March 30, 2026

Cognitive Oxygen™ (COx)

Cognitive Oxygen™ (COx)
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Season 1

What if the real constraint in your leadership is not strategy or talent, but the quality of thinking conditions around you? In this episode, Dr Toomas Särev joins Captain David Gallimore to explore Cognitive Oxygen™ (COx): the practical discipline of protecting and restoring the conditions for wise action under pressure.
We will examine how clarity, psychological safety, and agency operate at three levels: the individual, the relationships between people, and the environments they work in.

REGENERATE is broadcast live Mondays at 10AM PT on K4HD Radio - Hollywood Talk Radio (www.k4hd.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com). REGENERATE TV Show is viewed on Talk 4 TV (www.talk4tv.com).

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WEBVTT

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This program is designed to provide general information with regards

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to the subject matters covered. This information is given with

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the understanding that neither the hosts, guests, sponsors, or station

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are engaged in rendering any specific and personal medical, financial,

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legal counseling, professional service, or any advice. You should seek

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the services of competent professionals before applying or trying any

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suggested ideas. Behoy. Captain David Gallimore welcomes you aboard the

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Regenerate Show live Monday's ten am Pacific on KFOHD Radio

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at KFOHD dot com. We dive into the real messy

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work of transforming our lives. Leadership and organizations bring their

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hot mess and confusion. Lead with clarity, courage and confidence. Together,

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let's strengthen our resilience, accelerating the health of ourselves, people,

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plan and profits. Now here's your host, Captain Dave, your

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personal regenerator.

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All aboard, hooy, and welcome to episode eight eight.

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That's right, that MANI fingers.

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Our theme this week is cognitive oxygen. When I first

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heard that term, I thought, this is pretty special. What

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if the real constraint in your life, your leadership, your

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organization is not the lack of strategy or talent, but

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a shortage of the conditions that make clear thinking possible. Today,

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we're going to explore that question with a guest who

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has spent over two decades making high stakes decisions in

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cardiology and now help senior leaders and teams do the same.

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I know your investment of time will be well spent.

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And here's our prom First, going to have fun today

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when we're laughing we're learning. Second, to leave you inspired,

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and finally to leave you with one thing that you

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can apply before you go to sleep tonight, Rabipen Transformations

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happen here. It's my privilege now to introduce doctor Thomas Sarev.

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He's a consultant cardiologist and Fellow of the Royal College

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of Physicians with over two decades of experience in acute

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and interventional cardiology across seven countries. Truly a global physician Estonia, Finland, Sweden, Norway, Ethiopius,

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Sudan and the UK. He's also an EMCC accredited Executive

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Leadership and team coach, a certified Red Team thinker. Where

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I met doctor t as he's fondly called, and the

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creator of this new framework called the Cognitive oxygen framework.

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His work sets the intersection of clinical rigor, critical thinking

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and human centered leadership. And what I love about doctor

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t is he doesn't just talk about leadership as an

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academic exercise the complexities of leadership, but he lives it

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literally every day as an active consulting cardiologist, and he

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knows how environments carry real weight and there's really no

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margin for error. It's life and death literally. Today he

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helps senior clinicians, healthcare leaders, and their teams protect the

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conditions to create wise action under pressure. Please welcome my

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friend and dear colleague, doctor Timas Serrev.

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Thank you, Captain Dave. I'm really privileged to be here

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with you.

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I am so thrilled. You've had a long day, my friend.

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It's six pm in the UK. Thank you so much

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for extending your day on behalf of our listeners. So

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to get the fun started. What's that one thing that

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you just love to be or do that gives you

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the most joy?

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Just one thing? That's that's really cruel question, David. I

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think it changes. It changes with the seasons of life.

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And there was a time when martial arts was my

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center of gravity. I love the discipline of it, focus

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the honesty. You can't fake who you are in a dojo.

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But this season it's surprise riding my motorcycle. I have

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a Royal Enfield super Meture six point fifty in celestial red.

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Since see why I did the full picture, And there

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is something about being on two wheels that really clears

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the static from my mind. You know, the wind, the engine,

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the road all it brings me back into the present.

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So you can't really be worrying about emails or tomorrow's problems.

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You simply you are simply there, alive to the moment.

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And for me, it's a kind of moving meditation. And

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even better, my sweetheart loves writing pillion, so it becomes

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joy we can share. And then there is the quieter

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side of joy, my dog, my family, a good book,

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a new idea that makes me stop and think. So

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the real answer is that I love anything that helps

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me feel fully present, fully alive and deeply connected.

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Wow, that inspires, And I've seen pictures of your road bike.

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It's pretty pretty cool and it's got some giddy up.

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So before he became an executive coach, before becoming a

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critical thinker, Red Team thinker, before becoming a doctor, what

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a couple of life experiences really forged you. What's your

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origin story so far?

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In this part of your life, It's really interesting to

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look back. Grew up in Estonia. Estonia is a little

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country on this planet between East and West. I grew

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up during the Soviet era that shapes you in a

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ways you do not fully understand until you much later.

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Until much later in life, you learn early that what

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is said in public and what is true and not

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always the same thing. You learn to read between the lines.

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You learn that authority can sound really confident and still

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be wrong, that obedience doesn't always make people safe. And

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somewhere in all of that, if you are paying attention,

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you discover that thinking for yourself is not a luxury,

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it's a survival skill. And then Estonia regained independence, and

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I was a young doctor watching the entire society reinvent

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itself in real time. And that stays with you as well,

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because you realize that systems are not permanent. They are

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built by people, which means they can also be changed

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by people. These are choices, not destiny. I trained as

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a doctor in Estonia and Finland, and then I worked

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across multiple healthcare systems and over time, I saw a pattern.

