Live It Up!

John:    One of the hardest experiences I ever had was losing my parents at a young age. They were absolute rocks in my life for as long as I could remember. My wife is experiencing now, as her parents are in poor health, and she is afraid that today she will get the call that they are gone. While she still sees them frequently, they don’t get around as fast as they once did and, eventually, they won’t be around anymore. Words can’t describe how much I’ll miss them when they’re gone. I know quite well that the same thing will eventually happen with me. I will eventually lose a step, can’t get around as fast as I once did. And I will wonder whether or not I should be living life to the absolute fullest today instead of saving for tomorrow. But I still believe tomorrow will come and I need to be prepared.

Question for my three friends: do you live for the fullest today instead of saving for tomorrow?

Jen: Tough question! When I was 13 my mom was diagnosed with mixed connective tissue disease following a pregnancy that almost resulted in her death (and my sister’s, who was born in the car weighing just over 3 pounds!) Fortunately they both survived, but there were several years where every single day I thought it could be my mom’s last. She has since survived numerous blood clots, pulmonary emboli, AMIs, infections and more. My entire family lived for the moment, through every decision from choosing filet over sirloin to outlandish vacations over stay-cations. One day, my mom saw a car she really liked, and later that day my dad showed up at home with a brand new Candy-Apple-Red Mustang GT 5.0 convertible. I still have no idea how he pulled that off financially, we were far from wealthy. They made a lot of other seemingly crazy decisions over the years. When I was in middle school, they decided the Sunday as spring break was over to load up the car and drive from Bozeman, Montana up to Edmonton, Alberta ‘just because it would be really cool and make a great story!’ And they were right, it makes a great story!

It was not until more recently that they settled down somewhat. My mom is going on 23 years sick, but breakthrough medications have given her a second chance. As a result of these outlandish whims, I now lean towards a more conservative and steady approach. I suppose I don’t need to experience the risk or thrill of it.

No matter how you choose to live your life, do it authentically and own your choices. You don’t owe anyone an explanation.

What does living to the fullest really mean anyhow? For my parents, it meant sports cars, traveling, months-long international cruises, parties, and living a life that is book-worthy. For me, living to the fullest means doing whatever makes me feel complete, no matter what circumstances surround me. This usually comes from simple things like spending time with my children just watching a movie, reading a book, or talking together. It’s different for everyone and I don’t fault my parents for their choices. In a way, I find it admirable that they tackled life as they did instead of sulking or giving up on life. Reflecting now, I’ve just realized while writing this that it’s probably why my mom survived the worst of the years. No matter how you choose to live your life, do it authentically and own your choices. You don’t owe anyone an explanation.

Molly: In this point in my life, I am all about the balance between living for today and saving for tomorrow. However, I’m in this position now because I focused on saving starting in my early 20s. I always set aside part of my paycheck for savings in addition to what I put into my 401K. I worked extra hours and invested in myself by pursing professional certifications and education. I didn’t really think about whether or not I was living in the moment, as my peer group and husband were following similar professional paths. Popular phrases were “pay your dues” not “work/life balance”, and we followed suit without question. It wasn’t until my late 30s did I stumble on finding my sweet spot with saving for tomorrow and living in the fullest. I fiercely protect my family time and use my paid time off without guilt. I do not have regrets of grinding early on in life, as I’m reaping the benefits of being able to balance it now.

I work to live life to the fullest today, but I dream and plan of my tomorrow.

Trish: John, I work to live life to the fullest today, but I dream and plan of my tomorrow. I think of what retirement may look like, where I may want to live 5 years from now, 10 years from now, 20+. My tomorrow is what drives my today. My answer is as simple as that. I look forward to hearing what Jen and Molly’s thoughts are. I also look to you, John, to ask this same question to #fourfriends a year from now.


