A distinguishing feature of Going the Distance is that it avoids the oversimplification of offering a single principle that promises salvation. In fact, this book effectively organizes the experience and observations of two people who have collectively logged more than 50 years in complex organizations. The complexity that gradually develops in a successful company brings with it both opportunity and peril--it is a double-edged sword that can make the difference between winning and losing. The authors describe two categories of challenge--governance and execution--that provide guideposts to longevity or, if neglected, become the fault lines of eventual failure.
These two categories encompass eight critical challenges in all. This presentation makes it clear that it is seldom a single occurrence or characteristic that brings a company to its knees; rather, the book makes clear that it is the buildup of unmet challenges that choke a company over time. A second distinguishing feature of this book is its description of stages of evolution of companies, contrasting the nature of challenges experienced in startups, in companies on the rise, and in well-established, multibillion-dollar companies.
These challenges are possible during all stages of a company's evolution, but some are far more likely to present themselves at certain stages than at others. Just as important, some challenges, such as establishing a learning culture and a bias for constant innovation, are critical to meet early, as they are very difficult to address once the wrong DNA culture is formed. In fact, it is notable that throughout this book, the authors emphasize the importance of a learning organization as central to the adaptability necessary to survive quickly changing markets at any stage of a company's life.
Third among this book's distinctions, I particularly appreciate the authors' awareness that success depends on attending carefully to what's really going on in a company--facing the harsh facts as they are. One of my jobs as a board member has been to counsel management to avoid distraction and to execute with constructive paranoia. Going the Distance provides detailed practical application of these ideas. The unique and pragmatic insights necessary for success are here--for new and experienced CEOs, for other executives, for venture capitalists, for students of business, and for anyone interested in the dynamics of corporate success and failure.
This handbook is so fundamental to the process of creating world-class companies that I may continue in the venture capital business another 30 years! Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
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Please try again. Alcohol also damages the prefrontal cortex, which is responsible for judging risks and regulating behavior—one reason some people keep drinking even as they realize that the habit is destroying their lives. Why, then, do we so rarely treat it medically? W hen the Hazelden treatment center opened in , it espoused five goals for its patients: behave responsibly, attend lectures on the 12 steps, make your bed, stay sober, and talk with other patients.
No other area of medicine or counseling makes such allowances. There is no mandatory national certification exam for addiction counselors. Mark Willenbring, the St.
Paul psychiatrist, winced when I mentioned this. Perhaps even worse is the pace of research on drugs to treat alcohol-use disorder. The FDA has approved just three: Antabuse, the drug that induces nausea and dizziness when taken with alcohol; acamprosate, which has been shown to be helpful in quelling cravings; and naltrexone. There is also Vivitrol, the injectable form of naltrexone. Reid K. Hester, a psychologist and the director of research at Behavior Therapy Associates, an organization of psychologists in Albuquerque, says there has long been resistance in the United States to the idea that alcohol-use disorder can be treated with drugs.
For a brief period, DuPont, which held the patent for naltrexone when the FDA approved it for alcohol-abuse treatment in , paid Hester to speak about the drug at medical conferences. Many patients wound up dependent on both booze and benzodiazepines. There has been some progress: the Hazelden center began prescribing naltrexone and acamprosate to patients in But this makes Hazelden a pioneer among rehab centers.
And now that naltrexone is available in an inexpensive generic form, pharmaceutical companies have little incentive to promote it. The drug helped subjects keep from going over the legal threshold for intoxication, a blood alcohol content of 0. Naltrexone is not a silver bullet, though. Other drugs could help fill in the gaps. So, too, have topirimate, a seizure medication, and baclofen, a muscle relaxant.
It was here that J. After his stays in rehab, J. In his desperation, J.
Then, in late , J. During those sessions, Willenbring checks on J.
I also talked with another Alltyr patient, Jean, a Minnesota floral designer in her late 50s who at the time was seeing Willenbring three or four times a month but has since cut back to once every few months. At age 50, Jean who asked to be identified by her middle name went through a difficult move and a career change, and she began soothing her regrets with a bottle of red wine a day. When Jean confessed her habit to her doctor last year, she was referred to an addiction counselor.
The whole idea made Jean uncomfortable. How did people get better by recounting the worst moments of their lives to strangers? Still, she went. Another described his abusive blackouts. One woman carried the guilt of having a child with fetal alcohol syndrome. Then she found Willenbring. During her sessions with him, she talks about troubling memories that she believes helped ratchet up her drinking.
In his treatment, Willenbring uses a mix of behavioral approaches and medication. Moderate drinking is not a possibility for every patient, and he weighs many factors when deciding whether to recommend lifelong abstinence. He is unlikely to consider moderation as a goal for patients with severe alcohol-use disorder. Nor is he apt to suggest moderation for patients who have mood, anxiety, or personality disorders; chronic pain; or a lack of social support.
The difficulty of determining which patients are good candidates for moderation is an important cautionary note. But promoting abstinence as the only valid goal of treatment likely deters people with mild or moderate alcohol-use disorder from seeking help. The prospect of never taking another sip is daunting, to say the least.
No one knows that better than Mark and Linda Sobell, who are both psychologists. In the s, the couple conducted a study with a group of 20 patients in Southern California who had been diagnosed with alcohol dependence. Over the course of 17 sessions, they taught the patients how to identify their triggers, how to refuse drinks, and other strategies to help them drink safely. In a follow-up study two years later, the patients had fewer days of heavy drinking, and more days of no drinking, than did a group of 20 alcohol-dependent patients who were told to abstain from drinking entirely.
Both groups were given a standard hospital treatment, which included group therapy, AA meetings, and medications. The Sobells published their findings in peer-reviewed journals. In , the University of Toronto recruited the couple to conduct research at its prestigious Addiction Research Foundation. In , abstinence-only proponents attacked the Sobells in the journal Science ; one of the writers, a UCLA psychologist named Irving Maltzman, later accused them of faking their results. The Science article received widespread attention, including a story in The New York Times and a segment on 60 Minutes.
Over the next several years, four panels of investigators in the United States and Canada cleared the couple of the accusations. Their studies were accurate. The late G. Alan Marlatt, a respected addiction researcher at the University of Washington, commented on the controversy in a article in American Psychologist. They also run a clinic. Like Willenbring in Minnesota, they are among a small number of researchers and clinicians, mostly in large cities, who help some patients learn to drink in moderation.
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We can change the course. During my visit to Finland, I interviewed P. He told me that for years he had drunk to excess, sometimes having as many as 20 drinks at a time. A year-old doctor and university researcher, he describes himself as mild-mannered while sober. His wife found a Contral Clinic online, and P. From his first dose of naltrexone, he felt different—in control of his consumption for the first time.
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He drinks two, maybe three, times a month. By American standards, these episodes count as binges, since he sometimes downs more than five drinks in one sitting. He feels much more confident and stable, he says, than he did when he was drinking. He has successfully drunk in moderation on occasion, without any loss of control or desire to consume more the next day.
And he has more at stake now—his daughter was born in June , about six months before he found Willenbring. That remains to be seen. The Department of Health and Human Services, the primary administrator of the act, is currently evaluating treatments. But the legislation does not specify a process for deciding which methods should be approved, so states and insurance companies are setting their own rules. Still, many leaders in the field are hopeful—including Tom McLellan, the University of Pennsylvania psychologist. His optimism is particularly poignant: in , he lost a son to a drug overdose.
Americans need to demand better, McLellan says, just as they did with breast cancer, HIV, and mental illness.