Adversity does not always leave people and communities merely recovering from what has been broken. Under the right conditions, Edward Barksdale Jr., MD, FACS, FAAP, believes they can emerge stronger.
That idea of “antifragility” will be at the center of Dr. Barksdale’s “Best of Grand Rounds” lecture today at 4:15 pm in Room 201. His presentation, “Antifragility: The New Architecture of Healing: Transforming Despair into Hope through Surgical Leadership and Social Innovation” (GR02), will challenge surgeons to consider how their leadership can extend beyond treating injuries to helping patients and communities heal.
Dr. Barksdale, chief surgical officer of the Chicagoland Children’s Health Alliance and a professor of pediatric trauma surgery at The University of Chicago in Illinois, encountered the concept in Nassim Nicholas Taleb’s 2012 book, Antifragile: Things That Gain From Disorder. At the time, he was expanding his thinking beyond a narrowly scientific approach to healthcare and considering how surgeons could act on the social drivers of health affecting their patients.
“I thought about that relative to the human condition,” Dr. Barksdale said. “As surgeons, we take care of broken people, and we have a kind of a ‘treat-‘em-and-street-‘em’ mentality. I saw that there was a much bigger calling for surgeons to be leaders outside of the realm of the clinic.”
For Dr. Barksdale, antifragility is about more than returning to where someone was before adversity.
“In my own experience, the people I knew who had been severely broken and recovered were much stronger than those who were not. It may be an opportunity not to bounce back, but to bounce forward.”
The concept also extends beyond individual resilience or post-traumatic growth, he said.
“In antifragility, it's looking at how systems come back together. We're focused not just on how an individual can heal, but how people collectively, as institutions and societies, can heal,” Dr. Barksdale said.
His lecture will explore how surgeons can help “create conditions where adversity becomes the catalyst for hope and flourishing” and contribute to the structures that allow that transformation to occur.
Putting Antifragility into Practice
Dr. Barksdale also will share how he has applied the concept through surgical leadership and social innovation.
Working with a team, he created The Anti-Fragility Initiative, a program designed to help pediatric trauma patients initiate positive change following violence. The initiative has received $4.8 million in funding, and the team was invited to the White House to share its approach.
That experience illustrates a broader role Dr. Barksdale sees for surgeons. It extends beyond treating the immediate consequences of trauma to helping address the conditions that affect patients and communities after they leave the hospital.
Dr. Barksdale was nominated for “Best of Grand Rounds” after sharing his reflections on the antifragile qualities of New Orleans following Hurricane Katrina in 2005.
The “Best of Grand Rounds” series is a new Clinical Congress series featuring three presentations selected from lectures nominated by surgeons across the country. Joseph V. Sakran, MD, MPH, FACS, spoke yesterday about the use of personal narratives in surgical leadership; Tovy H. Kamine, MD, FACS, will present “Surgery in Space” tomorrow at 11:30 am.