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It kept repeating in every system, in every culture and

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every hospital I worked in. And what breaks teams is

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not the lack of intelligence. It's not laziness, it's not

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bad intentions. It's depletion. And that is the word I

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could slow down on because it matters, and people are,

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you know, running on fumes, and because the system has

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normalized exhaustion. Nobody nobody names what is happening. In fact,

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we often admire it. We confuse over extension with commitment.

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So that's that's what I observed, and that's that was

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the moment I recognize something is is interesting what I

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know now call cognitive hypoxia.

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I think this idea of oxygen and breathing, it is

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so fundamental to life. And both of us have gone

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through Laura Storm's regenerative leadership journey that year long, quite

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frankly disruptive to my way of thinking as a you know,

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I guess historic colonialist and extractor, and and what lessons

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can we learn from Mother Nature who's been around for

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a three point eight billion years, She's probably learned a

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thing or two. And of course oxygen is fundamental to

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life on Earth. Certainly water, oxygen, other key minerals and

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chemicals in our world. So when you have a lack

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of oxygen, obviously patients go brain dead. And then you know,

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the cells start to die and organs collapse and stop working,

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and and the patient dies. And in many ways what

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you've identified, I think is so endemic to our modern life.

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So let's pivot now to this exciting new framework that

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you've been thinking about for a long time. Finally, I

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hope I've had a little bit of influence in supporting

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your brilliance. You you know, say, sometimes we have imposture

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syndrome in areas of our life that are new and different. Obviously,

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you're a highly trained cardiologist, you know that that discipline well,

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but you know, being a thought leader and being a

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writer and being an executive coach, it's a whole new world,

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isn't it. So tell us a little bit about hoggative oxygen.

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What's the genesis, what's the origin story for this powerful framework?

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Yes, so as a cardiologist, the metaphor made immediate sense

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to me. In the body, when oxygen endurbs, as you mentioned,

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function begins to fail, always dramatically at first, but steadily,

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quietly and dangerous, and I realized that something similar happens

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in leadership and in teams. So people lose conditions for

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clear thinking before they lose the answers. And the knowledge

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has not disappeared. The person has not disappeared, but their

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cabenty of oxygen is low. And that insight also is

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I'm thinking backwards. Is what pulled me into coaching and

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leadership development. That I didn't leave medicine. I still practice it,

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but I expanded the frame of it. So how can

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we how do we help leaders regain enough clarity to

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think well under pressure? So that was my big question

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and that then led me to this framework. So as

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it's simplest cognitive oxygen is the margin, the buffer space

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we need to think clearly and stay human under pressure.

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And I think about oxygen every day. So the heart

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delivers oxygen to the body, and what when that supply drops,

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function begins to deteriorate and not and without oxygen, you

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know it cannot do it show well. And over time

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I really realized that something similar is actually happening in people,

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in teams, in organizations, and that is what then brought

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me to this concept. And it's really about marching enough

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inner and outdoor marching for people to think, to listen,

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to regulate themselves, to stay curious, and to respond rather

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than simply react. And I tend to see it at

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three levels. So first is the inner oxygen, which is

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happening inside the individual. Do I have enough attention, enough clarret,

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enough emotional steadiness, enough pause between stimulus and response to

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stay thoughtful under pressure? Or have I become mentally breathless?

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You see, we are on a treadmill often and we

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push until your body cannot continue anymore. But mentally we

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often have a story, Oh you have done this before,

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you can do it. You push over, and then at

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some point you are on the on the verge of

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this kind of yeah, burnout.

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The second yeah, if I may add what I see

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in my clients. So I, as you know, I'm an

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executive coach like you, and I don't work with medical

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organizations specifically, but I do a lot with tech companies.

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And one of the things that you mentioned to me

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when we were talking about this radio show is how

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high activity, which can be on the surface seem like

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a good idea, but often it is this I think

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you called it cognitive hypoxia. Before where people stop being curious,

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they stop asking, you know what, how might we blow

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this up? Like a pre mortem from red team thinking, yes,

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they're just reacting.

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And I think you called the word absence scene.

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Is that that sounds I say that right? So when

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you are in organizations, when when you're reporting in, you know,

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like for today, when you were working as a cardiologist,

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what were you noticed in terms of the activity, kind

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of the frantickness, if I may call it that, of

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just trying to get through their patient lists and maybe

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get a spot of lunch or not, or a snack

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in the vending machine. But what was it like today

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when you when you walked in to your medical facility.

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Yes, it was. It was pretty frantic day. Lots of

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new patients, lots of severely sick patients also, and two

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younger colleagues. Thankfully I had worked with both of them before,

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and they were inspired because I always enter a new

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ward and tell them that, hey, my friends, this is

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a playground, so let's let's be curious, let's learn something new,

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and let's swap roles. So actually it turned out to

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be a really, really good day. But often what we

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see is that you have depleted your inner oxygen, so

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you have not enough emotional steadiness, You have no pause

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between stimulus and response to state thoughtful, and then you

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are like mentally breathless and and you can't think clearly.

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And then there is this social oxygen, which is like

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quality of our relationships. So can we ask difficult questions?

