Decision-Making Under Pressure: Leadership on the Front Lines

By Ed Rutkowski

May 24, 2021—His friend Chris was lying in a pool of blood, his eyes fixed and dilated. Dr. Sudip Bose listened for a heartbeat, heard none, and declared him dead. The next patient, the man who killed Chris, was brought in screaming and kicking; he didn’t want Dr. Bose’s care any more than Dr. Bose wanted to provide it. But that was his duty as an Army doctor on the front lines of Iraq, a duty he somehow found the mental fortitude to perform.

This harrowing anecdote from the Iraq War was one of several Dr. Bose shared at the AIHce EXP 2021 Opening Keynote this morning. Originally planned for Dallas, Texas, the conference was rescheduled as a fully virtual event due to ongoing concerns related to the COVID-19 pandemic.

Perhaps best known as the man who treated Saddam Hussein following his capture by United States forces in December 2003, Dr. Bose would eventually receive the bronze star for serving one of the longest continuous tours by a U.S. Army physician since World War II. During his presentation, Dr. Bose turned his wartime experiences into lessons on how to handle extreme stress that attendees could apply in their lives and careers.

While people often deal with stress by attempting to escape it, Dr. Bose suggested that stress should instead be embraced. “The stress response evolved to help human beings thrive,” he said, and he recommended that attendees build up their resistance to stress by trying new things that make them feel uncomfortable or afraid. “In stressful moments, think of what you’ve been through in the past,” he said. “It will provide you strength so you can get through this, too.”

Once during his Iraq tour, Dr. Bose had to triage wounded civilians in the aftermath of a bombing. The first people he saw were a twenty-year-old in agony from a broken femur, five screaming, badly burned women, and an eight-year-old with a fractured skull. Quickly, he understood that the women didn’t need immediate care, that his medics could tend to the broken leg, and that the child wouldn’t survive. “For the greater good, I had to let him go,” Dr. Bose said. As gut-wrenching as this decision was, it allowed him to save his single backpack of medical supplies for the people who could most benefit from it. From this experience he drew two lessons for AIHce attendees: “recognize what can wait” and “recognize when to let go.”

Often the right decisions are the most difficult ones to make, Dr. Bose said, because emotions cloud our judgment. He urged attendees to “master that clear space between an emotion and an action” and to remember that the next time they’re under stress, their “inner army” can help them make the right decision. “Decisions under pressure lead to habits, and habits lead to character—your character,” he said.

Ed Rutkowski is editor in chief of The Synergist.