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Sun., July 8, 2007

Q & A with Mary Selecky

In the early 1970s, Mary Selecky — who grew up, received her education and gained her first work experience in the East — traveled with some friends to check out the beauty of the Northwest. Selecky ended up in Colville, liked what she saw, and settled into rural Stevens County. Her work in public health there garnered her statewide attention, and in 1999, she was named secretary of health for Washington’s Department of Health by then Gov. Gary Locke. In 2005, Gov. Chris Gregoire reappointed Selecky to the cabinet post.

Selecky, 60, oversees 1,400 employees, and stars in public service announcements explaining the agency’s mission. Selecky recently talked with editorial board members Doug Floyd and Rebecca Nappi and with videographer Colin Mulvany.

Q: Can you tell us about your childhood. Were there any indications in your childhood that you were destined to be a leader?

A: I grew up in a small coal mining town in northeast Pennsylvania, Glen Lyon, Pennsylvania. The big town is Wilkes-Barre. My grandparents, all four of them, came from northeast Slovakia and they were part of an in-migration from the 1880s. I’m one of seven. I’m middle in number, leader of the second grouping, so you get to be a leader and a middle child at the same time. When you are one of seven in a household that is active and has expectation – what did you today and what did you do to help someone else? – I think the expectation was that every one of us would be a leader of some kind.

Q: How did you end up in Colville?

A: That’s an interesting story. I went to school at the University of Pennsylvania. My dad had gone there. My older brothers had gone there. So we were quite a Penn-Quaker family. I was very involved in my student life. I worked the academic life, but I worked the student life, too. I worked as an assistant in the dean of students office. That was my work-study job. I wanted to be a dean of students. Those were my first two jobs out of college – at both Sarah Lawrence College in Bronxville, New York, and then at University of Pennsylvania. Then it was 1971, 1972 and a lot of people were saying there’s another part of this country that many of us have never seen. A friend who had gone to Colorado after college said it’s gorgeous, you should come and see. So several of us traveled through the West and Northwest and got his idea that we could live out West. And we literally picked Colville, for a variety of reasons. It seemed like a good place to live. People liked living in it. We interviewed the town and asked was there a possibility for jobs and were there people who might look like us? It was really one of those wanderlust stories.

Q: You have a history degree. How have you used that degree in leadership?

A: I need to understand what’s behind what we have to do. The books I like are historical fiction. They tell me a story and they remind me about history. A man who is a giant in public health, Dr. Bill Foege, a Washington resident, said in order to understand the future, you have to step back into the history. That really fits.

When I’m faced with a big issue, what is it that brought the issue to the forefront? What’s the story behind it? Then you figure your way out of the issue toward the goal. I think that’s the tie.

Q: You served 20 years as the administrator of the Northeast Tri-County Health District in Colville. How did that experience in that 20 years in a rural setting make you a more effective leader at the state level?

A: When you’re in a small town, you don’t have a lot of assets readily available to you. You have to search our partners and other communities who might be able to help you solve your issue. In a rural town, you know you can’t do it alone, it will take a village. In health care, it was really important for me to understand what was going on at the hospital, at the nursing home. I helped create the hospice, because we didn’t have one. We borrowed ideas from other communities. When Spokane Hospice wanted to partner with us, we were ready. When you think of experiences right on the ground, where you’ve got to roll up your sleeves, figure out what the issue is, look for the result, I use that everyday in my work at the state level. First question: Who else needs to be involved? This isn’t just about us. Who will be impacted? And will this be the right decision five years from now?

Q: We had a leadership brainstorming session with some experts and they identified several traits for leaders. One was intelligence. What kinds of intelligence are important for good leadership.

A: I agree and it’s not about your IQ score, it’s about all the ways you accumulate information. To me one of the most important ones is the one called emotional intelligence. What do you know about yourself? If you don’t know about yourself, how are you going to interact with other people? And how do you help draw out the best in other people for them to get done what they need to get done? You have to be a good observer if you’re a leader. That takes intelligence, because you don’t always have to be the showman. You have to be able to learn. You have to study all the time.