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Can we speak honestly before the problem hardens into dysfunction

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and people tell the truth. So psychological safety is not

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just a culture world. It's a sign that there is

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enough oxygen in the relational field. The third level is

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this structural oxygen, which is like the environment around us time, meeting, culture,

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decision process, reporting, lines, governance. There are a lot of elements,

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but because it keeps the structure, keeps people rushed, fragmented

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and interrupted and overloaded. Then even very good people begin

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loose their clarity. And this is where the idea of

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carrying capacity also matters. So how much strain can a

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system actually absorb before vitality judgment that humanity to begin

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to thin out? Yes, And there is one lesson from cardiology.

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So if you have an ongoing heart attack and you

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all of a sudden open up a vessel into basically

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dying muscle, then there is often more damage initially if

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the flow returns too quickly. There is similar aspect in leadership,

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so it has its own version of that. So when

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a person or a team or an organization has been

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depleted for too long, you cannot simply flood the system

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with change, challenge, honesty, or expectation and assume that they

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will feel like healing. Sometimes it is destabilizing for it.

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The capacity to absorb truth or transformation has been reduced,

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and so wise leadership is just about bringing back oxygen.

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It's about restoring it in a way the system can

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actually metabolize. That's what the element of project we have

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been involved with, which is richer and rate of leadership,

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it's very close. So these elements come together in this

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cognitive oxygen one set.

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So I am very inspired by these these ideas that

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you've shared, and I think it's so powerful to help

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create a metaphor the human body and oxygen and what

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you just mentioned a nuance related to a heart victim.

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Didn't know that, but.

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In my experience, when when change is occurring at such

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rates in the external environment that organizations have to adapt

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and there they're cognitive oxygen, to use your term, is depleted.

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Their ability to handle that change, to be thoughtful and

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to be strategic or balancing being strategic with being tactical.

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It really is is a challenging time. Now I'm going

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to ask rebel our producer to put some Claude table

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that I put together before I joined you, because what

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we're talking about with this epoxia, this do dodo running

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crazy hours, it's got a significant impact on in your

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world medical doctors and nurses. This is, you know, some

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metrics related to doctors.

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Let me make this go a little bit further.

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So what I did in Claude was ask about physician engagement,

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psychological safety, and burnout, and all of the sources will

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put in the show notes. So the characteristics first section

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here on burnout, next on engagement, et cetera. And I

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put UK doctors in this second column here, and then

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interestingly asked what was the top country the globe that

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had the least burnout and the best psychological safety and

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the least risk of issues, and it was the Netherlands.

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And then I finally in the last column compare the US.

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Probably no surprise to you about the UK statistics, but

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you know things like doctors in training at high risk

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of burnout one in five according to twenty twenty five

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Survey National Survey Emotional exhaustion. This one really grabbed me.

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Suicide risk. A UK doctor dies by suicide every three weeks.

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And I could keep going down this list, But do

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you want to speak to maybe a personal story. You

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might need to anonymize the if it's another person, or

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if it's about yourself and how you experienced some of

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these really challenging metrics related to engagement, psychological safety, and burnout.

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Yeah, this is this is really close to close to

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my heart, this question. And what I observe is that

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healthcare professionals are very They are very enthusiastic, or they

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have been at some point in their professional career, is

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very enthusiastic about their thing. Medicine, healthcare. You do your

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best to save someone's life. You have a psychological contract

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with your profession. And then there is this other side,

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the business, the managerial side, and often there's a big

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gap in communication. So there is a huge gap at

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the moment between the boardrooms of the NHS and the

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front line. Basically there is no communication. You have almost

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lost your agency and autonomy because you are pushed to

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do something which is not aligned with what you want

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to do actually, and the conditions squeak this cognitive oxygen level.

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So basically you are running like like in a hamster

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wheel with an empty cognitive oxygen tank metaphorically on your

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in your backpack, and and that creates misalignment. So it

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also causes the identity crisis. I was myself in a

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situation where I had two and a half kilograms of

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paperwork like patient papers on my desk and I could

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not find time to sort it and there was no

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help available, although I asked for help, and that was

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interpreted as When I then used radical candor, that was

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interpreted as bulling. So basically, someone pulls a yellow card

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for you and says that you talk truth, but that

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was interpreted as bulling. I really I, I was honest,

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and I said that I will resign from my NHS

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role if nothing happens in three months and if there

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is no help. And there was no help, and I resigned.

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I thought I don't want to become a patient on

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my own Catholic table. And before that, actually there was

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an impulse in a boardroom where we were listening some

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strategies to put another hospital on its knees, which was terrible,

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and I thought that I don't want to be a leader.

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I was at that time ahead of the clinic. I

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thought that that is not what I want to achieve

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in my life. I want to help other leaders to

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see more clearly. And that basically ignited this interest into

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that concept which then later got it's name. So I've

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been personally in this situation, and I was also seen

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this in boardrooms and the in executive teams. So and

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it's really sad that it happens. So and people often

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become blind they cannot see, and once you can see,

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then you can't not see it. So could stop treating

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depletion as personal weakness. We can't solve this with more

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yoga classes or pilates essons, and we should start seeing

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it as an operational condition. And that shift from blame

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to diagnosis is already were better leadership begins.

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Absolutely right. I mean you spoke about the environment that

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third level, the structural level. If that's not conducive to

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healthy people processes, then the outcomes are going to be

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what the outcomes are, good, bad, and ugly. Yes, So

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We're now going to need to just take a quick

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break and when we come back, we're going to pick

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up a little bit more details of doctor Tomas Sarev's

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cognitive oxygen framework. Please stand by for this important message.