Originally published on 11.15.18 on LinkedIn

By John R. Nocero, Jennifer Rawley, Molly Downhour and Patricia Graham

What We Wish We Knew

John: When I was 22, I got married for the first time, and wish someone would have told me that I was not emotionally ready to handle that level of commitment to another person. Sex, yes. Commitment no. When I was 24, my son was born, and I wish that I was less focused on me and more on raising him right, so he could’ve benefitted from my tutelage. At 25, I wish I would have cared less about what everyone thought about me, and focused more about what I thought about myself. I could’ve been happier. All of us have the tendency to be Monday Morning Quarterbacks, and look back on history with rose-colored glasses. The truth is, you are exactly where you are supposed to be right now because of all the decisions you made leading up to this point. Maybe I wrecked my first marriage, but I was able to grow from that, and have a pretty successful second one. Maybe I wrecked my relationship with my son, but I was able to repair it with him as he got older – and he was able to be where he is because his mom raised him. And let me say publicly, there was NO WAY I could have raised him as well as she did. She gets the credit. And maybe if I was less focused on what other people thought, I would not have been able to develop a ridiculously sick work ethic to work as hard as I can for what I want. Each year holds a few great lessons. The kinds that you must not miss, because you might not be able to recapture until two decades later. Damn sure pay attention.

Question for my three friends – what are the lessons you learned in your 20s that you didn’t catch until years later?

Jen: I have learned that increasing my overall knowledge ultimately multiplies how much I don’t know. I used to envision knowledge as something that is finite. Something that has a beginning, middle, and end. I was a card-carrying member of the “I’m a lifelong learner” club. By that I meant that I planned to learn everything there is to know about things that interest or are useful to me. For instance I would learn everything about drugs and the lifelong part would be learning about new drugs or new developments in the pharmacy world, etc. As I have grown in wisdom, not just knowledge, I have realized knowledge is infinite and ever-growing. Tackling certain subjects expands the mind and opens up more ’empty space’ to fill with new knowledge and ideas. I finally learned that there is a lot I don’t know, and that there will always be; and, moreover, that there will always be more that I don’t know than I do.

Molly: I am very thankful that social media did not exist in my 20s and that the lessons I learned at that time were not documented for all eternity! The biggest lesson that I learned in my 20s, but didn’t catch until later was that I do not have to drive full speed ahead all of the time. When I was 18 I had a plan for myself; go to college and graduate in 4 years, become a nurse, work for two years, and then get my masters degree as a nurse practitioner. I was on track until my first semester in my masters program, my mom was diagnosed with ovarian cancer. I dropped out of school to move home to take care of her. Without the family emergency, I most likely would have pushed ahead, despite not being happy on that particular path just for the sake of “not quitting”. To me quitting equated failing, even if it wasn’t the right fit. I made the same mistake again at the age of 30, when I thought it was a good idea to work full-time, with one year old twins, and started my masters degree again. Life intervened again, when I became pregnant with our third son and was put on bed-rest almost immediately. I was on the right path, I was taking on too much. I was fortunate to figure out that a more realistic approach was to work part-time while I went back to school and had three boys under three years old. You don’t always have to keep moving forward in order to get ahead, and sometimes quitting can be winning.

Trish: This is an interesting topic John. I think we all can look back to our 20s and wish we did things differently. I think about technology. How in my 20s, I got my very first mobile cell phone, my very own email address, and was thrilled to connect to the internet using a dial-up modem. How exciting those times were!!! Who would have known that all these years later we have super high-speed internet and super smart phones!! Looking back, I really wish that as new technology was introduced, that I would have been less excited and set a healthy distance in connectivity. I find that like most, I am too attached to technology and too “connected”. In my 20s I didn’t realize how much self-care I had because of the lack of total connectivity. I work today to find a healthy distance from technology to recharge my own batteries.

Originally Published on November 16, 2018 on LinkedIn

By John R. Nocero, Jennifer Rawley, Molly Downhour & Patricia Graham

Strength in Vulnerability

John:    If you have been told that showing vulnerability in the workplace is a sign of weakness, think again. All of us are vulnerable. None of us are immune. We may put up a false bravado to hide any sign of weakness, but your team sees right through it. One of the strongest work relationships I have ever had is because I was willing to show my vulnerability. We were working on a financial spreadsheet, and I kept pushing saying we have to finish by the specified deadline. She said, “Why are you pushing so hard?” I said “because this is the only thing I am good at. I suck at everything else. I suck at my marriage and I suck as a dad.” Because I was willing to show my weaknesses, she opened up and now we are amazing collaborators. But who knows what would have happened if I chose to stay within myself and refused to open up.


Question for my three friends: describe a time when you showed vulnerability and it was a sign of strength, and not weakness.