I spent some time with young people today talking about tobacco. But they wanted to know about my job, what did my days look like. I told them every night I have homework. They said, no. I said, oh yes, tomorrow’s a new issue, someone will bring something I don’t know about. When that phone rings and it’s the governor calling me, I don’t necessarily have a clue what’s it’s going to be about, so I better be ready. You have to have curiosity intelligence, too, not just academic intelligence, but people intelligence and curiosity.

Q: How do you describe your job?

A: They want to know what do I do? Do I spend my time with people? Yes. Do I get e-mail? When I tell them over 100 a day, they kind of glaze over. Then I tell how I manage that. Some I sort and give to other people. Some I take care of. Some are for later reading. The way our conversation went this morning, they were very focused on tobacco. While that might be my highest priority, I might at one minute be talking about medical discipline, the next minute a radiation incident in the state, the next minute how we were going to clean up Puget Sound and take care of shellfish, and the next someone might be calling to tell me we have an unusual disease in the state. It’s very varied and you have to understand who the experts are in your state to help you do your job.

Q: You’ve been appointed to lead state health by two different governors. Why is that?

A: For my first appointment by Gov. Locke, I was reluctant to go. To leave community, to leave a level of work on the ground where you got to see a project through all the way. I was concerned I wouldn’t get that opportunity. Little did I dream that I would be serving two governors, I would be there eight years and I’ve been able to see a change in our tobacco rates. They are lower than they were. I’ve been able to do something I couldn’t fathom. Gov. Locke gave me several gifts. He wanted public health and the department of health to be relevant in people’s lives. How do we get people to talk about this thing that they don’t even know, some days, exists in their lives? We had to do it in plain talk.

Another gift he gave me was I needed to upgrade the kinds of places our staff worked in. They were in pre-war barracks, in some instances. Taking on a challenge that had to do with bricks and mortar and leases and negotiations was a real project. And we were able to accomplish that. In doing that, you showed you could take on a tough project and be very adaptable, because the legislature didn’t see it the way I did or the governor might have had a different idea in the middle of the project. That shows you can withstand the barrier-crossing you have to do, you can withstand those who don’t think you are going to make it. I have a little flying pig in my office because someone once told me I wouldn’t get the building project done until pigs fly. Well, pigs are flying, because we got our project done; we’re in better office quarters.

Gov. Chris Gregoire was the attorney general then and she gave me a gift then. She said do something about those tobacco rates. I’ve now brought the tobacco settlement home and failure was not an option. It was an opportunity to roll up the sleeves and use every resource available in terms of your knowledge, your guts, your fear of whether you can do it or not. I think that’s what’s done it for two governors. I’ve been willing to take it on, willing to hear what we might need to change and deliver. But it’s a we, not just a me.

Q: You spend a lot of time in Olympia. You have watched legislators and other leaders in action. What characteristics distinguish the best ones?

A: The best ones understand that their colleagues have to have a comfort level about the issue in order to vote along with it, if they don’t the issue. You have to be bold about the idea. When I think about SIRTI or the health campus. I was there at the ground-breaking. Spokane legislators had an idea that we could do this in Spokane, and they were willing to throw the idea out when a whole bunch of legislators might not have seen it in the same way.

You have to be able to be truthful to all the questions that are there. My colleague Dennis Braddock was the head of Department of Social and Health Services after having been a legislator for a long time. We went to see one of the (legislative leaders) who didn’t like our idea. Dennis told him all the pros and all the cons — all of them. I said to Dennis, “It was very interesting to see you be so incredibly honest about all the cons. He said, “I only get one chance.” It was an incredible learning experience for me: Tell them all you know.

Q: You still have your home and property in Stevens County. How does that rural setting recharge you?

