Show Notes
Brian Ferguson: You're at a level one trauma center in Washington, DC. We're in there on a Saturday night at one o'clock in the morning. This is typically when, because of people being out of bars et cetera, you get a lot of trauma. And one time there were two people in there screaming and another person moaning. Just hearing that as I was standing there, I thought ‘it's insane what this does to the human emotion and cortisol levels.’
And what's crazy is if you were to observe that and you think about this whole body of knowledge that's come out of the military in the last 15, 20 years about post-traumatic stress and about the implications of people who are in very high stressed emotional environments, either combat or otherwise, we've put a massive amount of resources into helping those people. And yet we ask these trauma nurses and ICU nurses and physicians to go home and have dinner with their families. And no one thinks twice about it because they're not deployed.
So, we think about this as the environment is different. You might not be deploying overseas to Afghanistan or Iraq, but you are doing consequential, heavily emotional work that has a chronic element of stress. And when you look at the implications of chronic stress on human beings, that leads to higher levels of cortisol over time, not being able to focus, not being able to sleep. There's a second and third order, long-term impact that has.
Michael Moore: Today on The Climb we are joined by Brian Ferguson, founder and CEO of Arena Labs.
I'm excited about this one. I don't know Brian as well as some of our other guests, but we were introduced towards the end of last year, both being Gen Next members and got a chance to get on the phone with them for about an hour. And I don't know, 30 seconds in, I thought, dang, dang, dang. We got to get this guy on the podcast. What an interesting background.
He'll talk more about Arena Labs, but I think it's an interesting time to have him on because of the passion of what Arena Labs does, and the work that it's doing for our frontline [
00:02:00] workers right now, which is so important.
Brian, welcome to The Climb. We're excited to have you.
Brian Ferguson: Thanks fellas. I appreciate it.
Bob Wierema: I can't believe he agreed to come on after talking with you for the only 30 minutes. I mean, that was some, you must have a lot of faith, right?
Brian Ferguson: Yeah. We actually need it. Well, I certainly do, but we should also give a shout out to our friend Janeel Alonzo and Michael Davidson. Michael's one of your previous guests and is one of my dear friends and been a huge part of my life. And then Janeel who works with Michael is who I think set this up. So super grateful to her.
Michael Moore: Yeah, Bob as they say down in Texas, ‘even the sun shines on a dog's ass every once in a while’, I was on that day. My bullshit was flowing, and we had a great conversation.
Brian Ferguson: Michael sound cooler in a Texas accent, by the way. If I said it, it wouldn't sound as cool.
Michael Moore: We try. So, Brian, before we jump in, I got a little taste of this, but just give us the background. I mean, who is Brian? What shaped you? How have you gotten to where you are today?
Brian Ferguson: This is a random way to answer that question. But I have over the course of probably the last 20 years tried to refine an annual process where I just review the last year, think about the year ahead. And then I come back to what I call my life plan, which is really just my best efforts to aggregate everything I've learned in my life in the past and where I want to go in the future. The front of that document – I don't let myself go beyond one page – but the title of that first page is ‘who am I?’ And it's my best effort to get outside of a resume or the way that we often introduce ourselves in these kinds of conversations to remind myself of who I am, but it’s interesting, I'm coming to you guys from Cleveland, Ohio. before we started recording, we were talking a bit about that, but I grew up in the Midwest, which I think at this chapter of life, because I'm [
00:04:00] back here, I spent the last 20 years away from the Midwest living in Cleveland, Ohio where I think a lot of the things I value in life come out of having been raised in this blue collar community outside of Cleveland, Ohio. And I was super fortunate. I had this amazing upbringing and community; my family and I grew up with the town that I grew up in.
When we moved there, there was just starting to be this push into the suburbs of Cleveland where we were, but I had this idyllic youth. Our house was right on woods and my brother and I grew up in the woods outside all the time. And then, my mom was a nurse, my dad worked in the energy business, and I just had this amazing youth in the sense of the neighbors, the community, my friends, and I was a product of a public school system. That was extraordinary.
I think my mom being a nurse, I never appreciated how much that ideal of service was seeded in me from a young age and my brother and I both were always drawn to service in ways that just were natural to me. But now in retrospect, I think are more prominent.
And then, beyond growing up in that town, I went to college in Ohio and then I'm pretty fortunate to bounce around. I lived in Washington DC for a while. And the first part of my life was in public service, mainly in national security. So, defense and intelligence diplomacy – that realm.
And that was right after 9/11. So, I was an intern actually. I had a really crazy sequence of events. I ended up as an intern in the white house right after 9/11. And that was an insane way to see the world through the lens of ‘how do we think about the future of America after a consequential event like that?’
And I stayed in that realm for quite a bit, lived in London for grad school. And then later in life, I went into the military and spent seven years in the military. And that was all part of what I consider that chapter in the national security public service arena, and in the course of that I just increasingly had this desire to build something.
[
00:06:00] When I do any type of psychometric or character test, I tend to register high on creativity, autonomy, and I was really ready to leave the public service life and go build. And that led me to my current chapter, which is Arena Labs. But I think in all of that, the really important elements in my life, like any of us, the things that matter: I've got a daughter who's two years old now, so I'm experiencing life through her eyes, which is beyond rich, and Lindsey, my wife – we’ve actually known each other since sixth grade. That's a whole another story, but that's a super powerful subtext for me of being connected back to where I came from. It just feels super grateful. I think increasingly the mission we have in healthcare of helping frontline workers to understand how to navigate stress and pressure and prevent burnout is one that has been elevated in ways we couldn't have imagined.
So, it's a fun time to be building.
Bob Wierema: That was a good start. You got a lot of questions for us to go down, but I got to start with my knock a little bit, just because you're in Cleveland and the last time I was there, the Cubs won the world series. That's my only knowing in Cleveland.
Brian Ferguson: And I think Clevelanders have a weird respect for that just given the drought the Cubs were in at the time. Clevelanders appreciate the suffering that comes with being a perennial fan of a team that never wins. Yeah, the Indians, the 97-world series. You guys remember? I don't know if you remember the loss to the Florida Marlins was soul crushing.
