E70 Dan Vanhooren On Teams, Teamwork, And Coaching

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Chad Ball  00:12

Welcome to the Cold Steel surgical podcast with your hosts Ameer Farooq and Chad Ball. We’ve had the absolute privilege of chatting with some amazing Canadian as well as international guests over the past year. While the topics have been broad in range, whether clinical, social or political, our aims for the podcast continue to remain the same. We hope to inspire discussion, creativity, scholarly research and career development in all Canadian surgeons. We hope you enjoy our second season as we continue to highlight some incredible guests, deliver detailed masterclass sessions on a myriad of clinical topics and introduce some fresh new features such as debate and companion formats. We hope you relish the podcast as much as we do.

Ameer Farooq  01:13

This episode we had a very special guest, Dan Van Hooren. Dan is the head coach for the University of Calgary Dinos basketball team, it’s really not possible to list all of his achievements. But suffice it to say that just in four years after he took over the program at the University of Calgary, he took a program that had not enjoyed a winning season in nearly a decade, all the way to the conference title, and within two points of the National Finals in 2004. He has won numerous awards, including the US sports Coach of the Year in 2018-2019, and has also been recognized for his work off the court to promote inclusivity. We asked Dan to tell us about what goes into creating great teams, both at the individual and at the organizational level. The parallels to surgery are striking. And we think every surgeon will benefit from Dan’s thoughts on teamwork.

Chad Ball  02:05

We thought we’d just start by asking you to tell us a little bit about where you grew up and sort of what your your training pathway has been how you ended up being where you are today.

Dan Van Hooren  02:16

Well, it’s quite a path. I started out I grew up in Red Deer. I was born in Saskatoon. I grew up in a family that played a lot of hockey like most Canadians did. And I played a reasonable level of hockey up until Bantam, where I discovered I was maybe a bit too skinny and, and needed to become a man a bit earlier to be in that game. So I switched over and started playing basketball at that time. And fortunately for me, I had some great mentor type coaches. Thinking back into junior high when I started in grade nine grade 10 I had [inaudible] and some really good people through high school. So the, like, John Johnson was a my coach in high school and I think he had a really strong influence on us. We had a really great Phys Ed teacher at the time too. So when you shift from one sport to another, I think you have to have some, some fortunate luck and and I did with coaches and people where I could get into high school gyms when I wanted to work on my game and that kind of thing. I ended up going to Red Deer college for a couple years. And then it taken my Phys Ed degree. And I moved on to the University of Alberta to graduate from there and I played at U of A until 93. Then I did a master’s degree in sports psychology out at UBC. And while I was out there, I started getting into coaching. I coached a high school team called the John Oliver Jokers in East Vancouver, which was an education in what I would say the cultural diversity of our country and the challenges that that brings with the different economics that surround different people that I didn’t end up growing up with being as fortunate as I was playing at U of A. And then I worked for the Vancouver Grizzlies in the NBA for a little bit as a statistical analyst. And I worked in pro baseball with the Vancouver Canadians when they were triple A. Really I manage their office at times and did some work with ticket sales and some different things that number of different jobs there. And then after that I moved on to Medicine Hat College, coached and taught there in their Phys Ed department for four years and and I’ve been here at U of C for 21 years now.

Chad Ball  04:49

Wow, that’s a really neat path. It’s it’s funny because I think you and I probably a little bit overlapped in Vancouver when I was in grad school because I certainly remember going to Grizzlies games and big country Reeves being sort of the face of that franchise for a while. I don’t know, where did he end up?

Dan Van Hooren  05:07

Oh, I don’t know, actually, to be honest, after, after I left the Grizzlies, I don’t think he survived very long in the league athletically, he just didn’t have it. He wasn’t a real good pick for that franchise.

Chad Ball  05:20

Yeah, exactly. Hey, I mean, I’m sure we could talk about drafting, and all the intricacies of of your of your, your pathway for hours. But I think really what we wanted to get at and and to be honest, in all disclosure to the listeners, you know, as we were talking about before, you gave our Department of Surgery, Grand Rounds on that on the concept of team and a lot of the things that surround that. And it was one of the best Grand Rounds we’ve ever seen here. And as I mentioned, we still talk about it really on a weekly basis. I was curious if we could go down that term, go down that that pathway, and in particular, ask you, maybe out of the gate here how you personally define team, because as you and I have talked about before, certainly there’s variable definitions and different views of that. But how do you define how do you how do you frame that concept?

Dan Van Hooren  06:08

Well, I think, number one, the actual concept of team is really a group with the same collective vision, if I could use that as a phrase, and they understand their goals and how they’re going to get there. I think that what people forget when they define team a lot, is the concepts that are around the leadership portion that’s necessary and the accountabilities that are needed in order for that to be successful. So the other three concepts I would add into that definition would be a need for cohesion. So that would include things like the word inclusion, I think that the people that are involved in a team need to feel a sense of belonging. And the other part of that I would say, comes from defined roles, and, and responsibilities. Those things are, are absolutely paramount to, to maintaining cohesion, and maintaining team culture. When people don’t understand their roles, I think it starts to wane a bit. And then the leadership portion is around stewarding that culture. So, I know that team culture seems to be some kind of a some people have gotten away from using that word, and they’re trying to use other words, they don’t like it for whatever reason. But it is a word that’s that actually really defines well, what’s necessary, because the number of components that go into it, but your leaders really need to be able to steward that culture and understand the expectations around your your program, or whatever it is your team is doing, and and be able to hold people accountable to that.