A: A couple of things. One is you have to be brutally honest. People want you to fix their problems. They will walk up to you in church or in the grocery store or at the gas station and say hey, I have this issue. I got my car serviced the other day. A woman said to me, “I answered your survey” — this is the behavioral risk factor survey — “why do you ask us how many potatoes you eat?” So I went back to Olympia and asked, “Why do we ask that?” Well, it’s in the context of how many fruits and vegetables. I was able to give her that.

The other thing about going home? It’s not all about you. It’s about being part of a community. People really appreciate that I’m in Olympia, doing something on their behalf, but I’m home, too. I’m them. I’m at church, or at the local graduation because someone invited me to their gathering. It definitely recharges your battery, because without a sense of community, how can we be leaders?

Q: Why don’t more of our natural leaders in the private sector take the risk and run for public office?

A: I’ve been in public service since 1975. In those 32 years, the level of exposure has ramped up, not just for elected officials but for everyone who works in government. The criticisms clearly outweigh the positives. A colleague of mine was asked to be head of the health department in another state. He had worked in a private hospital and he was asked by the new governor to serve. He left after 18 months. One of his comments about leaving was, “I have to be so public about everything. I can’t make a decision without hearings. I can’t make a decision without people looking at it 16 ways ‘till Sunday. When I was in my other setting, if it was a good business decision, I made it.”

There’s a very different atmosphere in which we operate in government. There are many things to be learned by private sector from government and by the private sector to government, both ways. But there’s that level of exposure that’s very different. You belong to everybody.

Q: About a year ago, you and your agency were in the spotlight in a critical way for what was called “lax oversight of unscrupulous care providers.” You told the truth as you knew it. What did you learn from that experience? And what do the best leaders learn when they come under fire?

A: We go into these jobs knowing there is always more to do. But when you hit an issue that comes across as negative as that did — three days above the fold, editorials across the state, including here — you have to say, “Am I willing to read this one more time to understand what it looks like from their eyes? How does it look out there?” I may know my truth. And I may know my situation. But I better pay attention to how it looks and what the perceptions are. Those are very humbling lessons. After you step back from the shock of the headlines, you’ve got to be able to stop for a moment. It’s a personal leadership lesson, in that one, and there will always be another one of those and I’ll have to remember that leadership lesson again.

With that situation, we were aware that the investigative reporting had been going on, but we hadn’t a clue what the conclusions would be. The most important thing for me as a leader was to create a holding environment for the staff. They were watching how I reacted. If I reacted overall negatively or lost heart, how could I turn around and say to them, “We need to improve and fix this.” There were times that I realized if I needed to have a personal reaction, that’s how it needed to be — private. But I was creating an overall reaction for the staff by the way I carried myself in those tough times. Those are hard lessons to learn. When everybody’s watching you, it makes you think about what you are really doing.

There are a couple of others that jumped into my head that had similar feelings, but different situations. It was when Sept. 11 happened. And how are we going to take care of people who are so afraid? They didn’t know what would happen to them. And they worried about family and all that. It was a matter of absolutely being there, absolutely being present. I just abandoned everything I was going to do and went to every one of our 21 buildings that we had in Olympia at the time, to see how staff were doing, just to say, “Are you alright?” To be a very present leader in times of crisis is very important.

Q: You’re one of the stars in a state Department of Health ad campaign. The focus group asked that you be in those, and maybe Dr. McDreamy from Grey’s Anatomy. Was that hard to be the public face? And how is it hard for leaders to be the public face?

A: Hard to say yes, is the why me and understanding that it’s OK that it’s you. It’s not just about ego, but someone expects you to be the calm voice. The focus groups talked about if it’s that important, we want to hear from someone in public health who is a leader, so we will understand we need to pay attention to it. That’s my responsibility. I needed to accept that responsibility.

The harder part was doing some of it in Spanish. I am doing the speaking in the Spanish commercial. I don’t do the whole dialogue. I haven’t spoken Spanish to any extent since high school. I read the script. Staff said we’ll help you with a few of the words. I was very honest with the staff person who was helping me with it. I said, “I don’t want people to think I know Spanish.” She said, “They’ll know.” But she said, “They’ll care that you tried, that you made the effort.” If it’s that important, carry the message.