And so, the losing of the Cubs was a tough one, but I feel like the city respects Chicago in that way. I'll say the other weird thing. Cleveland sorta has a chip on its shoulder I think for a number of reasons, people talking about the river catching on fire in the seventies, but the Browns are in the playoffs for the first time, since 2002. So, you're 18-years-old as a Cleveland Browns fan and this is the first time the Browns have been in the playoffs and a big part of that is because we have an extraordinary young head coach in Kevin Stefanski who we found out yesterday has COVID [
00:08:00] and can't coach in the playoff games.
Oh man.
I have vivid memories of my dad. A lot of people in Cleveland, the only disposable income they have goes to Browns tickets – t's very much a football town. My dad had season tickets growing up, but some of the losses in the late eighties deer in his binder fumble like vivid memories of just emotional trauma.
Michael Moore: You know, Bob, with this being our 15th episode, one of the things we talked about is that there would be a neat culmination of all this as we get up on a year and a podcast alumni group. I think we need to get Brian and Bret Kaufman hooked up together. A lot of similarities and overlap there for sure.
So, Brian, to Bob's point, you gave us so many rabbit holes to go down, first and foremost that maybe it was shaped by your mom and her background as a nurse with that service mindset. Was it the events around 9/11 and your time in DC and seeing it through that lens that led you to the Navy? Talk to us about that.
Brian Ferguson: You guys may have gone through this, you're going through it, or you will, but I suspect that all of us have this natural arc of our own evolution where we then are more curious about where we came from, and there's the people who get into genealogy and family heritage. Maybe it's because my daughter's now two and I want to be able to explain to her more.
I also had loss in my family. My father passed this spring, and he was the last of my family. And so, there's this legacy element of really wanting to know that legacy or the longer story there. And so, as a result, I've been digging in on this. And I think to your question, Michael, part of it was my mom, for sure, and seeing her in the service mindset, but my brother and I were very fortunate. Our [
00:10:00] grandfather, we were very close to my dad's dad, and he served in World War II as a Naval officer on the USS Dayton. And then my mom's dad, we never met, he passed before I was born, but this is crazy. I just found this out.
So, I always knew growing up that he had been a fighter pilot. He had flown the P 51 Mustang. But what I didn't know is that he actually was this very rare mission set, which was long range reconnaissance. So, he would fly from Iwo Jima and escort bombers to mainland Japan. And these were eight-hour missions at sometimes negative 60 degrees in the cockpits. These guys that have three layers of long underwear on, they couldn't move when they got back because their bodies were cramping so badly. So, my grandfather had this insane, really rare mission set. And so that whole story was part of the lore of our family.
But it wasn't talked about in detail. It was just that my grandpa flew planes in World War II, and then three of my uncles, my mom's brothers – my mom was one of nine – three of my uncles were in Vietnam. And two of them were, one in particular was in very heavy combat in [inaudible]. And so again, that was just a big part of the story, we were close to our families, our cousins.
So, I think all of that in the aggregate was what led me there. It’s funny, I was just in the spirit of going through a lot of my dad's belongings. I found a bunch of newspapers that I had saved as a kid. And I saved a whole series from, if you guys remember, the coast of a war in 1998. And I remember at high school, I think I was a senior just being fascinated by statecraft and geopolitics and decisions of consequence like this war happening in what seemed to me to be a part of the world and understand. So, all of that stuff led me to college where I was very fortunate to have some professors who kind of stoked that flame a little bit.
And so, by the time I got to that internship at the white house, I was just mesmerized [
00:12:00] by the complexity and magnitude of decisions that had to be made for a nation or a set of nations and that kind of environment. And then I think to maybe finish that thought, if I'm being honest, I was drawn into service. My brother went into the army and my brother had a very illustrious career in the army. And I had looked at West Point when I was in high school. And I had the foresight to recognize that military academy was not for me, but because I saw what was happening in 9/11 and then I worked in the white house and the Pentagon in that era, I had always thought that was going to [inaudible] my desire to serve, but I always felt like I was in an air conditioned building, safe while my peers and my brother were out actually deployed. And there’s a powerful story about a stranger who said to me, “Brian, if that's something you want to do until you go do it, you'll be inherently dissatisfied with the rest of your life.”
I would say the best advice I've gotten in my life has been from strangers and that notion of being inherently dissatisfied because I didn't get to where the nation's cloth was something I knew I couldn't live with. So, I was 28 when I was about as late as you can be to join.
Bob Wierema: So was that what made that turning point to make you go join? Was it that conversation with that stranger, as you mentioned?
Brian Ferguson: It was a big part of it. I had the short version intern in the white house that turned into my first job which was incredibly fortunate, but I just didn't care for politics in that intense sense. And I was really lucky to go over to the Pentagon where there's still politics, but at the end of the day, the thing I love about national security in the military is that there really is a higher order of good that people attempt to pursue, whether you agree with it or not, it's more pragmatic. And I really enjoyed that environment. And so, a lot of those people I worked around at that time became either people who were mentors for me, that I looked up to and took their advice. I think if I'm being honest, I didn't have the courage to let go of that career and take the risk of going into the military. And so that [
00:14:00] stranger just being totally clear with me and telling me what I needed to hear was probably the final straw where I was coming out of grad school, I was looking at going into investment banking, and I realized that anything I go do, I'm going to continue to come back to this desire. So, yeah, that was probably the final straw.
Michael Moore: So then from that moment, Brian, into being in the Navy, with your brother being in the army, how did you go about making that decision or did the Navy find you?
Brian Ferguson: I actually, I was incredibly fortunate because I was working in the Pentagon, so I had access to just about all the information, advice, and resources you'd want. I was very close to joining the Marine Corps. At that point in my life, I'd seen enough where I knew I wanted to be able to deploy in – the term is used as combat arms. So, you can go into the military and maybe go work in space or in intelligence, I wanted to be able to deploy potentially in a combat environment. And so, the Marine Corps was the fastest way to do that. The Marine Corps played a massive role in the conflict over the last 20 years. And at the time you can go in very quickly that the Marine Corps is very good at getting people in quickly.
