surgeon has performed hundreds of surgical procedures similar to the one we need, with most patients returning to good health.