Q: When you’re at public events, you always seem to be enjoying yourself. What we haven’t brought up enough in this series is some of the joy and the fun of being a public person and a leader. Do a riff on that.

A: I’m an “expressive.” You get your energy from other people. So it’s a matter of understanding that this is very energizing for me. Even if people are pulling me in different directions for problems, they really want me to do something about it. Being in the kind of job I’m in, people want to know you actually care about them. Part of leadership, no matter what kind of person you are, has to be relationship-based. You have to be able to make a connection with someone else. When you make that connection, you have made an impact on them. When they have a problem, they will believe you when you say something.

With all this work on preparedness and the flu pandemic and we get talking (and people ask) “Are you going to tell us all to stay home?” I say, “I won’t tell you that unless I really mean it and when I do I really want you to do that.” If I can personally deliver that message, how much better is that than sitting behind a desk and delivering it in some other way? The people contact keeps you honest, energizes you and helps you see where we need to go next.

Q: How do you differentiate between good administration and good leadership?

A: Good administration is doing things right and good leadership is doing the right things. On a day-to-day basis I expect a heck of a lot of people — whether they are the people in the laboratory or the people digging water samples — to do things right. We depend on them to collect it right, do the testing and all that kind of stuff. But the fact we have to make the policy decision that we should be doing that testing in the first place means you’ve got to accumulate a lot of information and come to a conclusion that that’s the right thing to do. So the distinguishing to me is really about the bigger picture of what’s this all about and where are we going to go once we make these steps?

Q: Walk us through that process, when you come across a challenge that’s your responsibility to address and you have to put that intelligence to work. How do you engage in that analysis and evaluation to get your agency through a policy-setting process that by the time it’s over, you have people willing to follow your lead?

A: Let me use the issue around the discipline. We license 57 different health professions. There are a lot of people in that process. There are people who get the complaint, people who investigate the complaint, there are people who interview people, there are lawyers and judges and a whole bunch of people. Each one has a part of that process. And on a daily process, I wouldn’t hear much about what’s going on in that work. And as issues surface — you didn’t do a good enough job, I wished you’d investigate more or professionals would say you are too hard on us — it seemed like we were focusing all on the discipline end. As I listened to people talk about their parts of their job, I asked, “What’s our goal? Where are we going with all this? What’s this really all about?”

We had to work hard to change the whole thinking process to look at it as being about patient safety. I’m talking about the lawyers who looked at the cases. I sat with them, or the investigators who would go out — what’s it like to do that and what’s your part in this? It was a matter of sitting and being very respectful of them telling me with passion why their part of the job was important and how it added to the whole process. It was also saying if you are doing it, who are you thinking about? For so many years, it was really about the provider, the person we gave the license to. And we had to work on a shift that had to do with the patient who might have had the harm. Folks were willing to shift how they came at their approach to work once we all saw the same picture at the end. There is a provider who might be getting disciplined in the process, but will it improve patient safety for everybody in the future? Will it be the right thing to do?

This is one that is as about as abstract as you can get, because it wasn’t about perfecting laboratory tests, it was more about a whole approach. And we’re always refining that one. We talk about it consciously very differently.

Q: As you work with other people, knowing you are head of the agency and ultimately have to accept the responsibility, how does a person in your situation deal with the issue that you might be working with people who are smarter than you are, more experienced, people who have more technical knowledge. Some people might be intimidated by that. How do you deal with that imbalance of whatever the asset may be when you still have to make the decision and it might run counter to what those people are telling (you)?

A: I’m going to go back to my family. I’m one of seven. We’re a 20-year-age spread in that seven. I had a sister 10 years older and a brother 10 years younger. My dad was a lawyer and a judge. He only lived to age 49, unfortunately. He died young. I was the oldest one home when he died. My older brothers and sisters had already done this college thing. They were way smarter than I was. What we learned in my family was that you sought out advice, not just from inside the family, but from people who had more information than you did to help you make your decision, because ultimately we were responsible for our own decisions, someone else didn’t make them for us because we didn’t like that. I don’t know how else to that except to listen to someone who is wiser than I am, because there is something for me to learn from them.

