Leadership Lessons From My Deathbed Published Sept. 29, 2023 By Lt. Col. Kera A. Rolsen 350th Spectrum Warfare Wing EGLIN AIR FORCE BASE, Fla. -- On August 15, 2022, I asked to relinquish command after only 15 months in the seat. My commander, having watched my health rapidly decline over the past few months, to include losing large chunks of my hair, agreed. Less than 24 hours later, I had a suspected cardiac event in the middle of my own staff meeting and was driven to the emergency room (ER). This was my second trip to the ER that year. Three days later, I was pulled from my car by EMTs and hauled back to the ER after my entire endocrine systems decided to take the day off. I laid in the ER bed and told the nurse I felt like I was dying. She scared the hell out of me when she very calmly put a hand on my arm and said, “Honey, you are.” The fact that I can sit here and write the lessons I learned from last year is the big spoiler - I lived. I relinquished command, gave up five organs, but I lived and I learned. I learned five important things from what is undeniably the worst year of my life: don’t ignore your own health, the system doesn’t care but people do, know when to set your ego aside for the mission, know when to set your ego aside for yourself, and the mission will go on without you. “Pull up! Pull up! Pull up!” Many U.S. Air Force aircraft are equipped with a voice system called Betty, that gives audio warnings meant to cue a pilot when they are ignoring all other indications. Many aviators can tell you of a time when Betty’s timely “Pull up! Pull up! Pull up!” saved them and their aircraft from a sudden terrestrial halt. Like our aircraft, the body gives its own warning signs. Some are subtle and some are not. Through late 2021 and early 2022, I’d been ill on and off. I was tired, I was run down and, I kept getting weird pains. But I was a relatively new commander, determined to bull through the pain and keep the team moving forward. In January, I had what the doctors suspected was a kidney infection from the location of the pain. I got some antibiotics and was determined to push on because the next week I was slated to brief Air Force Chief of Staff Gen. CQ Brown, Jr. I still recall walking out of my office on Friday and telling my director of operations, ‘I’m either briefing the CSAF or I’m gonna be in the ER.’ Fun fact: I ended up doing both. “Pull up! Pull up! Pull up!” indeed. I completed my briefing to the CSAF and a constellation of other general officers, still in pain but managed by timely doses of Motrin and Britney Spears for morale. What I didn’t know was that as I stood their briefing the head of my service, I was very slowly bleeding out inside. As I packed to go home the next morning, the flight doctor called me to say the bloodwork they had pulled ‘showed anomalies’ and I needed to get in ASAP. We set the next available appointment and all the imagery (MRIs, x-rays, mammograms, etc.) that I was scheduled for at the medical group’s leisure were put in as an urgent issue and bumped up. It wasn’t fast enough though because I collapsed at work a few days later before I could make it to my appointment. Even after diagnostic surgery confirmed I had a chronic illness that had already progressed to stage III, I was determined to white knuckle another year in command and ignore the blatant warning signs my body was giving me. Like the heroes is a Greek tragedy, my hubris nearly killed me. The System Doesn’t Care, But People Do After my first surgery diagnosed me with stage III endometriosis, I was put on a course of medication meant to suppress the lesions the surgeon was unable or unwilling to remove due to proximity to vital organs. After only two months, that was deemed a failure and we made the decision to try a strong and more risky medication. The plan was to essentially shut down various hormone production to allow the lesions to heal over, then restart them slowly. Yes, the human equivalent of ‘have you tried turning it off and back on again?’ This was ultimately a failure as it caused ‘fun’ side effects like hair loss, insomnia, chemical menopause, weight gain, and eventually a near catastrophic shut down of my pancreas and kidneys. My specialist and I decided that the next step would be to remove the peskiest organs and see what happened next. He did acknowledge that I needed a robotically assisted procedure due to the complexity and severity of my case, something we couldn’t do on my base. A referral was put in and a few weeks later I was matched to a clinic 90 miles away. Unfortunately, upon seeing my records, they declined to take my case due to the risks involved. I was a liability, and the system doesn’t care about you. What’s worse, when I asked for referral management to give me another doctor, they pushed