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You're listening to Regenerate with Captain Dave, your personal Regenerator

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00:22:59.200 --> 00:23:06.319
on K for A Radio. We'll be right back. Are

332
00:23:06.400 --> 00:23:10.359
you feeling overwhelmed? Are you ready to regenerate and live

333
00:23:10.440 --> 00:23:15.440
the life of your dreams? Start the transformation now called

334
00:23:15.559 --> 00:23:19.480
Captain Dave at two five three two three seven two

335
00:23:19.480 --> 00:23:25.200
five five eight. Stop overthinking again. Call two five three

336
00:23:25.599 --> 00:23:29.680
two three seven two five five eight or go to

337
00:23:30.000 --> 00:23:39.079
regenerativeworldgroup dot com to book a free, no obligation clarity call.

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00:23:39.160 --> 00:23:42.680
Let's get back to regenerate right here on K FOURHD

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radio for more life changing transformations. Here's your host, Captain Dave,

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your personal regenerator.

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Welcome back if you're just now joining. I've had the

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privilege of chatting with my dear friend and colleague, doctor

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Timas Sarev, who is a consulting cardiologist and an executive

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coach and Doctor t Time is never our friend and

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I know that we would love to do both the

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red Team thinking conversation as well as the breath practices.

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Which do you think, based on what we've been discussing

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so far, you think is the most important that you'd

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like to share with our audience.

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I think we could touch how this uncertain world goes

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on and touch an element. But most organizations make the

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same mistake. They assume that in uncertain conditions, the answer

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is more information, more data, more meetings, more reporting, more control.

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But you see, healthcare is especially vulnerable in this field

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because it belongs to a complex adaptive system. So complexity

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doesn't just require more information, it requires better thinking conditions.

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And that were also critical thinking and retin thinking clicks

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in So because when uncertainty rises, organizations offer, you know,

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start piling things on. Every xcel rator consumes more cognitive oxygen.

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The result is that leaders have less and less margin

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to think clearly but exactly the moment when when clarity

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matters most. How does that look in your in your world?

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Oh my gosh, so so true.

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You know, I have a client who I spoke with

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over the weekend who there's so much change that they're

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trying to introduce relative to generative AI and how to

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create a human centered implementation of generative AI. They're not

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a publicly traded company, so the good news is they

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can kind of do it the way they think is

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best for them. But many publicly traded companies that are

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driven by quarterly returns. You and I that you know

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one are seven percent annual return on our portfolios.

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So we're partly culpable.

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With Wall Street, uh and and other financial industries in

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the UK and across the globe. They are replacing people

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with generative AI agentic systems, and you know that's causing

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a tremendous amount of hardship and stress for people in

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the tech worlds, especially where a lot of programmers, for example,

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are getting replaced. So the red team thinking, do you

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want to just describe a little bit about if if

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you were knowing what you knew then now that you

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know now, but you used it, applied it back then

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when you were accused of bullying, how might you have

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leveraged red team thinking techniques one or two of those

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to help create a safer environment to speak truth to power.

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Yes.

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Retin thinking is the decision quality engine inside cognitive oxygen framework,

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and it is it is the discipline of structured dissent

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basically basically testing assumptions before they test you. And in

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healthcare people quite understand quite well understand what does post

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mortem mean. So things go wrong, someone as a complication

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person dies, then we think, you know, oh my god,

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what happened. But I use tools like pre mor time

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where you imagine a decision has already failed and work

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backwards to find find out why. The assumptions challenge is

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very powerful, where you surface and stressed as the beliefs

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which are underpinning a strategy, and something I call we

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call in writing thinking four ways of seeing. It's very

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useful framework where you examine a situation from other person's

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lenses for different perspectives, for committing to a course of action.

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And there is one paradox, David, and this is one

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I want your listeners to sit with. The more pressure

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you are under, the more certain you feel, and the

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more certain you feel, the more likely you are to

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be wrong. It's interesting, but it's true, and certainly, under pressure,

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there is often a cognitive hypoxia. Wearing a confident mask.

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It feels like clarity, but it's actually a narrowing of

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the field. And interestingly, the more expert you become the

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narrower your vision might become. Also, and you have stopped

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seeing options because you are so certain about your thing.

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You have stopped hearing dissent. You are running on pattern

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recognition without checking whether the pattern still fits. It's like,

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you know, becoming pregnant with something you really, really like,

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and then you lose your critical thinking and retin thinking interrupts.

415
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That title creates a structured moment of doubt, and that

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moment of doubt is where the decisions leave. Also, it's

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engaging other people in this thinking. And there is there

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is one question what I think consistently changes rooms. If

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you ask what would have to be true for us

420
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to be completely wrong about this? That question does something remarkable.

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It gives people permission to challenge the dominant narrative without

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feeling like betrayal or disloyalty. And in that opening the

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truth often walks in.

424
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Yeah, I have personally experienced the value of that question.

425
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I'm so glad that you brought it into this conversation.

426
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I think that masking that it's very counterintuitive as a leader,

427
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and I had to learn this the hard way. I

428
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was leading a very complex turnaround program for BC Hydro

429
00:29:55.319 --> 00:29:59.079
nine hundred and thirty million dollars smart meter Implementation program,

430
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and we were already two months late, and we had

431
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to get a certain amount of scope done in two

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years because of the provincial funding and the law that

433
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had required this project to be done by the end

434
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of twenty thirteen, and I frankly did not know exactly

435
00:30:18.759 --> 00:30:22.640
how I was going to get this done, and so

436
00:30:22.960 --> 00:30:26.599
I had to admit to my leadership team, you know,

437
00:30:27.240 --> 00:30:30.119
I'm really needing your help. I know you're looking for