The army, on the other hand, part of what I wanted to do in the military, in the army, it would have taken me a lot longer to get there. And then frankly, I've always been drawn to the . My hometown is on Lake Erie and I just loved the maritime element. And because I'd been in the Pentagon, I saw the strategic thinking of senior Navy leaders.
A friend of mine always talks anecdotally about this. If you're a commander of a ship in the Navy, you're out at sea in this little piece of real estate you're responsible for that has real strategic capability globally. So, you have to learn to think strategically. And I just saw that in Naval leaders and so culturally, I was drawn to the Navy and then the part of the military I wanted to go into, I loved the idea of doing that in a maritime environment. And so, it was, probably a three-year Odyssey of getting there. I looked at the air force. I was kind of all over the map, but really close to joining the Marine Corps.
And then [
00:16:00] got lucky and got into the Navy.
Michael Moore: And so, if you're willing to share, seven years is a long time. Can you tell us about some of the defining moments in the Navy and things that you were a part of and witnessed?
Brian Ferguson: Yeah. It's interesting because it’s funny for me to hear you say that Michael, because seven years in the context of the military is often short.
You get guys and gals who will do 30 years, and that's not uncommon and some of my good friends now that I work with or people who did 25 or 30, but it was definitely, I would say unequivocally, it was the most consequential and formative period of my life. Of everything, from character to understanding myself and potential.
I think I was really fortunate to serve in the special operations community. And if you think about that moment in time, post seven(?), the role that community played in the conflicts overseas in Afghanistan, Iraq, I sort of walked into this culture where I was literally standing on the shoulders of giants because that reputation that special operations has benefited from, all of these guys who preceded me had built.
And so, I came in in 2008, 2009, and that reputation has really been solidified and there was this amazing community. So, I always felt really humbled and privileged. It is without a doubt in terms of character, in terms of the type of people you're proud to be around, I will never be in a richer environment that way and wanting to be better pushing oneself. But I think if you go into the military any capacity, but I found particularly the training environment I was in, I would say the first part of that is being in training. You learn that if you believe in something bigger for the right reasons, you can transcend what you're capable of, and most of us don't realize that in our lives.
And so, when you're exposed to that in a raw way, when someone forces you to see, my friend uses the term, ‘what's at the bottom of your own well’, it's the most powerful, liberating part of the human experience [
00:18:00] that a lot of people don't push, and you don't have to do it in the military. You can do it in a whole bunch of other realms, but that for me – another friend and teammate of mine always says that when you go through that type of training, you’re a completely different person and the same person all at once. And it's so true because from a character and a personality perspective, you're the same, but you've suddenly seen what you're capable of in the world. And it's hard to live any differently once you've been exposed to that.
And then from a deployment perspective, I had two deployments and both of them were relatively, I would say, low key compared to what most people know, or a lot of my buddies experienced in special operations. And the time that I came in and ended up deploying 2012, 2014, things were really calming down at that point. We were no longer in Iraq. And so, it was an interesting time where this community that had been so postured for very intense operational tempo was moving back into an almost non-war posture. But any person I meet who's thinking about the military, if that's on your mind, there's just nothing like it in terms of experiences, skillsets, and just the things you're exposed to.
Bob Wierema: I was going to ask for some of our listeners, when you made that transition, and obviously it was a big decision for you to go and do that, there's folks out there thinking about doing it. How would you, if you look back, how would you educate or guide them on making that decision of, do you go or do you not go?
Brian Ferguson: It's interesting because these things, if I think about myself, I don't make decisions. I wouldn't say I was a person who knew this idea of making decision from the heart. I'm probably overly analytical, tend to over intellectualize things. That one for me, because it was something I felt in my gut for so long, it was just being honest with myself. And there's this simple question of, ‘if I didn't do this, what would that mean?’ And I had seen enough people who didn't [
00:20:00] do it, that I knew I couldn't live the life I wanted to, without at least committing. And interestingly there's a book called The Alchemist by a guy named Paulo Coelho.
I just read that at that moment in time. And it was one of those books that spoke to me, almost. I keep a running list of my favorite quotes and I've got like three or four long passages from that book that are so profound because it almost sounds cliche and trite, but in life, it comes down to follow your heart. I mean, stay true to a value system and a North star and it's not about just being a hedonist and doing what you want, but one of my favorite authors Ayn Rand too – wrote the Fountainhead and Atlas Shrugged – one of her quotes is, “why is it that we tell people it's bad to do what we want because there really is nothing harder, truly harder than doing what we truly want in life?”
It's not the thing that is just the easy, today I feel like going out and drinking rather than fulfilling some responsibility, but like the deeper, what is my life meaning? Can I go pursue that? It's actually really hard. And so, The Alchemist for me opened up that if you don't at least pursue this journey, your heart is always going to wonder. And that was powerful for me.
Bob Wierema: It's so funny because I think it goes within anything you do, right? The comfortable or easy decision would have been for you to stay and do what you were doing. Right. I think a lot of people don't follow their heart because it's more comfortable not to, it's easier not to. And I think you made the comment earlier on, if you believe in something bigger, you can transcend what you think you're capable of, and to have that type of mindset – that's just incredible to get that because I think we miss out on a lot of opportunity in our lives if we're not thinking big, if we're not trying to push to that next level. I always say to my fiancé, I don't want to live a life of mediocrity. I can't have that. [
00:22:00] That's not going to give me the fulfillment I'm looking for in life.
Michael Moore: I was just going to say to that point, because I completely agree. Back to this advice that you were given by this stranger that literally changed the path of the life you were on, growing up were told not to talk to strangers, but I think at a certain point you gained so much raw truth.