The other thing is I’ve been very blessed with mentors. They seemed to know something I didn’t know and I was inquisitive how I could be as smart as they were. So by hanging out with them, I might get a little smarter. And it’s paid off. So it’s a matter of being a sponge, learning how to hold on to that stuff you gather as a sponge, and then being willing to share it at some future time.

Q: Can you elaborate and tell us who a couple of those mentors were and what you learned from them?

A: Because I’m a family-based person, even though I’m a single person with no kids of my own, my dad was the standard-setter and my mom was the standard-bearer — who really made sure you towed the line— especially after my dad (died.) My mom was widowed with seven kids, including with a 2-year-old at home. There was no question about the standards my dad had set being part of my life today. So clearly, my parents.

There was a dean at the University of Pennsylvania for whom I babysat, for whom I worked, as an undergraduate. as a student assistant and then I came back when she hired me as an assistant dean. She was a successful woman. She had kids. She taught political science. She paid attention to students. I spent a lot of time with her and we’re in touch to this day. Her name is Tish Emerson, Alice Emerson. She was at the University of Pennsylvania then she went onto be the president of Wheaton College in Massachusetts. She’s retired today. Tish was so inquisitive about things, but she’d bring together the president of the college and the university, into our office when there was student unrest and get students together so we could talk together in the ‘60s. She was a pretty smart lady to pay attention to. And that was one I watched more than there was mentoring, but it was going on, no question.

Probably the biggest one in my life was Ed Gray in Colville. I went to work for the health department. I did not know about health. I was asked to come in to help manage the thing, because I worked in county government and the county commissioners knew I was a pretty good manager. Little did I know that a man who is very quiet, who speaks when there is something to be said, was one of the greatest visionaries I could ever meet in my life because he could see things others could not, and he would quietly figure out, or just lead you, how to get those things implemented. And that there was always something to learn from the next experience.

His few words to me, when I first went to work for him was you need to go to Olympia to tell them the rural story, because they’ll make decisions without us. I wasn’t sure what that all meant at the time. When he’d send me off to a meeting and I’d come back, we’d talk about the experience and what went on. By the way he questioned me I learned how to question them. He’s still very much a giant in my life.

Q: Right now in the political, governmental arena you’re in, you are dependent upon the political climate. The governor goes, you could go too. Or the governor changes her mind, you could go. How do you stay focused on your objectives and the leadership path you want to take your agency on with that kind of potential uncertainty in the back of your mind?

A: I went to work in county government and worked for more than 40 county commissioners up in Ferry, Pend Oreille and Stevens counties. They would come and go and I was able to stay the path. What I learned from that is you’ve got to stay tuned to the environment, because you never know when someone will ask you to leave. So the point was to do a good job every day. If it’s not your time, while on the one hand it may not be about you, it’s all about you. It was quite scary in the election in ‘04, not knowing who was governor for as long as that was the case. And I will use the word scary. I knew I wanted to continue to do this job, because public health was so important, and I could do more for public health by being there than by not being there. But I didn’t have a clue who the governor was going to be. And it went on and on and on.

The humble learning from that one is that I serve this governor. I’m committed to her for her term. Should her term end and I might end, I will have had an incredibly important time in public service, serving for Gov. Gregoire. I had an incredibly important time serving for Gov. Locke. In the process of doing a good job every day, we’ve reduced tobacco rates, we’ve improved patient safety, we’ve improved the level of preparedness for the state of Washington, and whomever comes after me will be able to take it to the next notch. They’ll find something perhaps that I left undone that they’ll do. That’s the spirit you have to bring to public service in this kind of job when you serve at the governor’s pleasure.

Q: Why do you do it?