it back to me to figure out. Trying to find a surgeon, in this specialty, who can do a robotically assisted procedure when my body is a ticking timebomb and I’m recovering from the emotional turmoil of relinquishing command was not ideal. The system doesn’t care, but people do. So, I did what any Millennial would do: I put out feelers on social media and crowd sourced it. Within a week I had the name of a doctor at Walter Reed National Military Medical Center willing to take my case. Working through the system to get orders to go up to Bethesda, Maryland, was rough but at every turn, there was a human willing to help me navigate the system and get help. Once I arrived for a consultation my doctor quickly diagnosed me as having moved up to stage IV. With organs binding to other organs and bone, my body was literally tearing itself apart inside. My consultation was converted into a pre-operative appointment, and I had a surgery date set. The system doesn’t care, but people do. I don’t know what would have happened if I had let the system move at its own pace, but I am extremely grateful to every person who looked at me as a human being and not a case number. As leaders, we should all be willing to see past the trouble, to the person and work for solutions. Leave Your Ego At Home I ended my command tour with only 16 of my planned 24 months. If I were being honest, it should have been shorter, but hubris is a real monster. I had a very strong team behind me, they were willing and able to step up, and I believed that I could bear down and get through this little hiccup while they handled the mission. In retrospect, I should have asked to relinquish command sooner. I robbed them of precious months they could have had with a commander who was fully present, capable of handling the long days and stressful situations. Instead, I let my pride bind me to a course. After all, I had worked 15 years to get to that command position? Surely this is temporary. After struggling for months and being told the condition was chronic, I should have bowed out then to allow the mission to operate at its best, not weighted down by a leader who is struggling with health issues. My team deserved better. In my change of command speech, I apologized to my team, “To my Roadrunners, I fought as long as I could, but you deserve a commander focused on the mission and I deserve to heal.” Those were hard words to say. No one wants to quit early, but I deserved better too. I deserved the time and space to heal my damaged body. Working 15 years to achieve my dream would mean nothing if I died foolishly because I wasn’t willing to take the time I needed to recover. This might be the hardest lesson for leaders to learn and certainly takes the most self-reflection to know when you’re at that point, but its ok to admit you aren’t ok. It’s ok to step back so you can heal, because that’s when I learned the final lesson. The Mission Will Go On Without You The last week of my command, I had three non-judicial punishment actions being processed with another starting, and we had a hurricane bearing down on the line of travel and locations my team was set to visit later that week. All while trying to coordinate a very last-minute change of command. It was stressful. It was chaotic. We were making contingency plans for the team right up until the change of command. But the moment I passed the guidon, it was out of my hands and on to a brand-new commander who had to pick up the ball and run. The mission went on. The non-judicial punishments still processed. The missions still executed. Briefings were still briefed, and I got my surgery as well and time to heal. As leaders, I think we sometimes lose sight of our position. Yes, we lead, but with very few exceptions, any one of us could be replaced overnight and the mission will still move forward. The unit, the team that executes the mission was still there. I should have put my ego on the backburner and stepped aside sooner to let them do their mission. It is no stretch to say that making the decision to relinquish command early was the most difficult professional decision I’ve ever made. I had never personally seen a leader willingly relinquish commander early, I’ve only ever seen them removed early for cause. It was a complete unknown to me, and I accepted the risk that I wouldn’t get command credit or that it would negatively affect my future career. But by the time I made the decision, I also knew that I could very well die and then what did any of that matter? Learn from me. Learn that self-awareness and the ability to put your ego aside to look at the whole picture is invaluable. Learn that empathy for yourself and others does more for the mission than letting the system work. Know that its ok to not be ok, as long as you take action.