My Dad, an Agent of Change

So what does an Agent of Change actually do?

I'm going to use my father as an example. He received a highly prestigious award, the "other" most prestigious Public Health award in the State of Minnesota, three days before he died. He had received the first most prestigious award more than thirty years previously. Both were given to him for the same achievement. He had worked first to document a problem and then to design and implement a system to address it. He had acted as an Agent of Change.

The problem he addressed was that people living in small towns and rural areas had many more adverse health outcomes than people living in the city. They, and their physicians, had no access to the cutting edge facilities, tools, and knowledge that were available in the urban research hospitals. At the time there were two independent health systems operating in the state, a network of small-town health clinics, and a network of city hospitals. The two did not communicate, and there was significant rivalry between them.

Dad spent years traveling around to every small town clinic in the state, meeting and talking to the leaders, and convincing them they would benefit from working together, instead of in competition, with the big city hospitals. At the same time he was speaking to the leaders in the hospitals, telling them about people who were dying in rural areas for lack of specialty services that were readily available in their facilities, and convincing them their services would be more effective if they worked together with small town doctors, instead of looking down on them. Eventually he convinced enough people to get a group together to discuss how they might form an alliance. When they came up with a plan he took it to the State Health Department, where he worked, and convinced them to fund it. Then back to the hospitals he went, and the small town clinics, to convince them to use the system. And he monitored -- and documented -- how it was working.

Minnesota was the first state to forge such an alliance, and the system my dad developed became a model for the rest of the nation, implemented state by state over the years between his first prestigious award and his second. Meanwhile, dad's life fell apart and then, slowly, came together again. The work (and the dissolution of his marriage) had taken a toll on him, and he developed stress-related health problems. Then a regime change took place in the state's political system, and he was reorganized out of his position as Assistant Commissioner of the State Health Department into what he considered to be a dead-end desk job. I believe he blamed himself for the reassignment: in any case, he abandoned his attempts to reform public health and turned his attention to becoming an Agent of Change for himself. He went into medical treatment, took up yoga, took up jogging, learned to cook, and transformed himself and many of his relationships in the process. But he hated his job until the day he retired.

Shortly before my dad went into hospice care, his former colleagues approached him about nominating him for that second award. He was incredulous at first, but they convinced him to let them do it. And so, many years of bitterness were healed -- at least in part -- during those final months of his life.

I suppose you might be able to map this onto the classic tale of a hero saving the world -- there is a central actor, an agent of change, in any case -- but the process was dramatically different from that action-packed adventure. There's no arch nemesis, no object of desire, no happily-ever-after, and very little dramatic tension. What I see in this story (most of which I've fabricated, or inferred, from the bits and pieces I observed and discussed with him over the years,) is a vast amount of legwork, persistence, problem solving, networking, organizing, documenting and justifying and estimating and measuring, and a heart that made him care enough to keep it up until he was done.