Crisis: What This Stress Test Reveals

Updated on May 27, 2020

By Dr. Michael J. Zappa

Every crisis reveals the truth about systems, processes, and people. Amidst the tears and the heroes of the COVID-19 pandemic there are many valuable lessons to be learned. People will be the focal point of this discussion today: recognizing the Unfiltered View of society and what attracts us to Crisis Leaders.

Most would agree that crisis, or more precisely the stress of crisis, brings out the best and the worst in people. Specifically, it gives an objective and honest view of people: what motivates them, how they think, and how they naturally behave. This is the unfiltered view of society – where you can’t fake concern, altruism, motivation or anything; you behave as who you really are because of the pressure of the situation.

I have had the privilege of treating over 100,000 patients in emergency departments over my career. Every ED in the nation is a window revealing how our society behaves in crisis. Reflect for a moment: no one ever plans to have an emergency, from a minor injury to a life-threatening event.  Each of these disrupts that individual’s life and often that of friends and family; when you mix that with loss of control, pain, inconvenient wait, and a negative personal fiscal impact – the result is a crisis.  Sound eerily familiar to a mini pandemic?  Such a “stress test” or “crisis” reveals the truth about who that person is: selfless or selfish, resilient or frail, optimistic or pessimistic, kind or indifferent. 

Some results I wish I didn’t recall: a woman with an ankle injury yelling at staff for her long wait while we were doing CPR on another patient; she probably was among the first to hoard toilet paper too! Children of elderly parents complaining about the wait for test results to see if their parent needed hospitalization, I bet they have sent their parents grocery shopping for themselves amidst this outbreak! 

There are inspiring results as well: patients being given a terminal diagnosis who worried more about buying food for the staff who had not had a break all shift; these are probably the selfless people donating thousands of meals to local healthcare heroes.

Whether simply guiding your own life, leading your family, or heading the response of a healthcare system facing a global pandemic, are you pleased with the results of your stress test? Having completed your self-reflection, opened your eyes to leaders, new or old that have risen up during this crisis. Just what are the characteristics that make this leader stand out?  Why is a crisis leader so attractive? 

Starting with the second question, the attraction is a survival instinct – a crisis requires leadership to pull the group through. Some might argue that talented teams can run themselves when its business as usual, but their observed behavior is that even the brightest, hardest-working teams begin to fall apart with disruption of routine, uncertainty, and fear becoming their focal point.  People are looking for answers; they need a plan. Almost any plan will do as long as it’s based on current facts.  In crisis, there is despair and worry. People need the flame of hope to be stoked; they seek inspiration and reassurance. 

Focusing on the second question, it might seem that crisis leaders are simply charismatic, naturally talented individuals. I am sure some are, but I propose that the common element is the desire to serve and the ability to pull the most basic tenets of great leadership together all at once.

The following basic abilities appear to flow spontaneously, simultaneously, and publicly among Crisis Leaders: they listen, think, feel, decide, speak, and do.

LISTEN Seek feedback from experts, leaders, and staff

THINK Able to accurately and frequently analyze the situation

FEEL Express empathy for all affected 

DECIDE Able to make decisions, not impaired by the lack of a 100% certainty 

SPEAK Frequently communicate honestly, even if direction needs to change

DO Ability to execute the plan, holding himself and others accountable

As we emerge from this crisis, remember all knowledge is power; don’t lose sight of the Unfiltered View of our society, both the good and the bad. Recognize that the characteristics of great Crisis Leaders will transcend the pandemonium and prove valuable in everyday life. 

About Michael J. Zappa, MD, FACEP

Dr. Michael J. Zappa is the president of Highsmith-Rainey Specialty Hospital, and Cape Fear Valley Health System Vice President and Associate Chief Medical Officer. He balances business acumen with clinical expertise, and shares his thoughts on leadership and the healthcare industry at

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