A: I do love public service. My folks would always ask us, when we’d say — gee, how come they are or they aren’t doing this, that or the other — they’d say, well, what about you, why aren’t you stepping up to the mark, why aren’t you taking it on? There is a poem by Henry Wadsworth Longfellow, the “Psalm of Life,” and it ends with:

Let us then be up and doing,

With a heart for any fate;

Still achieving, still pursuing,

Learn to labor and to wait.

And my dad would say it at the table and all of us could recite it. When I think of the grounding I had, it was about service to someone else, service to someone who had what I didn’t have. When I look at all my brothers and sisters, in very different ways, they are all engaged in a similar kind of thing. I’m the public servant out of the group, though.

Q: When you look for leadership within your own departments, what are the traits you look for?

A: They have to be individuals I can trust and they can engender trust in someone else. Without that trust, you can’t move molehills or mountains. They have to be brave. If they are going to run at the first skirmish…I need somebody who can be brave, because we get a lot of slings and arrows and all those things tossed at us. And every one of them can hurt as an individual, but as an individual who is responsible for a governmental organization, you’ve got to be able to hear it and move it on. They have to be risk-takers but be wise about their risks, because everybody wants progress but no one wants change. Somewhere in between those things you really have to do both. And they have to understand that sometimes you need patience. Things don’t change overnight. There are hoops to go through, report backs, time that’s needed to get things done. If I can find those things in individuals — and I work with an incredible team of people — but also they have different personality traits that help a team do its job. Not everybody should be an analytical. Not everybody should be the one who wants the stage. Not everybody should be the one who says but when is this going to get done? You need a whole variety of folks, but you need some common traits?

Q: Why is smoking such a big deal? Were you ever a smoker?

A: My family did not smoke. I had a couple of brothers who smoked for periods in their life. Nobody at this point, that I’m aware of, smokes. One of my nephews might have a cigar now and then. In college, I did. And some of post-college. The atmosphere in colleges was pretty much — smoke. Neither of my parents ever did. They were respectful of people who smoked, and the house would stink, and as kids we knew enough to bring out the ashtray and then, when everyone was gone, we emptied the garbage, took it outside and washed the ashtrays.

I have a brother, Paul, who is a pulmonologist in Southern California, and he came home for a family reunion one time wearing a T-shirt that (depicted) healthy lungs. One of the other brothers smoked and (Paul) proceeded to put out a cigarette with a bottle of beer to get the point across that smoking was bad for you. This was back in 1979, for God’s sake.

Ed Gray was another one. I remember him subtly saying of somebody in ill health that if they quit smoking, they would get better. I thought what’s that all about? I asked him and he taught me the physiology of the whole thing. One of the sentinel events was going to work at the health department. We were in the courthouse, and people smoked all over the courthouse. This was 1979 again. And we were moving the clinic into its own building, and the public health nurses came to me and said, “Can we make this into a no-smoking building?” I said, “I’m willing to give it a try if you are. And I said, “We’ll have to do it together. We’ll have to teach our clients.”

So the first time someone came in with a cigarette, they came back to my office to get me. I go up front and here’s this guy and I walk up with an ashtray and say, “We have signs out front. We’re not allowing smoking in the building anymore. Would you put this out?” He was a little disgruntled. They did that three times and I finally said, “Look guys, I’ve showed you how to do it three times. It’s your turn.” It was really very impactful. If we were going to make a difference in people’s health, we had to have a consistent message all the way through. If you want to be healthier, don’t do that (smoke.)

Q: What do you want your legacy to be?

A: From a health standpoint that we really have made a difference in people’s health through reduced smoking. My responsibility is to improve people’s health as secretary of health. And I think that is one that will pay dividends to the population of this state for many, many generations. From a leadership standpoint, responsible for an agency with 1,400 people, that we had a learning culture. People could learn from each other, learn from mistakes, learn from successes, and we were able to share those kinds of learnings to improve the work that we did. From a community standpoint, that we respected all the views that were out there. We may end up with a policy statement that people do or don’t agree with, or a change in a program, but we were able to hear what they had to say about it, we were open to that. That’s what I’d like for any kind of imprint I’d leave for my service in state government.

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