438
00:30:30.160 --> 00:30:34.640
me to point us in this direction and be very

439
00:30:34.680 --> 00:30:38.240
clear about that. I'm clear about some things, but I'm

440
00:30:38.359 --> 00:30:42.440
not confident. But the power, you know, admitting that that

441
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authenticity and vulnerability asking for help creating then a little

442
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workshop that I facilitated, and we were able to bring

443
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wonderful cross section of people that had different perspectives of

444
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the elephant, if you remember the Three Blind men and

445
00:30:59.599 --> 00:31:02.920
the and at the end of a half a day,

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not only did I get smarter, but I think everybody

447
00:31:06.359 --> 00:31:10.039
else got a lot smarter, listening deeply to each other,

448
00:31:10.559 --> 00:31:13.960
and we emerged with a strategy, and one of the

449
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keys to it was this word called decoupling. We had

450
00:31:17.119 --> 00:31:21.519
twenty three different vendors and a lot of new technology

451
00:31:21.880 --> 00:31:26.880
that was bleeding edge, and you know, certain deadlines from

452
00:31:26.960 --> 00:31:33.799
certain companies were being missed. But still this two year runway,

453
00:31:33.839 --> 00:31:36.359
that's all we had. We couldn't go beyond that. So

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we had to decouple things that were late and slide

455
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other things in its place so that we could hold

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the critical path and that vulnerability. I've never forgotten. It

457
00:31:46.559 --> 00:31:49.839
was scary at the time, but it was such an

458
00:31:49.839 --> 00:31:54.759
affirming experience that now from this point on, I just say,

459
00:31:54.880 --> 00:31:57.680
you know, here's what I know to be true, and

460
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here's the facts and data to support that.

461
00:32:00.039 --> 00:32:03.279
But here's where I'm not clear at all. What do

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00:32:03.359 --> 00:32:03.880
you think?

463
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And then shut the f up and listen. We have

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two ears and one mouth for a reason. And the

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power of the team and using red team thinking approaches

466
00:32:16.359 --> 00:32:19.640
like you just outlined, I think create some structure for

467
00:32:20.279 --> 00:32:21.799
healthier conversations.

468
00:32:21.960 --> 00:32:25.759
And that is very close also to reach generate to leadership,

469
00:32:25.799 --> 00:32:29.519
because if you're depleted them, so you jump to conclusions

470
00:32:29.680 --> 00:32:33.880
your great situation we call groupthink and satisfying you know,

471
00:32:34.480 --> 00:32:38.440
the first idea and then you go with that without

472
00:32:38.519 --> 00:32:44.279
actually holding the space holding the complexity, so and reach

473
00:32:44.319 --> 00:32:47.480
and rate of leadership requires something different. It requires the capacity,

474
00:32:47.880 --> 00:32:52.359
I think beyond the quarterly cycle, so to hold multiple perspectives.

475
00:32:52.519 --> 00:32:56.279
I think it thinks really well together with the critical

476
00:32:56.319 --> 00:33:00.400
thinking techniques. Also just to sit with them biguit long

477
00:33:00.519 --> 00:33:03.839
enough for the wiser answer to emerge. I think that's

478
00:33:03.880 --> 00:33:07.599
really important. And we do so many mistakes when we

479
00:33:07.720 --> 00:33:11.839
jump to conclusions too quickly, not talking to people, not

480
00:33:11.880 --> 00:33:15.920
asking questions. Often I see it in healthcare. A manager

481
00:33:15.960 --> 00:33:19.039
comes in and says, Thomas, we have this challenge. You

482
00:33:19.079 --> 00:33:22.039
have to do X, Y Z, and then Thomas thinks

483
00:33:22.079 --> 00:33:24.400
that I don't like it. That's wrong, it's not the

484
00:33:24.480 --> 00:33:28.079
right thing to do. Instead, if the manager comes and

485
00:33:28.160 --> 00:33:31.279
asks Thomas, doctor, Thomas, we have this challenge, and I

486
00:33:31.359 --> 00:33:34.680
know that you are most resourceful here, so what would

487
00:33:34.680 --> 00:33:38.880
you do? It is a different coaching style leadership which

488
00:33:39.279 --> 00:33:42.440
makes you you think, you zoom out from the situation.

489
00:33:42.599 --> 00:33:46.759
You come to better decisions, and especially in a team setting,

490
00:33:47.319 --> 00:33:53.200
that creates more communication, more questions, more listening, and in

491
00:33:53.240 --> 00:33:55.960
that field than using your airs and mouth in the

492
00:33:55.960 --> 00:33:59.920
same ratio as the creator has given these organs to us.

493
00:34:00.480 --> 00:34:01.880
He's really really important.

494
00:34:02.200 --> 00:34:05.160
Plus you get better sin in the game to implement

495
00:34:05.319 --> 00:34:09.960
whatever ideas emerge from those discussions. It's one thing to

496
00:34:10.000 --> 00:34:12.920
come up with an answer, it's another thing to implement

497
00:34:13.119 --> 00:34:13.840
the answer.

498
00:34:14.400 --> 00:34:16.679
Yes, yes, So in.

499
00:34:16.599 --> 00:34:20.400
The final third of our regenerate show, my friend time

500
00:34:20.440 --> 00:34:22.519
is never our friend. Sorry about that, We'll have to

501
00:34:22.519 --> 00:34:25.559
have you back if you're willing. I would love, love,

502
00:34:25.639 --> 00:34:29.119
love to be a bit of a patient. You being

503
00:34:29.159 --> 00:34:35.320
the doctor related to the breath acronym, and would you

504
00:34:35.360 --> 00:34:39.360
be willing just to describe it and then let's try

505
00:34:39.400 --> 00:34:41.840
it out so that our listeners can see you in action.