Jen:   In my college years and early career days, I would push forward with a “fake it til I make it” mentality. It was a false display of confidence to cover for lack of experience. More recently, I have swung the pendulum. I readily admit when I don’t know something and follow the statement up with an offer to learn or find out. A time when I showed this same vulnerability and it was a significant experience is related to my current role and the interview process. I was transitioning from a senior leadership role over a handful of departments in a mid-sized hospital to the chief executive of a small hospital- yikes! I did not want to over promise on my abilities, but I also didn’t want to lose the opportunity. I played up my strengths and quickly admitted my weaknesses and areas where I knew I would need to grow. I expressed an honest desire and willingness to close the skill and knowledge gaps.

I still don’t know everything but I DO KNOW that I never will…


I did this at the risk of losing the job. However, it worked in my favor and I got the job. I found out during my orientation that the leadership team places significant value on transparency. Good, bad, ugly- after all, it cannot get any worse than the truth. When I interview candidates to hire on my team, I am more focused on their personality, work style, motivations, and fit than their skills. In fact, aside from very rare situations I don’t bring them in to discuss their technical skills. I tell candidates I can teach them anything except how to be a good person and make good choices. Looking back, I believe my interviewers were seeking the same information about me. I have learned so much, and learn more every day. I still don’t know everything but I DO KNOW that I never will- and that is the key to balancing success with fulfillment.


Both are vulnerable-the egg to cracking and the hammer to a sticky mess…


Molly:  Well this question was timely in that I forgot it was a half day today for my youngest. He sat in the office for over an hour while the school tried to call me and my husband. We were both out of town and worse, I was on a flight to New York (5 hours). My husband called friends and family frantically from his meeting in Chicago. Being the champ that he is, my son quietly read his book until he was picked up. I took it as an opportunity to tell all of our kids that I messed up royally. I made no excuses of which I could share many (crazy schedules for a family of five, two different school calendars, blah blah blah). I want my boys to know that their parents are not perfect, we make mistakes, and take responsibility for them. I shared how I felt powerless to fix the situation at the time and was worried sick, but we can make a plan to ensure it doesn’t happen again.  I make a conscious effort to share with my boys how I make mistakes in both my personal and professional life hoping it will become ingrained that no one is perfect and trust is built when we own the mistakes and make it right.

Trish:  As leaders, we participate in all sorts of professional leadership coaching and training. I actively look for opportunities in addition to those activities provided by my employer. Several years ago, I completed a comprehensive professional leadership version of the Myers–Briggs Personality Type Indicator test and received a 30+ page results analysis document to pour over. The results of this particular test documented my strengths, challenges, and opportunities. It also had a section that documented how others would best work with me and I with them. One particular area in the analysis that was very interesting said that in communicating with me, others should, “Be bright, be brief, and be gone.” Wow. Did I have THAT low a tolerability for stupidity? Was I THAT impatient? Did I want people giving me information and getting out of my office the second they were done? I knew that being patient is a weakness for me (and it still is…but I am a work in progress). Many of the leaders in the organization quietly took their results and worked on themselves. I took my results and immediately did something quite drastic. I shared my results word-for-word with my management team. Talk about being vulnerable! The team and I laughed at some of the items as my team found some of them very true and also took note as a team member stated that “this one is sooooo me, too!” I realized that there was so much power and collegiality in being so raw as to show these results. Later, as conversations with my managers would occur, we would laugh together as they would give me a dig while saying, “I need to talk with you about an issue, but I promise to be bright, brief, and will be gone!”

by John R. Nocero, Jennifer RawleyMolly Downhour & Patricia Graham

Originally published on LinkedIn on 10/25/2018.

All About Ego- Truth or Lies?

John: I am working on breaking the habit of being self-serving. John 1.0 had a tendency to take credit for success and deny responsibility for failure. In other words, it worked because of me. If it didn’t, it was because of someone or something else. On some level, it makes sense; as it protects and builds your own ego. The problem is, if you deny responsibility for when something goes wrong, you can’t learn from your mistakes. John 2.0 is accountable to everyone and does not care who gets the credit, as long as he is a valuable contributor. This made me think about the last time I made a drastic mistake as John 1.0. Maybe you thought about it too. Did the mistake occur because you spoke too quickly, didn’t get all the facts before you made a decision, or alienated someone and ruined a relationship? Chances are it was either fully or partially your fault. After all, you were there. Pain and mistakes are your greatest teachers though; without them, how can you improve?

Question for my three friends: when was the last time, you protected your ego for fear of admitting a mistake and you missed an opportunity to learn?