I'm the guy that is going to talk to you on the airplane. You find when you don't know somebody, the advice that you get is raw and true because they have no preconceived notions of who you are or what you would want the answer to be because they know you really well. So, thank you for that insight.
I think this can help us transition to the business side, the point you made on seven years not being long in the military. You're exactly right. I think being in the business world like Bob and I are, seven years – especially for the generation below us – is a lifetime in any type of industry. So, you have a lot of different jobs in seven years to ultimately get you to where you want to be. And so, before we jump into Arena Labs, if you guys are good transitioning, there were a lot of steps after the military to get you to Arena Labs in this passion mission that you're on.
Can you dive into that for us?
Brian Ferguson: Absolutely. I want to just quickly put a period, Bob, on your talking earlier of the notion of how do we make those hard decisions? And one of the things I've learned is that like anything, that's a muscle to be exercised, the ability to lean into something uncomfortable. I'm amazed even now. It’s something I have to really be aware of when I'm resisting something, or I know something's the right move. And I think living authentically, I really believe it's the hardest thing to do in the world. To be honest with yourself and your [
00:24:00] relationships. But it's a muscle to be exercised.
I think it's something we think about intentionally with raising our daughter now, but in society, when you get comfortable and in particular from perception perspective, if things are good, it’s really hard to leave that from an ego aspect. So, there's a whole separate discussion there, but it's been on my mind a lot lately.
Michael, to your question, so when I left the military, one of the things I was really privileged with was I worked with this leader who was an extraordinary leader in special operations. And I was in Hawaii in a unit that focused mainly underwater and when you decide to leave, you tend to have a 12-month glide slope where you're no longer operational and guys who've been in for 30 years really need to use that time to figure out how am I going to acclimate to the world and the other side of this?
And that's called military transition. There's an entire, fortunately, body and ecosystem of organizations that have sprung up in the last 15 years to support people who are leaving and their families. But because I had been a civilian before and had a life and came in later, I knew roughly I was going to go out and I wanted to work in the human performance, human potential space.
So I used that last year to focus on building an innovation cell that was looking at how we bring emerging technology into special operations, and how do we do that particularly to amplify human performance? And in the course of that, I was in touch with a whole bunch of unlikely partners. Some of them in the private sector, some in national laboratories, DARPA. But being from Cleveland, Ohio, I was back in home in Cleveland, just visiting for the holidays. And I was put in touch with the heart surgeon, and the Cleveland Clinic heart and vascular institute has been ranked number one in the world for 26 years in a row now, when it comes to heart care. Doing anything at number one in the world for 26 years is doing something right. And even growing up in Cleveland, when the city was struggling, that was sort of the shining star. So, I reached out to this heart surgeon and I sent him an email.
I went on [
00:26:00] the list of 15 heart surgeons at the Cleveland Clinic. And I just got lucky. I reached out to this guy named Doug and he invited me in and so I said, “hey, here's the stuff I'm working on. I would love to know what you guys think. Interestingly, heart surgery is very similar to special operations. You have a group of eight to 12 people working in a life and death, high pressure, time constrained environment. And there's a lot of technology and that team has to come together around the mission and technology”, and I wanted to see how they were thinking about it.
So, I reached out to Doug. He has me in for breakfast. We have a really fascinating conversation about teams and culture and technology. He brings me into his operating room. I watched him do a couple of heart surgeries. And on one hand I would say I was blown away by the technological advancement of the number one institution in the world in heart care. But on the other hand, I was astounded that there was no conversation at the individual or the team level about pressure, stress, burnout. How do you perform and communicate in a crisis when things go wrong? What do you do? All of these things that you could be in any part of the military, they're almost 101 and that are also very prominent and prevalent in sport and the creative arts, they just were missing.
And so that really was this epiphany moment for me. There’s a great opportunity here, and this is a really cool area that needs help. And that was the seed that began a sequence of events, Michael, that eventually led to founding Arena Labs.
Michael Moore: So, what's it like going in cold and seeing a heart surgery like that?
Brian Ferguson: I think different people have different reactions. I'm always very humble about my own background. I've never been to medical school. I’ll never have to go to nursing school. I always find being in the operating room humbling number one, to just see the advancement of human beings – we can put someone to sleep for eight hours and open up their chest and do surgery on their heart or their brain or their leg. It's just, that's fascinating. Again, you realize how advanced we are as a society. And then I personally, I find heart surgery to be almost a divine [
00:28:00] experience, to see the human heart beating or up close and to see someone operating on it and saving a life. It's just a very sacred thing.
So, it's never lost on me whenever I have the privilege of being in the operating room. It's really powerful.
Bob Wierema: Do you still go in the operating room then today?
Brian Ferguson: So the way that we built the company is around that whole concept I just told you about, which was, “hey, there's this Delta that exists, what if we were to bring the tools, training, and technology that other high pressure disciplines use – whether that's from the military, from sport or the creative arts – what if we brought that body of knowledge into healthcare?”
That became the basis of our company, and we call that high performance medicine. The first part of the business was a services business, where we brought people who had those backgrounds, and we would embed them alongside medical teams in the operating room. And so, we would watch surgery and then we'd interview people.
And of course, we're not looking at the technical side of surgery, like, “how well are you performing here?” We're looking at what happens before, when things go wrong, what does that culture look like? What happens afterward? What are the rituals, the protocols, the team dynamics? And we would aggregate that into a set of observations that then we would use to help hospitals build what we called surgical performance programs.
And so, if you're running a hospital, generally right now one of the biggest issues you're dealing with is burnout. So, people who are stressed, who are overworked, who don't understand how to navigate this really difficult career. And you're also trying to figure out – you've probably mastered the technical skill if you're a place like the Cleveland Clinic – but no one's really thought about human factors and how do you help people actually lead teams and serve on teams that are high pressure? And so surgical performance programs bring all of that knowledge and help hospitals implement it.
