Culture woes. They’re a constant: my team isn’t gelling. We’re missing deadlines. Mistakes keep repeating. We’re siloed. We show up late to meetings even though we committed to being on time. Or, even at home: chores we agreed to go ignored, or some sort of disrespect has crept in.

How do we create the culture we’re aiming for? Countless resources find their way into our inboxes every day — regular features in well-respected business publications, online platforms like CultureAmp, books, and change management theories and tools. Picking any of them and consistently applying their concepts helps, yet we still miss the mark. Culture’s never perfect, of course, and it’s ever-changing, yet we just feel in our gut there’s a “better.”

Atul Gawande, surgeon, writer, and now CEO of Haven is one of my most admired life-livers and wisdom-sharers. While re-reading Being Mortal — his work about how misguidedly we deal with aging — a story about the transformation of a nursing home made me wonder if there is a more basic, holistic way of diagnosing and treating our culture headaches.

Plants and birds and rocks and things...

In 1991, Bill Thomas, a young Harvard-trained physician, left the ER to become the medical director of Chase Memorial Nursing Home, an Upstate New York facility housing “eighty severely disabled elderly residents. About half of them were physically disabled; 80 percent had Alzheimer’s or other forms of cognitive disability. . . . The staff saw nothing especially problematic about the place but Thomas with his newcomer’s eyes saw despair in every room. He initially figured they were medically underserved, so he examined them, expecting to find misdiagnoses and wrong combinations of medicines. But that wasn’t it.

Thomas was “more farmer than doctor” — he lived on a farm with his wife and five children, grew his own food, raised animals, had a sawmill and sugarhouse, and generated his own wind and solar power. The nursing home conditions “fundamentally contradicted his ideal of self-sufficiency.” As he spent time with the residents, he learned “they had been teachers, shopkeepers, housewives, and factory workers, just like the people he’d known growing up.” He came to believe that life itself was the missing ingredient that left them so devoid of spirit or energy. “So, acting on little more than instinct, he decided to try to put some life into the nursing home. . . . by literally putting life into it.” He brought in plants, birds (100 parakeets!), dogs, cats, bunnies, hens, vegetable and flower gardens, and the children of the staff (ultimately a child care center and after school program.)

Gawande expands on how long it took to do this, how hilariously chaotic it was at first, and how powerfully it turned lives of despair into lives of purpose, connection, dignity, and joy. “‘People who we had believed weren’t able to speak started speaking,’ Thomas said. ‘People who had been completely withdrawn and non-ambulatory started coming to the nurses’ station and saying, “I’ll take the dog for a walk.”’ All the parakeets were adopted and named by the residents.” The number of prescriptions fell by 50 percent and deaths fell 15 percent.

“Culture is the sum total of shared habits and expectations,” Thomas told Gawande. “As [Thomas] saw it, habits and expectations had made institutional routines and safety greater priorities than living a good life . . . and did not address what he called the ‘Three Plagues of nursing home existence: boredom, loneliness, and helplessness.’”

Thomas had no formal experience in shaping culture or change management. He did have a powerful combination of a “beginner’s mind” (an openness, eagerness, and lack of preconceptions), a deep connection to the natural order of life, and no fear of trying unconventional things. This led him to diagnose the root cause of the residents’ collective despair, and to experimenting his way to putting life back into their lives.

Hidden in plain sight?

While it may be a bit of a stretch to apply the lessons of an 80 resident nursing home to our culture challenges, it does make me wonder. What if we were to put away the research, theory, and tools for a moment and study the world around us with a beginner’s mind to really get to know our people, and observe with a scientist’s curiosity their daily interactions? What could be at work in our cultures that’s equivalent to the mismatch of the systems, practices, and behaviors at Chase Memorial to the real problems of their residents? What’s keeping our team from gelling? Causing our silos? Keeping us from meeting deadlines or learning from our mistakes? Preventing us from showing up to meetings on time? Or, doing our chores?

Thoughts are welcome