From time to time, I am stunned by what humans are capable of when they really believe that they are omnipotent and surround themselves in little bubbles where conflicting information doesn't enter.  

When I was in international work, the "Save the World" types were everywhere.  If you believe that you have the one true path to save the world, it is much much harder to listen when your path is drifting towards destruction.  

I've seen plenty of willing people who wanted to Save the World who were quite lovely but didn't really have the stamina or the talent to really do the job.

I've seen the emergency refugee types who life in an adrenaline filled world where doing the hard work of changing a refugee camp into a sustainable living environment drives them into the same levels of agitation that any junky would experience when deprived of their drug of choice.  So, they are doomed to perpetually seeking out the next new emergency and never completing the cycle of seeing the refugees become citizens.

I've had bosses with "VISION".  Excellent vision really.  The type of vision I happily would and did follow.  Yet when that vision was not matched with good management skills, it was impossible to attain the vision without managing the "followers" in ways that enabled them to work together as a team.  

I've also had bosses whose "VISION" was myopic.  The type of vision that sounded good on paper or running off their lips, but was impossible to achieve in real life.  Where it simply wasn't possible to attain the vision not matter what type of team you assembled because the wrong solution was applied to the problem.  In this regard, I think of Wakefield who so wanted his own invasive treatments for autism to work that he CHANGED the data in his article that attacked his perceived competitors and therefore did achieve infamy by being the only author I know of to have his article removed by a peer-reviewed journal --- and to be outed by the parents of his patients.

I've been in working environments where people were told that they were doing a great job when they were barely making an effort. Where because of some bias or another, the bar was set way too low.  Oh, you're from this country so you can't be expected to attain this level.  The most horrific of these example was a participant from Zimbabwe who was allowed to bully women because "everyone knows that's how men behave" until he finally hit a woman from Indonesia who was sufficiently "pristine" that his behavior could no longer be ignored.  My sister deals with this all the time in her continuation high school where her students have had the bar set way too low.  They start out hating her for finally setting the bar where it should be, then appreciating the bar being set higher because they actually feel that they can accomplish something.

I've been in environments where the VISION filled boss could not tolerate any other possibility than his own vision, and so only the true believers who never uttered a word of disagreement were rewarded.  Ultimately this created an organization of pathological liars.  Even those who wouldn't ordinarily lie would lie, but just to a lesser degree in order to survive.  Karma sometimes pervails.  One of one of those bosses had reorganized out anyone who was good enough to make suggestions about how to improve the organization.  The board finally caught on and banished him to work in Indonesia.  He was expecting and demanded his "golden parachute" from the new President of the small nonprofit he had almost demolished twice and she laughed in his face.  

So, today, I am contemplating the types of environments that assist willing people to work to the best of their ability and the types of environments that allow cheaters to thrive.  Cheaters exist everywhere.  When I was at Cornell they made all the graduate students take an ethics class because of the guy who dyed black spots on his rats to fake his experiment.  You have to give him credit for working incredibly hard to fake it.  Chandra didn't show as much creativity and energy when he padded his data sets with fake subjects and padded his pocketbook with his fake nonprofit.  He was merely lazy.  

In yet another example of how some people cheat, I just learned of someone who took one of those short five-day courses and parents thought she was a lactation consultants.  Parents had reported to me that she was bragging about how this lactation thing is so easy and mentioning how she didn't understand why the rest of us who had worked for many years found it so complicated.  Of course this led to an influx of frustrated mothers into my group.  But even I dropped my jaw to the floor when I heard the allegations that she had been fired because she had been personally charging parents for office visits while she was already receiving a salary for that work (effectively double dipping) and had stopped referring to the lactation consultants.  

Now, even though I know cheaters will find a way to cheat, I do believe that certain environments make it easier to cheat.  Our Internship Coordinator always feels that the challenge of doing supervised practice has value far beyond the educational aspects -- it also weeds out many of the lazy and the cheaters.

And as for the Vision thing, I think sometimes too lofty of a vision gets people pissed off and creates bumper stickers like the old "Nuke the Whales" or Whoopi Goldberg being ridiculous and completely misinterpreting Baby Friendly.  If you think about the article that was published a few years ago about the history of women in France where upper class women rebelled and didn't breastfeed their babies and most of their babies died as a result -- a male doctor was glorifying breastfeeding.  We recently had the article showing that parents found the recommendations about breastfeeding intimidating.  Now, I do NOT think we need to change our vision, nor do we need to change our recommendations.  But I DO think we need to set out objectives that are doable and let the parents see the doable steps.  

What needs to be pointed out to Whoopi is that many of the steps in Baby Friendly equally apply to the formula fed baby.  I think a step needs to be added to the Baby Friendly initiative -- it is really there in the details but not explicit.  Every mother who doesn't want to breastfeed her baby should be taught to formula feed like a breastfeeder.  If you helped mothers recognize that they were depriving their babies of important stimulation if they do NOT hold their babies for at least 160 minutes a day (which is a minimum if you consider a very fast baby who finishes feedings in 20 minutes only 80 times a day), that their babies needed responsive feeding rather than funneling, that their babies do NOT bond through bottle feeding as Harlow's monkeys so elegantly demonstrated at a very high cost to those poor monkeys perhaps you could make tiny little baby steps into the culture of die hard formula feeders.  Baby steps sometimes can slowly drag people from one form of behavior into another. 

Best,

Susan E. Burger, MHS, PhD, IBCLC

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