Bob Wierema: I guess I've never thought about it like that. You’re talking and my head's going, “yeah, that team has to be such a high functioning [
00:30:00] team working together. There can't be nuances between team members or someone pulling the team down because if there's a little slip up – here in my world, right? The slip up here, it's not life-changing. Yours, in that world, could be. There's a ton of pressure that comes with that.
Brian Ferguson: And what's interesting, Bob is that the world I came out of, and special operations as an example, usually at a minimum you're with the same team for two years. And in that two-year 24 months cycle, roughly 18 months are spent training together, understanding. And so, when you're on night vision, there you go, you can tell someone just by their silhouette, how they walk, you get to know people in a very intimate way. What's amazing about medicine, even at a place like the Cleveland Clinic, is it's not uncommon for a surgeon to get in the room and never have met someone on his team for that day. So there's a whole separate challenge, and that's that isn't changing in medicine anytime soon. And so, the question becomes, if you're going to serve on any team, how do you control for culture so that when people show up, they may have never worked together, but they're all on the same page about what's the standard of performance? How do we cultivate trust quickly?
How do we get people to understand back to this idea of transcending what you're capable of? This is why it's so important to believe in something bigger, because people then want to serve. They want to do their best to serve that mission, and a lot of times that's lost in healthcare and those are some of the things that we start to help hospitals think about.
Michael Moore: You know, Brian, we talk leading up to this podcast when we're getting to know each other, and unfortunately, I have a little bit of experience in trauma centers in ICUs just with my mom and my wife's mom. And to your point, you've got situations and decisions that have to be made in a split second that either create longevity [
00:32:00] or wind things up and then that, for whatever reason, always seems to happen in the middle of the night. And then you've got this super stressed out family that's just looking for answers and has been thrown into this and doesn't understand. So, the pressure on those frontline workers from the surgeon all the way down to the person just coming to buy and reading a chart is just a level of stress that most people don’t understand. And so, give us some more insight into how Arena Labs works. What's the DNA and how does it deliver results?
Brian Ferguson: You’re keying in on the things that we think are most important. One is if each year, Time magazine does a person of the year, you may have seen that, and last month they had the three finalists for the person of the year, one of which was frontline medical workers. And the proposed cover of that magazine was this amazing set of images of all of these frontline staff. You guys have seen I'm sure some of these pictures – because they're wearing personal protective equipment for so long, it's literally imprinting these marks on their face and they just look exhausted. It's just powerful imagery. And so, you think about that in the context of dealing with COVID and all of the emotional challenges you've heard about, of people having to say goodbye on Zoom and a nurse holding up a phone in the room. It's super intense stuff.
And you think about, as you're bringing up Michael, the ICU or trauma, and when our team was observing, we were at a level one trauma center in Washington, DC, but we were in there on a Saturday night at one o'clock in the morning. And this is typically when you have, because of people being out of bars, et cetera, you get a lot of trauma. And at one time there were two people in there screaming and another person moaning. And just hearing that, as I was standing there, I thought ‘it's insane what this does to the human emotion and cortisol levels’. And what's crazy is if you were to observe that and you think about this whole body of knowledge that's come out of the [
00:34:00] military in the last 15, 20 years about post-traumatic stress and about the implications of people who are in very high stressed, emotional environments, either combat or otherwise, we've put a massive amount of resources into helping those people. And yet we ask these trauma nurses and ICU nurses and physicians to go home and have dinner with their families. And no one thinks twice about it because they're not deployed. So, we think about this as the environment is different. You might not be deploying overseas to Afghanistan or Iraq, but you are doing consequential heavily emotional work that has a chronic element of stress.
And when you look at the implications of chronic stress on human beings, that leads to higher levels of cortisol over time, not being able to focus, not being able to sleep. There’s a second and third order, long-term impact that has, so to answer your question, what do we do? When we initially were building the business, the first three years were what I just described as we were running a services business. We were embedding in hospitals and we are helping those hospitals build not only a program around performance in these human factors. Things like, it's one thing to say that we want our operating rooms to run on time. It's another to think about what's the leadership structure in place here? How are we training the leaders who have to run those operating rooms so that they can make decisions and be clear and connect that into a culture? And so, it's implementing all of these elements that allow that human system to do what it does best and then focus on the individual, giving that individual tools around, what does it mean to get good sleep? What does it mean to recover after a stressful day? How do I decompress on the weekend? What we were finding is that as you guys well know, in the services businesses, it's really important for human touch, but it's not scalable and it can be daunting. And I don't think starting with scale is ever the right approach for a startup. But what we started to realize is we weren't reaching enough people and in the dynamic nature of healthcare, it's tough to get in front of people in the right way. So COVID completely killed our business in March, our services business literally evaporated [
00:36:00] because we could no longer go into hospitals alongside frontline medical teams. Most hospitals still, if you're not essential personnel, you can't go in.
And so that was a blessing for us because classically, we had to say, “okay, we know there's a demand signal for what we're doing here. And actually, it's heightened because of COVID”. And we took three-and-a-half years of learning and we created a content and a data business. So, what we've built is a platform that takes all of the learnings and teachings of our team and our performance ambassadors and it's now built into a series of three pillars. A pillar around the individual, learning about how to be a high performer in healthcare, how to manage sleep and stress, how to optimize interactions with your teammates. And then there's a second pillar on how do you serve on a team that’s high pressure in a life and death environment? And the third then is how do I lead and manage in that environment? And so that's all offered digitally, but while you're on our platform, we have a partnership with a company called Whoop, and so you have a wearable sensor that's gathering biometric data on your sleep, on your stress, in your recovery.
And so, the things we're teaching you, you're actually getting personalized feedback on that topic. And you're starting to learn how to not only understand yourself in terms of these critical biomarkers, but what that means in the context of recovering and flourishing over the course of a career. And then we take all of that data and most importantly, we now give that to hospital leaders and surgical leaders so that they can for the first time actually see what their team looks like in terms of stress and recovery and be smarter about how they allocate human capital train and let people recover.
Bob Wierema: Brian, I want to go back to the Whoop piece. Because I was thinking, are they wearing that throughout the day? And then you're actually taking not only monitoring sleep and things like that, but also how they are in a surgery or a certain environment within the hospital?