506
00:34:41.960 --> 00:34:43.880
I think it's so powerful this idea.

507
00:34:44.360 --> 00:34:47.719
Yes, let me briefly explain. So, breath is a mnemonic

508
00:34:47.840 --> 00:34:52.320
for the seven daily practices or cognitive oxygen. And yeah,

509
00:34:52.360 --> 00:34:54.800
it sounds a bit cheesy perhaps to some people.

510
00:34:55.239 --> 00:34:56.840
I don't excuse you at all.

511
00:34:56.880 --> 00:35:00.760
I think I can actually remember those things because of it.

512
00:35:00.760 --> 00:35:01.719
It makes a lot of sense.

513
00:35:02.239 --> 00:35:06.760
So b is for behold to suspend automatic judgment for

514
00:35:07.039 --> 00:35:10.360
long enough to see clearly what is actually happening before

515
00:35:10.360 --> 00:35:14.280
you react. You notice. So that sounds really simple, but

516
00:35:14.400 --> 00:35:16.880
under pressure, it's one of the hardest things a leader

517
00:35:16.920 --> 00:35:21.559
can do. We often jump to solve the problem. But

518
00:35:21.639 --> 00:35:25.000
if you just hold it a little bit longer so

519
00:35:25.360 --> 00:35:30.199
that you break this automatic judgment cycle. So that might

520
00:35:30.280 --> 00:35:35.000
be a good good first element, so being the.

521
00:35:35.039 --> 00:35:39.519
Risk of assuming yeah, because we are then sorry, go ahead.

522
00:35:39.719 --> 00:35:44.280
R R is for regulate, so restore enough inner steadiness

523
00:35:44.280 --> 00:35:48.360
to avoid a kind of contamination in medical language, contaminating

524
00:35:48.360 --> 00:35:51.199
the field. If the leader walks in anxious, the room

525
00:35:51.280 --> 00:35:56.000
becomes anxious. You know, regulation is not suppression. It's it's

526
00:35:56.039 --> 00:35:59.920
like choosing what you bring into the space. So regular

527
00:36:00.559 --> 00:36:05.119
E is then or engaged deeply to listen for week signals,

528
00:36:05.639 --> 00:36:08.880
listen for hidden concerns and what is not being said.

529
00:36:09.199 --> 00:36:12.480
And this is where the social oxygen lives or dies.

530
00:36:13.079 --> 00:36:18.360
So it's it requires good listening skills, like like old

531
00:36:18.679 --> 00:36:21.400
you know valve radio. You remember these old radios were

532
00:36:21.800 --> 00:36:24.880
there were glowing lamps inside they picked up all the

533
00:36:24.920 --> 00:36:29.320
wavelengths even between the stations. Metaphorically, B like that, and

534
00:36:29.480 --> 00:36:34.000
A is then for articulate reality. So put reality into

535
00:36:34.119 --> 00:36:39.400
language early before it hardens into into dysfunction. So name it,

536
00:36:39.800 --> 00:36:42.559
name it, what is name what is true. The earlier

537
00:36:42.639 --> 00:36:45.360
you name it, the more options you have than teased

538
00:36:45.480 --> 00:36:51.320
for test assumptions. That is actually rich team element challenge assumptions,

539
00:36:51.440 --> 00:36:57.119
wuiden options, losing the grip of premature certainty, and I

540
00:36:57.239 --> 00:37:01.079
like h H is for hack the system, to take

541
00:37:01.159 --> 00:37:04.199
one small real world step to test a better way

542
00:37:04.239 --> 00:37:09.360
of working. Not the ground transformation, but in complex adaptive systems.

543
00:37:09.360 --> 00:37:12.960
We need safe to fail experiments. So prove it works

544
00:37:13.000 --> 00:37:17.760
in miniature first. You know, complex system in Kineffin's framework

545
00:37:17.920 --> 00:37:24.880
is like chess. Chess game with small little elements. One

546
00:37:25.039 --> 00:37:30.239
moves everything else. That's a really hard place to work

547
00:37:30.599 --> 00:37:36.000
an ease for enable the ecology to protect them the rhythms,

548
00:37:36.239 --> 00:37:39.960
boundaries and relations and conditions that keep oxygen circulating in

549
00:37:40.000 --> 00:37:43.559
the system. So this is a kind of stewardship practice.

550
00:37:43.599 --> 00:37:47.719
So this is where also cognitive oxygen meets regenerative thinking

551
00:37:47.840 --> 00:37:52.559
and and here is the beautiful paradox at the heart

552
00:37:52.599 --> 00:37:57.480
of it. So the discipline of breathing whenevery instinct says

553
00:37:57.800 --> 00:38:02.079
says you move faster, so you just do the opposite.

554
00:38:02.639 --> 00:38:06.199
The coaching question, what if the opposite is true? Is

555
00:38:06.320 --> 00:38:07.000
really valid?

556
00:38:07.000 --> 00:38:07.239
There?

557
00:38:08.239 --> 00:38:09.920
How does how does that sound?

558
00:38:10.320 --> 00:38:11.559
I love it? Do you do? You want to?

559
00:38:11.679 --> 00:38:15.400
Now? Maybe guide me through. We've got about three or

560
00:38:15.440 --> 00:38:19.159
four minutes to guide me through. This breath approach.

