The Leadership Framework I Learned Before I Could Walk

What three years in a hospital taught me about leading people through stuck seasons.

Photo by Jonny Gios on Unsplash

The physical therapy rail was cold.

That’s what I remember most: not the triumph, not the victory, not the moment I proved that doctor wrong. Just how cold the metal felt under my palm when I tried to stand for the first time in nine months.

My legs didn’t belong to me anymore. They were strangers I’d been introduced to but couldn’t quite trust. The body cast had held me rigid for so long that my muscles had forgotten their jobs.

The physical therapist positioned herself behind me. “You’re going to fall,” she said, matter-of-fact. “But I’ve got you.”

I didn’t believe her. But I gripped that rail anyway: knuckles white, heart pounding, every muscle remembering the doctor’s words from months earlier: You’ll spend the rest of your life in a wheelchair.

Something inside me whispered back: Watch me.

That cold metal rail became my daily practice ground for what I’d later understand as leadership’s most essential skill: learning to move when you can’t see where you’re going.

What My Body Taught Me About Leading Minds

The physical therapist had a rule: no mirrors in the room.

“I don’t want you watching yourself struggle,” she said. “I want you feeling it.”

Without the mirror, I had to pay attention to what my body was telling me. The difference between sharp pain (stop) and burning pain (keep going). The tremor that meant muscle fatigue versus the one that meant I was about to fall.

I was learning to lead from the inside out.

For two years, I practiced what neuroscientists now call metacognition: observing your own thinking and choosing which thoughts to follow. When the voice in my head screamed you can’t, I had to find the quieter one whispering not yet.

Some days the story was: This is punishment. Other days: This is temporary. And on the best days, the ones where I gripped that cold rail and took one shaking step, the story was: This is training.

Years later, managing my first team through a brutal systems change, I’d remember that mirrorless room. Because the hardest part of leadership isn’t what you show people. It’s learning to read your own nervous system accurately enough that you can regulate it before you walk into the room.

The first territory you lead isn’t a team. It’s yourself.

The Doorway

My mother stood in the doorway of the physical therapy room most days.

Not hovering. Not interfering. Just… there.

She never told me I was brave. Never promised it would be easy. She just showed up, coat still on from teaching all day, exhaustion in her eyes — and created a presence that said: You’re not alone. And I trust you to find your way through.

Decades later, standing in doorways myself while my own son fought for breath in a hospital bed, I finally understood what she was doing.

She was modeling what I now call regulated leadership.

She didn’t fix anything. Didn’t rush in to rescue me when I fell, and I fell often. She just held space. Created safety without controlling the outcome. Trusted me to find my own strength while knowing I wasn’t abandoned in the finding.

That’s the leadership nobody teaches: the kind that doesn’t rush in with solutions, the kind that trusts people to grip their own cold rails while standing close enough to catch them if they fall.

When I became a manager, I remembered that doorway. And I learned to stand in it: not solving, not performing certainty I didn’t feel, just showing up and saying through my presence: I see you struggling. And I believe you’ll find your way.

The Night Nurse Who Understood Systems

The night nurse, I’ll call her Maria because I never learned her real name, did something that wasn’t in the protocol.

Every night at 9 PM, she’d stick her head in my room and say, “Still awake?”

If I nodded, she’d pull up the chair and stay. Five minutes. Maybe ten.

She never asked about pain levels or range of motion. She asked about my life. What I missed. Who I was before my body stopped working. Whether I’d read any good books lately.

The doctors measured my progress in degrees of hip flexion. Maria measured it in whether my eyes looked less scared than yesterday.

Twenty years later, leading teams through corporate restructuring, I’d remember Maria. Because here’s what I learned: systems can’t heal. But people can.

The org chart said her job was medication administration and vital signs. But Maria knew something the system couldn’t measure, that a twelve-year-old in a body cast for nine months needs someone to remember she’s still a person, not just Case #4782.

Now, when I’m coaching executives drowning in OKRs and sprint cycles, I ask them Maria’s question: “What are you measuring? And what matters more than that?”

Because in hospitals and corporations alike, the most important work often happens in the spaces between the protocols. In the doorways. In the 9 PM check-ins that aren’t required but change everything.

What That Rail Still Teaches Me

Today, I call this healing-informed leadership.

It’s what I practiced gripping that cold metal rail when my body didn’t belong to me anymore. What my mother practiced standing in doorways. What Maria knew when she asked about my life instead of just my vital signs.

These aren’t separate principles. They’re dimensions of the same practice:

Leading yourself first, so you can hold space for others. Learning to read your own nervous system, understanding the difference between pain that means stop and pain that means keep going.

Finding meaning in stuck seasons, so paralysis doesn’t become permanent. Choosing whether the story is “this is punishment” or “this is training.”

Creating safety before demanding performance, so nervous systems can collaborate instead of just survive. Measuring what matters, not just what’s easy to count.

That’s healing-informed leadership. It’s not about having all the answers. It’s about standing in the doorway while your people find their way, and trusting that the cold rail they’re gripping right now is teaching them something they’ll need later.

Your Version of the Rail

Every leader I’ve coached has their version of that cold metal rail.

Maybe it wasn’t a body cast. Maybe it was a failed launch that gutted your confidence. A layoff. A betrayal. A moment when your legs didn’t belong to you anymore and you had to learn to stand again.

But the question is the same: What story are you telling about the moment you couldn’t move?

Because that story, the one you’re telling right now, whether you realize it or not, is shaping how you lead.

The leaders who transform their teams aren’t the ones who never fell. They’re the ones who gripped the rail, took the shaking step, and then turned to say: “I’ve got you. You’re going to fall sometimes. But I’ve got you.”

I want to hear yours.

Drop it in the comments. I read every single one. And if you’re not ready to share publicly, hit reply.

Because somewhere, there’s a manager gripping their own cold rail right now, terrified, uncertain, convinced they’re the only one who doesn’t have it all figured out.

And your story might be the doorway presence that helps them take the next shaking step.

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