Brian Ferguson: Exactly. So, any of these devices is on 24/7. One of the things that we know, we [
00:38:00] want to understand acute events, meaning if something really goes wrong in surgery and it's super stressful, the reality is that those events, particularly for veterans of medicine, are not as common as you'd think. If you or I go into the operating room, it feels stressful, but that's become fairly normal, they have acclimatized to that.
What we're trying to understand is the chronic implications of being in a high stress environment over time. And so, it's equally important to understand what does the weekend look like? One of the things we learned early on is if you have a really stressful week, your weekend isn't relaxed. There’s a residual effect of that stress on your weekend. And that bleeds into interactions with your family. Interestingly, when I was in the special operations community, we were going through this massive Renaissance that was the same thing, because what we realized was that guys were deploying at very high operational tempos on reverse circadian rhythms.
So, they were operating at night, awake during the day. They weren't getting enough sleep. They were in high stress environments. So, their cortisol levels were spiked. And with all of that, then they'd come home and try to reintegrate into this family environment. And it was creating this real challenge. And so, a whole sequence of events happens from the stuff we're doing around educating things like sleep, how to optimize your actual sleep hygiene and your environment you sleep in, all the way down to how does your family understand this so that your family is aware of the realities of your job and how best to maximize recovery time. That over the course of a decade then led to this very sophisticated organization. So, what we're looking to do in healthcare is that same phenomena.
Let's start with the basics of getting people educated and increasingly give them tools so they can be smarter and feel more empowered and more agency.
Michael Moore: Brian, with the crossroad and defining moment that occurred when COVID hit and business as normal did not exist because you couldn't go in there and you pivot, it hadn't been a lot of times since that happened, right? That was March. [
00:40:00] But in that time, what KPIs and ROIs, what has come out of that now that you're implementing it in a different way? What are you seeing?
Brian Ferguson: Number one - I think even this gets into Bob's point earlier – the things about we get comfortable and we know something isn't working, we need to change. If I'm being honest, we have built a reasonably comfortable business. It was a services business, but number one, I was increasingly unhappy because I was on a plane all the time, I was in hospitals. And more importantly, I was like, “we're not getting the data we need here. What I'm realizing is that on one hand, people leaders in healthcare are saying their number one issue is burnout, and yet the only way burnout is measured is self-reported surveys. So that's super problematic. We don't actually have data to understand what does burnout mean? How do we recognize it early?” So, the first set of KPIs, Michael, is we for the first time actually have data at scale on teams and medicine. You could go to most hospitals in the United States right now and ask them, “what is the overall state of health? How rested is your team?” They would have no idea, but if you go to the Cleveland Brown, you go to an NFL team, you go to a Cirque de Soleil, there are elite performing artists. This is stuff that's seen as essential. If you want those people to last and flourish and be around, and it's not a big investment, it's just saying this is a priority. So, for us, what happened is for the first time we started getting data on heart rate and what’s someone’s HRV? HRV ends up being this amazing predictor of how stressed someone is. Just from feedback and qualitative surveys we’re for the first time starting to get data around how does a critical event, how is that perceived across the team? And then how does that correlate to the biomarkers in that team? Did they not sleep as well? So, we're starting to get a data picture that we can use to correlate this massive [
00:42:00] endemic problem in healthcare which is burnout, and give hospitals a proactive posture, rather than just saying, “this is a huge problem. What do we do?”
Bob Wierema: Brian, when you say that, so I'm going through this a little bit right now. And I'm in just the business world, right? I'm in sales and one of the things I've been spending a lot of my time on lately. So, my fiancé’s a professional ballerina – going back to your sports analogy – I was talking to her and she obviously has to be in phenomenal shape and do all these certain things and COVID put a damper on that. So, what can she do to stay in shape so that when things do come back, she can be at optical for performance. And then we were talking one night, and I said, "if I think of myself as an athlete, my business, what are the things that I can focus on? All I have is my mind, and then what can I drive most in my mind to keep me good? There's the stresses of business and all of these different things. How do we exercise? What’s my heart rate? What’s my sleep? All these things you're talking about. And I've already noticed as I'm learning this and trying new things, the little upticks in performance, or how sharp I feel that day from those little things. And it's amazing when you tell me that about a medical community, someone that we rely on to save our lives and they're not spending all that time in that area, because there's probably so many other places they can put their resources towards. And to me it seems like from talking to you that you should be spending a lot more time there to get optimal. You said amplify human performance, that's exactly where we should be spending our time with those people right?
Brian Ferguson: Yeah.
Michael Moore: Is that stigmatism around because medicine and trying to help – people have been born and died since the beginning of humankind. So, and you've had medical people along the way trying to figure that out. Is it because it's occurred for so long? And the expectation is that [
00:44:00] especially if you're a trauma surgeon, it's going to be stressful that this key ingredient was just missing.
Brian Ferguson: Yeah. I actually – see personally I've thought about this lot. I think the phenomenon is just for three reasons. But before I get into that, let me say it's really important that I foot stomp this – we are not in any way advocating that choosing a life, whether that's on the front lines of medicine or in the military, those jobs are not for everyone. Resilience and the willingness to do hard things – that's a precursor to make sure that someone can perform when it counts. So, we are never suggesting that these organizations should soften in a way that takes care of everyone. It doesn't account for the fact that this was just a stressful career and that's part of the society. People have to do hard things. However, when I look at the state of the landscape of medicine, there's really, again, there's three avenues that I find interesting around what culture has happened.
So, one is just in the modern world. Technology has advanced in a way that allows hospitals to do more with less. So, it's like the same amount of people were asking you to do more operations, just like we see in businesses, right? People are being asked to do more because technology is an amplifier, but just like we see in business, there's a toll that takes on a human system.
And so, when we start to intersect human systems with advanced technologies, like artificial intelligence and big data and predictive algorithms like that, that has an impact. The second is that culturally people – it's very similar to how it is on special operations. So, in the seal community, you go through something called hell week and hell week is a week period where it's the crucible.