561
00:38:19.599 --> 00:38:23.119
Yes, so you you you don't need hopefully a lot

562
00:38:23.119 --> 00:38:26.679
of time to do it in practice, it's in essence

563
00:38:27.239 --> 00:38:32.880
taking a deep breath and pause and think through these steps. So,

564
00:38:33.519 --> 00:38:38.400
how can you become a better in your decision making?

565
00:38:38.800 --> 00:38:43.280
How to stop this automatic judgment long enough? And then

566
00:38:43.920 --> 00:38:48.280
once you take a deep breath, you lower your shoulders,

567
00:38:48.400 --> 00:38:53.320
you regulate your emotions, You enter say, meeting room in

568
00:38:53.360 --> 00:38:57.840
a different different way, and then you you are present,

569
00:38:58.000 --> 00:39:02.679
you engage deeply and then reflect back what is real,

570
00:39:03.000 --> 00:39:07.079
what's going on? And test the assumptions.

571
00:39:06.440 --> 00:39:12.280
And maybe ask the team what are they seeing exactly?

572
00:39:12.920 --> 00:39:15.679
Engaging rather than me telling.

573
00:39:15.880 --> 00:39:19.960
That requires some vulnerability. You can ask do I have

574
00:39:20.039 --> 00:39:24.280
blind spots here? What are we missing? That requires curiosity

575
00:39:24.320 --> 00:39:30.239
and that requires that steady good emotional regulation. So emotional

576
00:39:30.239 --> 00:39:33.079
intelligence has to be a good level. If you are

577
00:39:33.079 --> 00:39:37.079
stressed and run out of your cognity oxygen, you're not

578
00:39:37.159 --> 00:39:40.559
able to do that because then everything new is like, oh,

579
00:39:40.679 --> 00:39:43.199
go away, I don't want to hear you're hiding your

580
00:39:43.239 --> 00:39:46.960
below the line. That is a way of thinking yourself

581
00:39:47.000 --> 00:39:50.199
into better space. Also, you can ask can I break?

582
00:39:50.280 --> 00:39:52.559
Can I do this? Can I go through these steps

583
00:39:52.920 --> 00:39:56.360
and it can be like a self reflective process which

584
00:39:56.400 --> 00:39:59.360
helps you to get clarity what you need to do

585
00:39:59.440 --> 00:40:04.440
if you in a really difficult situation and perhaps run

586
00:40:04.440 --> 00:40:07.400
out of options, and that will give you some options,

587
00:40:07.760 --> 00:40:09.800
you know it, So he helps, right.

588
00:40:10.360 --> 00:40:14.360
It's so interesting that to prepare yourself as the leader

589
00:40:14.519 --> 00:40:15.480
going into such.

590
00:40:15.360 --> 00:40:17.559
A meeting that you breathe.

591
00:40:17.480 --> 00:40:22.159
Yeah, it's it's not about telling yourself a mantra or

592
00:40:22.639 --> 00:40:27.239
necessarily you know, eating a certain food or going for

593
00:40:27.360 --> 00:40:30.480
a run ahead of time. It's as simple as just

594
00:40:30.719 --> 00:40:35.159
take a few deep breaths and if we can have

595
00:40:35.360 --> 00:40:37.639
agency in our state.

596
00:40:38.360 --> 00:40:38.519
Right.

597
00:40:38.960 --> 00:40:41.119
And I saw this when I was in the corporate

598
00:40:41.440 --> 00:40:45.719
world going from back to back meetings and now in

599
00:40:45.760 --> 00:40:49.519
the virtual life that we lead back to back zoom

600
00:40:49.559 --> 00:40:55.559
calls literally no time to breathe between. And I suspect

601
00:40:55.719 --> 00:40:59.920
you as a doctor, there's a tendency to just next patient,

602
00:41:00.199 --> 00:41:04.639
next patient, paperwork, next patient. And yet if you don't

603
00:41:05.159 --> 00:41:08.559
have that self awareness to say, man, how do I

604
00:41:08.599 --> 00:41:13.719
bring my best self in this next patient encounter or

605
00:41:13.760 --> 00:41:17.199
the next corporate meeting, then I'm I'm going to have

606
00:41:17.519 --> 00:41:20.119
epoxia oxygen hypoxia again.

607
00:41:20.559 --> 00:41:25.159
Yes, And there are some tough questions which which give

608
00:41:25.239 --> 00:41:29.800
you kind of rapid qalnitive oxygen diagnostics. So you run

609
00:41:30.079 --> 00:41:34.000
originative world group. You're building something meaningful if I ask

610
00:41:34.119 --> 00:41:39.079
you some hood questions so we can see what surfaces. So,

611
00:41:39.559 --> 00:41:43.760
for example, one really good coaching question is what conversations

612
00:41:43.800 --> 00:41:44.639
are you not having?

613
00:41:45.000 --> 00:41:49.159
Yeah, I've been pondering something like that question.

614
00:41:49.199 --> 00:41:50.679
Thank you so much for asking it.

615
00:41:51.119 --> 00:41:53.519
You know, I still think I have quite a bit

616
00:41:53.559 --> 00:41:59.119
of imposter syndrome related to asking for my ideal cloud,

617
00:41:59.360 --> 00:42:03.239
who is a generative, purpose driven client. I keep telling

618
00:42:03.280 --> 00:42:06.840
myself I need to take another certification program, I need

619
00:42:06.880 --> 00:42:11.800
to read more, I need to hear you more regeneratively myself.

