6 - Uncertainty in Medicine: Navigating Uncertainty with Admiral Mike LeFever
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In October 2005, Michael Fever hovered in a helicopter over the Himalayas of North Pakistan. It was less than 48 hours after a devastating 7.6 magnitude earthquake. He told us the mountains looked like they had been sliced open with a hot butter knife. Whole hillside villages were wiped out. Survivors were grabbing at the helicopter, trying desperately to climb on board.
When I landed in Pakistan, it was chaos. It was people from all over the world trying to figure out how to help and how to get there. Over eighty thousand people died on a Saturday morning, over a hundred and seventy eight thousand injured, and three and a half billion people homeless.
The earthquake that hit India and Pakistan on October 8, 2005 was one of the most devastating in a century.
The devastation was nothing I had expected, nothing I had planned for. And so here I was an admiral. sitting seven hundred miles from saltwater up in the Himalayas and uh my good friend and classmate John Allen goes, We always need a good Admiral in the Himalayas.
Mike had no plan, no protocols to fall back on, just a simple directive from his superiors provide humanitarian aid and improve US PAC relations. This is the Nocturnous Uncertainty in Medicine. I'm Emily Silverman. Today we're joined by retired U.S. Navy Admiral Mike Lafever for our newest uncertainty profile: conversations with people who are skilled at navigating high uncertainty environments. In medicine, we make life or death decisions every day, but usually it's just one life at a time. One patient on the table, one diagnosis. In the military, those decisions play out on an entirely different scale. A single choice doesn't just affect one person, it can shape the lives of thousands, even the trajectory of entire regions.
Mike is a career officer who spent nearly four decades navigating uncertainty in high-stakes environments. From 2008 to 2011, he led all US armed forces in Pakistan during a time of immense geopolitical tension. And before that, in 2005, he found himself in an unexpected position. Coordinating humanitarian aid in the aftermath of the earthquake in northern Pakistan. It was freezing cold in the Himalayas, resources were scarce, and Mike, a Navy admiral miles away from the nearest ocean, had no playbook.
Here I found myself in this very unique situation in an embassy with all these organizations and egos. I was the elephant in a room, so to speak, in a country that really didn't want me there.
Just days before the earthquake, Mike had been off the coast of Egypt, commanding a US Navy strike group, five thousand five hundred people, six ships, a few submarines, and an air wing. He'd been preparing for a six-month deployment in the Middle East, but when the earthquake struck, he was diverted to Pakistan.
I could have easily came into that room and said, listen, nobody in the world operates at the scale and capability and capacity that we do. I have all the people, I have all the manpower, I have all the unique toys. And I could easily go on, okay, I'm in charge here.
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