It's sort of the defining moment in early seal training. And you are awake from Sunday evening until Friday morning. So, for five days, you're awake. You take two naps in there and those naps are critical just for the brain to essentially stay functional. But otherwise, you spend five days in a state of motion and physical activity.
The purpose of that is, [
00:46:00] as I said on the front end, is to show you what’s at the bottom of the well. What you're actually capable of beyond what you think you're capable of. And it is an incredibly liberating experience for people who get through it. The problem then is people are falsely tricked into thinking they don't need sleep, when the reality is that sleep is the single most important performance drug we all have access to. So, then the community has to think, you have to get people to realize if you truly want to pursue mastery and be a special operator at the top of your game, taking care of yourself is paramount and you're responsible for that. And here's the tools to do it.
Now that doesn't suggest that sometimes you might actually be deployed and you're not going to have the ability to sleep eight hours a night, you're gonna get two hours. And so how do you maximize that? That same cultural challenge exists in medicine. They just never addressed it. Never addressed it. I kid around that people revere hell week as this crazy crucible and it certainly is, but people who are surgical residents in medicine, these people sleep three to four hours a night for six years at a time. It’s madness how hard being a surgical resident is, and what’s expected of you, and how under rested you are.
So, they come out of that thinking, “I don't need to sleep, sleep is for the weak. If I sleep, I'm not going to be good”. And so culturally it becomes commonplace in medicine that not taking care of yourself, not resting is seen as a sign of strength, and that has not been broken yet. It's starting to break a little more with a younger population, but the most important one, Michael, the third reason – you see this across medicine, I saw it in public service, people who are service minded, who want to give to the world, who want to do hard things and save lives, they will give of themselves and give of themselves to a fault. And they will sacrifice their own health in the process. If you don't have leaders who see that and know how to protect those people from their better angels, what it leads to is a massive human toll of people being burned [
00:48:00] out. We see this in the military, you look at what was asked of young soldiers, men and women over the last two decades who were willing to give of themselves. And this is one of the reasons I'm so passionate about leadership, because if you don't think about these things, you don't think about the implications of asking people to go to war or go to the front lines of an ICU day in and day out, what you see is a human toll that you can't reverse.
Michael Moore: Brian I want to ask a summary question just because you've seen it from so many angles. You’ve seen it from the military side. Your time in DC now, your time as a CEO and founder of a company that truly is making a difference. We thank you for that. As you look back on this last year with all the politics that we’ve endured, with the hit of COVID, with the beginnings of the rollout of a vaccine, from your vantage point, how do you feel about it? Score that for us.
Brian Ferguson: I go in and out of this one, Michael, because I – on a personal level – I feel incredibly fortunate that number one, we've been able to navigate this and for the most part are not suffering in the way that I know a lot of people are. when you're asked a question like that, it's hard not to recognize that and just say, from a humble human perspective, whatever one thinks of this scenario, a lot of people have died, a lot of people are suffering economically. Our nation is really in a state of pain right now. When I move myself into a higher level of thinking, or I shouldn't say that – I’ll zoom out. The thing that I see in all these sectors is, and I saw this in the military, there’s a real tension. If you think about the organizations, the [
00:50:00] institutions that govern our lives, that we rely on, that we learn in – education, the military, medicine, they’re legacy structures of the 19th and 20th century, and they're not equipped for the 21st century. And that tension is only accelerating.
And so, what we see is the reason I personally think that having worked in government and in politics and in the military, those organizations have a beautiful legacy that we're all proud of, but they don't work in the 21st century. They can't move fast enough. You see it in election cycles, you see it in defense deployments. One day we're worried about viruses in a lab in China. The next day, we're worried about a threat from the cyber realm in Russia, and the speed of the change, our institutions can't keep up. And so, in a weird way, I've always felt like everything going on in the world is symptomatic of that creative destruction that needs to happen.
I am an optimist in that I think we are as a human society, in a collective society, are going to have to evolve into new structures. I would be lying if I figured out what those are, but I'm not someone who's a post-nationalist who believes in this sort of global environment, nation states are still going to need to exist. I just don't know what the structures are that are gonna allow us to flourish? But I think right now we're seeing a breakdown that is a natural product of Moore's law (?), technological advancement, and all of the complexity that creates. And the last thing I'll say is the beauty in all of it is that it's forcing us to return to the very human side of ourselves. I could sound almost cliché, but think about what the last 10 months has done for all of us. It's pushed us into a state of appreciating the human experience in the most basic way. My Christmas this year was just my wife and daughter and I, and we had nowhere to go. No obligations, no rushing around. I didn't even care about presents. And there was this presence in that existence [
00:52:00] that I think is beautiful and that’s where the moment in time, that goes way back. I do think that that is the blessing in all of this.
Bob Wierema: Brian, do you think that – because we've talked about the social media presence and some of this and do you think there's also the other side? I think there's also the other side of our society that’s so caught up in the media and social media and this isolation, I think there's going to be so many challenges with that as well. You’re looking at it from the optimist view. What do you think about that flip side of the view?
Brian Ferguson: It's a great point. And I would agree. Actually, I was talking to a really impressive woman who’s a young cardiac surgeon and having this discussion, and she was saying that we still don't really have data on what social media does to the brain and to the human experience, the longitudinal. There’s that the movie you guys may have seen called The Social Dilemma, which talks a bit about the neuroscience of social media. I will tell you what I’ve said from day one is look, first and foremost I am not in government right now, and it's always easy. It's why my company is called Arena Labs and the namesake of our business comes from the Teddy Roosevelt quote that is commonly known as the ‘man in the arena’ quote, but it comes from a speech he gave in 1910 called Citizenship and Republic. Roosevelt is talking to a group of leaders in France. And he's saying, “look, you are accomplished successful leaders, but you have an obligation to stay involved in society. Because it's not the critic who counts, but the man or woman in the arena marred by dust and sweat and blood, who knows the great victories of success, the great failures of defeat”.