620
00:42:11.920 --> 00:42:14.119
So you know, I'm putting the finger on my own

621
00:42:14.199 --> 00:42:17.920
nose and acting in alignment with with my values. But

622
00:42:17.960 --> 00:42:22.119
the truth is it's just fear and those are excuses

623
00:42:22.760 --> 00:42:26.400
and and so I've been reaching out to more people

624
00:42:26.920 --> 00:42:31.199
that are my ideal client and that can afford to pay,

625
00:42:31.800 --> 00:42:34.800
you know, the for the kind of value that that

626
00:42:34.880 --> 00:42:37.000
you and I can bring. But I think you and

627
00:42:37.039 --> 00:42:40.960
I share this tendency that maybe I'll do that later

628
00:42:41.039 --> 00:42:42.039
when I feel like it.

629
00:42:43.400 --> 00:42:48.159
Yeah, I hear you. It's it's very very very close

630
00:42:48.199 --> 00:42:52.280
to me that that problem as well. So that means

631
00:42:52.320 --> 00:42:56.000
that we are having this imposter type challenges, that we

632
00:42:56.159 --> 00:42:59.320
are working outside of our comfort zone. And I feel

633
00:42:59.360 --> 00:43:01.800
in this space as a trapeze acrobat. You know, I

634
00:43:01.800 --> 00:43:05.400
have left one and then not yet grabbed the next one.

635
00:43:05.920 --> 00:43:10.639
Really and that is very painful sometimes space to be,

636
00:43:11.159 --> 00:43:15.000
but it's also fruitful because you learn all the time.

637
00:43:16.159 --> 00:43:19.400
So we're down to the last couple of minutes. How

638
00:43:19.440 --> 00:43:22.800
can people learn more about you and your work? And

639
00:43:22.840 --> 00:43:24.719
I'll be sure to put these in the show notes.

640
00:43:25.000 --> 00:43:30.519
People can and connect with me via LinkedIn and I

641
00:43:30.559 --> 00:43:34.280
will respond to every message. I'm writing a book together

642
00:43:34.320 --> 00:43:37.559
with one of my friends who is a nurse, so

643
00:43:37.599 --> 00:43:40.559
it will be not another leadership book, but it will

644
00:43:40.599 --> 00:43:43.400
be a book how to be more human in healthcare,

645
00:43:43.920 --> 00:43:47.880
and perhaps the Cognitive Oxygen Framework book will be the

646
00:43:47.920 --> 00:43:50.960
next one then excellent, and I have applied for a

647
00:43:50.960 --> 00:43:55.840
trademark which is very close to be finalized for that framework.

648
00:43:56.119 --> 00:44:00.880
So we are in this book. We are week eighteen

649
00:44:00.920 --> 00:44:05.119
at the moment, and I'm publishing some snippets on LinkedIn

650
00:44:05.760 --> 00:44:09.400
with some small little experiments people can try. Oh brilliant,

651
00:44:09.480 --> 00:44:15.239
will implement these cognitive oxygen and framework elements into this work.

652
00:44:15.559 --> 00:44:15.920
Excellent.

653
00:44:17.320 --> 00:44:20.760
And the last question before we wind down is, you know,

654
00:44:20.920 --> 00:44:24.679
is there anything that you've not yet shared that is

655
00:44:24.800 --> 00:44:27.360
really really important to you. Maybe just take a minute

656
00:44:27.559 --> 00:44:30.199
and tell our audience that one thing that you'd like

657
00:44:30.280 --> 00:44:31.000
them to leave with.

658
00:44:32.280 --> 00:44:36.440
Yes, The real question is never whether you are under pressure.

659
00:44:36.480 --> 00:44:39.880
You are, we all are. The question is whether the

660
00:44:39.960 --> 00:44:44.039
conditions around you allow you to think clearly inside that

661
00:44:44.079 --> 00:44:48.559
pressure and protecting those conditions is not the luxury, it's

662
00:44:48.639 --> 00:44:51.840
the most operational thing a leader can do. So here's

663
00:44:51.920 --> 00:44:56.320
my invitation. So this week, ask your team just one

664
00:44:56.360 --> 00:45:01.400
of those five diagnostic questions, which below to the framework.

665
00:45:02.039 --> 00:45:06.159
One was the question I already asked you. Another is

666
00:45:06.159 --> 00:45:10.719
what decisions are under unclear or stuck? Third question is

667
00:45:11.119 --> 00:45:14.719
where do people hesitate to speak? Fourth is what the

668
00:45:14.719 --> 00:45:20.000
assumptions have gone unchallenged? And the last one is who

669
00:45:20.079 --> 00:45:23.519
lacks permission to act? So these questions are quite powerful,

670
00:45:23.960 --> 00:45:29.239
and I hope that today's conversation has added a new

671
00:45:29.320 --> 00:45:34.440
layer for your listeners thinking, thank you, thank you for invitation.

672
00:45:34.920 --> 00:45:39.679
So regenerate show listeners, thank you so much for investing

673
00:45:39.719 --> 00:45:42.840
your valuable time with Doctor T and our entire Talk

674
00:45:42.920 --> 00:45:43.840
for media team.

675
00:45:44.000 --> 00:45:45.599
We wish you great health.

676
00:45:45.960 --> 00:45:50.679
Consider reviewing one thing that you would be open to applying.

677
00:45:51.119 --> 00:45:52.079
We're better together.

678
00:45:53.199 --> 00:45:56.119
Thank you for listening to Regenerate with Captain Dave and

679
00:45:56.119 --> 00:45:59.039
i'm K for HD Radio. We invite you to give

680
00:45:59.079 --> 00:46:03.159
yourself grace, embrace the messy middle. See you every Monday

681
00:46:03.199 --> 00:46:07.079
at n am Pacific time. Until then, you got this