By Nick Jacobs

The day starts with a trip to Starbucks where they hand me my decaf, nonfat, grande, latte. Reaching for my car keys the foamed skim milk drips onto my black top coat and as the sleeved cup is carefully placed in the holder between the seats, the car lunges forward. When I fumble to place my Bluetooth headset back into my right ear, the excess foam drips onto the screen of my Treo cell phone, and it’s only 6:30 AM.

The lighted icon of a yellow skidding vehicle appears on the top of my odometer as the company car flies toward the first meeting of the day with the medical staff. This group prefers the predawn hours of the day more than any other time. (As a former professional musician, the only time I enjoy seeing the sunrise is when I'm coming at it from the night before.)

After the medical staff meeting, the next three hours are filled with meetings with my direct reports. If charted, these meetings would look similar to my last EKG as the personality types move from conservative to liberal, from detailed to ethereal from muted to encouraging. It's a roller coaster ride of emotions, issues, problems and potential solutions as they bare their souls in this hourly cleansing session, receive absolution where appropriate and move on with their work lives with the same passion and commitment that Rudy displayed at Notre Dame, that Armstrong demonstrated on the moon, that Custer . . . well, you get the idea.

At noon, lunch is consumed as almost an afterthought. It's vegetable or meat loaf, tossed a salad and a whole wheat dinner roll with a side of bottled water. Chewing and swallowing continues as we contemplate the fates of the various physicians who have applied for privileges to work at our hospital. All are considered as the names are discussed by the various physician leaders. Their credentials, their recommendations, their history, their record with the Physician data bank and, when appropriate, the side of their head on which their hair is parted, are issues for discussion at this meeting.

After this working lunch, there is a one hour teleconference with six CEO's from other hospitals where we discuss governance issues for our regional organization.

All of the earlier meetings lead to the high light of my day, the marketing meeting. I'm sure that my peers from finance probably have a similar high from meeting with their number's jocks, but, for me, it's the right brain creative's, their interns, their assistants and subcontractors.

This group gathers in the conference room with a high level of positive energy, usually not exactly on time, usually not in an orderly fashion, sometimes with late lunch in hand. This group is filled with our dreamers, the positive, not usually too serious, creative types. They plan the press conferences, the television commercials, the employee parties and the strategic acceleration that will produce dynamic marketing surges for our various service lines. With this group it is about telling the positive stories, translating those complex medical issues into understandable human speak. Usually, these employees are fun . . . out of the box types who, without their input, would make my life a little more tense. In fact, I'm thinking that without this weekly meeting that grande, decaf, latte would include a couple of shots of something else!

Two more meetings with individual physicians and our Chief Operating Officer, a dinner board meeting of a local non profit, and then finally, at 9 PM the beginning of 90 minutes of e-mails that went unanswered during the day.

Bed finally arrives at 11:30 PM and the clock clangs again at 6 AM the next morning. Believe me when I tell you that, compared to many, this isn't a bad schedule.