And the idea is that in life, it's easy to be on the sidelines and be a critic, but it's about people doing hard shit that really advances the world. So, I say that as a precursor, I'm not having to make hard decisions right now, but from the start, my biggest gripe in all of this has been in what one could argue is the biggest domestic crisis we faced in our lifetime, [
00:54:00] full of stress. We have asked people to stay inside and in doing so they're consuming news. They're getting more stressed. They're not active, they're drinking more. And we're seeing higher rates of depression, and the psychosomatic impact of asking people to sit inside for a year of their lives and not interact with human beings – I'm seeing that play out in close friends, family. I think we have undervalued the implications of that from the beginning of this. I recognize there's not an easy solution, but that has been my biggest concern from the start.
Michael Moore: That's a great point. I guess probably just because it was leading up to the end of the year and people are reflecting, you just heard it over and over again. “I'm so glad 2020 is going to be in the rear-view mirror”.
Unfortunately, this isn't just a 2020 problem. Bob and I have talked a lot on this podcast about 2020 being such a defining moment of the old economy and the new economy, and what is that really going to look like? So, I think we would really appreciate the opportunity maybe towards the end of 2021 to bring you back on and just get another rear-view mirror look from where you're seeing things and what your company and technology and the frontline workers are going through because it's not going away, but it's people like you that are passionate about it coming up with out of the box ideas that are certainly gonna get that back headed in the right direction.
So, both of us really appreciate what you're doing.
Brian Ferguson: Well, that means a lot. I will quote another person I looked up to when I was little, which is the great Arnold Schwartzenegger who when asked, said, he's a self-made man. He's like, I'm the furthest thing from being self-made. And I'll tell you, the reason I feel so fortunate, guys like Michael Davidson, these people who've been massively influential on my journey in our team right now at Arena. [
00:56:00] The amount of people who are involved in this mission, I just feel super humbled. So, it's always awkward coming on a podcast representing myself, but definitely part of a way bigger mission, which I'm super grateful for.
Michael Moore: Well, we like to ask a question and it kind of ties in with – we may have to ask you if we can borrow it, I love that visual of seeing what's at the bottom of your own well. So, the question really is going to be what's at the bottom of your well? But the way that we have asked it historically has been, there's that saying of, it's not what you know, it's who you know, and then we turn it around and say, it's not who you know, it's who knows you.
So, using this podcast as a medium, whether it's future business for Arena Labs, whether it's your daughter and wife, what do you want people to know about Brian Ferguson?
Brian Ferguson: I think at the end of the day, it's a very sincere life dedicated to being authentic around the things I believe in. And I work really hard for the person I am publicly to be the person I am privately.
And I don't think that's always easy in today's world. It's often convenient to have two different archetypes. When I was young, a senior in high school, I got in trouble. I was on one hand a leader in my class and my community, and I got in trouble for this big party. And my mom was very wise about it. She’s like, “right now you're two different people and at some point, you need to make a decision on who you want to be”. And three years later, when I was graduating college, my grandmother gave me a list of her favorite quotes. The top of which was “character is what you are in the dark”. And so, for me, I really want to live a life of virtue and be someone who contributes to society and serves and is a phenomenal mentor and role model for my daughter.
That, I believe, starts with being the person I say I am as much publicly as I am privately. And so, for me that I always bucket [
00:58:00] into authenticity, and I just want to be authentic in how I engage with my friends, people I work with, the ideas in the world, and that is actually really difficult because it requires a lot of work. It requires having to let go of a lot of things and make hard decisions. So it is humbly being authentic, or humbly pursuing authenticity.
Michael Moore: I love that. It’s all of it. It’s career, it's family, it’s what we're deciding. I lost my dad about a month ago, and 15 days after he passed away I got a letter in the mail that he had instructed his wife to send me.
And it was just an amazing way of him communicating from the other side and saying I'm still going to be here. Because I was looking for that spiritually, before I was going to bed at night or tucking my daughters in and saying prayers, I was looking for “Dad, how are we going to communicate and continue? Because I've still got a lot to learn from you. And in that letter, he said, you are transitioning from being old in the young part of your life to being young in the old part of your life. I think that's what we're all going through right now is that we've done a lot of cool things. We've accomplished a lot or successful in life and love and business, but what are we going to do with that now? And so, your story today defines that. It's why Bob and I are so passionate about this podcast and just thank you for sharing.
Bob Wierema: Yeah. Thank you, Brian. It's been awesome. I've learned a ton from you today, so I appreciate it.
Brian Ferguson: Yeah. Again, it's humbling when guys like you ask me to come have a conversation, you’re never quite sure what you might add, but I really appreciate it. Michael, I appreciate you sharing that story. Just as a closing thought here, when you deploy in the [
01:00:00] military, you often you write a letter before you leave in the event you don't come back. But the idea of doing that proactively for one's kids and survive, I just love that. It's something, I just speak volumes about your own DNA and where you come from, but that it's going to take to talk to the back of my mind. And it's just such an awesome way to, to think about your own life and passing something on.
No, I love that, man. I appreciate you sharing that.
Michael Moore: Yeah. I mean, if the whole notion is, you know, put others before yourself, I mean, here he is battling ALS. He knows it's terminal. He knows he's got a certain amount of time and he’s got the wherewithal to dictate a letter to me and my brother and my stepsister for that very purpose. It's just talking about defining moments. That’s the kind of person I certainly want to be and the daughters I certainly want to raise. So again, thank you for your time and sharing. And this has been fantastic.
Bob Wierema: We're going to have you back next year. Around the same time, we appreciate it. This was definitely a super enjoyable conversation.
Brian Ferguson: It was great to meet you.
Michael Moore: Thanks so much for tuning into this episode of The Climb. If you enjoyed the episode, please consider subscribing. And if you know someone who you would think would enjoy the podcast, feel free to share this with them. Thanks again, and we'll see you on the next episode.