Jen: I cannot think of a specific situation where this exactly applied, aside from silly situations with my kids. “No, Mommy never did anything like that…” Rather, I sometimes lean too far in the opposite direction and readily admit my lack of knowledge of something early on. Let’s just say that I may sometimes tip the balance of confidence vs. transparency. I have, however, had situations where I truly believed I understood an idea or a process and set out to undertake the affiliated task. Then downstream I realized I was mistaken and had to backpedal and work extra hard to get back on point.  A recent example was related to marketing and patient selection.  In my specialized healthcare field, there are specific criteria and stipulations from CMS that define which patients are candidates for our care. Over a year into my role, I found out that I was mistaken about one seemingly minor caveat related to length of stay calculation. I shared this incorrect ‘fact’ with many individuals during training and in business development meetings. I used it as a point of argument for why we could not accept certain patient populations.

It took an ‘ego hit’, but I made the right choice

and I learned what I needed to.

Thankfully, my misunderstanding did not have any impact on which patients we were able to care for since our internal policy aligned with what I had been saying, just not for the same reason.  I discovered my error when reading a peer-reviewed article on a different subject that happened to make mention of it. I had a jaw-dropping moment, and a knot in my throat as I dialed my boss to ask, “Have I been wrong all this time.” I risked my credibility when it was necessary for me to divulge and correct my mistake, but I did it quickly and with sincere apology. The bigger risk to my credibility, and my job, would have been to continue on sharing the misinformation, or even to dismiss it as if it never occurred. It took an ‘ego hit’, but I made the right choice and I learned what I needed to.

 Molly:  When I started my career in oncology clinical research, there were only five employees; two oncologists, two nurses, and one coordinator. It was all hands on deck and a great learning experience as I got to see (and do) most of the areas in clinical research. One of the areas I did not have exposure to was the clinical research contract, budget, billing, and negotiations. That was all taken care of by the university clinical research office in Tucson, about two hours south of Scottsdale, AZ. In hindsight, I wish I had taken the initiative to learn more about the process at that time. As I advanced in my career along the leadership path I quickly identified this as a knowledge gap for me. To shorten this gap, I earned my masters degree in healthcare administration, attended a clinical research finance boot camp, and hired a consultant to train our team. What was hard for me was going from being an all-around expert to having to lead a team that I had no experience in other than education. I was used to being the expert and having credibility for the changes I was recommending to the team. In this scenario, I wanted to improve our clinical trial contract language and budgets, but I was getting a lot of resistance from the team saying “this is how the industry has always been”. For financial sustainability we had to change. My solution to was hire people who I felt was a lot smarter and business savvier than me. I was very open about my lack of experience in this area when hiring. While I was uncomfortable not being the expert, it actually demonstrated leadership and character to surround myself with very talented individuals who raised the bar for everyone in the program and ultimately our patients.

Living in a loving and accepting family environment, I learned quickly in my youth that being transparent and admitting mistakes always helped me be a better person.

Trish:   I can’t think of the last time that I protected my ego for fear of admitting a mistake and missed an opportunity to learn. When John posed this question, I had to sit back and think about this question, had to even walk away for a few days, come back to the question and think some more. At the end of the day, I still can’t think of a time I have done this. I assume it was in my youth, and I probably did a fair share of lying to my parents after I screwed something up or hurt myself doing something dumb. Living in a loving and accepting family environment, I learned quickly in my youth that being transparent and admitting mistakes always helped me be a better person.

I’ve lived my personal and professional life quite comfortable with admitting mistakes and being forthcoming in my knowledge base. I also feel that as a leader, it’s important to create a culture in your organization or department that promotes the fact that mistakes are made, that they can be fixed, and we all move forth better and more educated. I’ve also worked hard to create and maintain this culture in my own household.

Now, I must admit that recently, I was using electric shrub clippers in the backyard and I was bit on the foot by several red ants (if you live in the South, you know that these ants are vicious and the bites sting and itch for days!) While being bit mercilessly, I cut wayyyyy through the thick outdoor electric cord! While yelling out to my partner, throwing the clippers away from me, and assessing the ant bites, I didn’t say that I ruined the power cord and almost shocked myself. I focused my verbal re-creation on the ant bites first and then said we needed to go to Home Depot and get a new cord. After a hearty laugh, my partner later said to me on the way to Home Depot, “Why don’t you wear socks and sneakers instead of flip flops when you are out in the mulch!?!”

by John R. NoceroJennifer Rawley, Molly Downhour & Patricia Graham

Originally posted on LinkedIn on 10/30/2018