Ameer Farooq  08:06

Can you unpack that for us? Why? Why would someone want to go away from the term “team culture”?

Dan Van Hooren  08:13

Truthfully, I don’t know. I’ve only heard a few other coaches say that more recently, I think that sometimes, words get used so often, that they become sort of cliche in people’s minds. And, and then they take on maybe a less, less important light in other people’s thought processes. So I would suggest that that’s probably the reason why I actually still use team culture a lot. And and I think it is king. Culture is king, you can’t win without it. You can’t be successful as a team without great culture. And so it’s really a great, a great word. I think that defines all the needed, they needed entities and pieces that go into making up successful groups.

Ameer Farooq  09:06

So interesting. I mean, I think there’s been a number of shows that have come out even in the last year that that have really tried to kind of pick apart what it is that makes some teams, cultures so much more conducive to success, and it’s so indefinable in some ways. And yet, when you see it, you can sort of recognize it. You’re obviously a coach, and you’ve had a long career in basketball. But can you sort of talk about in your mind some of the examples of of the greatest teams either in sports or out of it? And why do those teams stand out to you as being amazing teams?

Dan Van Hooren  09:48

Yeah, I think that there’s three that came to mind when I looked at that. Certainly the Warriors in the NBA recent times, maybe not this year, necessarily, but when you include their ability to be successful, the kinds of people that they had melded together, doing various things. You know, a coach like Kerr, who I think broadened imagination to the game that wasn’t there maybe previously. I think the Edmonton Oilers of the 1980s would be another one, where you see multiple personalities with great skill, but you also witness that creativity again, in their approach to how they played the game. And I would say maybe the Spurs in the NBA from Popovich, there, I think you could name a number of teams. But the number one thing that came to mind, out of each one of those groups that I’ve witnessed is joy, they play the game with a joy that, that is tangible and visible, and they’re having a great time doing it, and they’re doing it the right way. And it’s clear that they’re playing the game like a team, it’s clear that they have a level of cohesion, and certainly an ability to, to trust each other. And, and then that trust obviously creates the ability to have those conversations that are necessary to hold people accountable to the various elements, or expectations of the teams, those three teams came to mind. And, interestingly enough, they last five years, four or five years. I think each one of those, those teams had dynasties in some fashion. Those are the unique things that the joy portion of it for me is the one massive tangible element that you can witness that I think allows you to see that there is something very healthy underneath of it.

Chad Ball  12:07

So interesting. How do you potentially, I mean, you talk about it directly, indirectly there. So joy is a foundational reality or requirement for these great teams. You know, I couldn’t agree more. So what do you do in a scenario where, where your team or your group is not achieving joy? How do you? How do you reset? And I guess that sort of fits in with maybe to your point about five years or so, you know, these teams do seem to have a lifespan, I think we see that really in teams from all walks of life. So how do you inject change or reorganization or reinvigoration in in that sort of struck given structure to help, you know, change the trajectory of the team back to a positive one?

Dan Van Hooren  12:53

Yeah, well, I couldn’t necessarily claim to be an expert at it. I think that it’s the hard part for coaching is when things start to go south, not to focus on all the negative items. There is a necessity for coaches to bring some level of joy and enthusiasm into the environment, and maybe change up drills that do some different things that that are creative and fun. And, and, and that’s at all levels. Like whether I’m at a team candidate camp, and I’m watching Nick nurse work with a bunch of pros who have been been at it for 90 or 100 games, and now they’re going to try to play with Team Canada and, and they just do some little things like where, you know, at the beginning of a practice, maybe the player of the day. For practice, they announced at the end and and they talk about who that person is and why they’ve they’ve won today’s practice, basically, and they give out some goofy award or whether it’s changing drills and really delving down into some things. I think it erodes much less if the relationships are are built upon and and have more depth. And so I think at the beginning of each year, a lot of people talk about doing things like team retreats and you see these activities that they do their go rope climbing or they’ll go do different things. But the truth of it is if you can have good conversations with people you can find out about them. Then then they know you know each other they trust each other and the the ability to go through some of these doldrums or these lower times where require some energy becomes less false. So I think we spend a lot of time on our relationship building at the beginning of the year, and then through the year. And, and then our captains and our communication is good. So that we know that we can adapt how we’re, we’re progressing through the year, how we’re approaching a practice, the guys are maybe in a bit of a low weekend, inject some enthusiasm and some fun into practice that, that brings that joy back. So I think it’s a collective responsibility if your team is healthy, to be able to provide that.

Chad Ball  15:33

That’s such an interesting description, you know, a lot of those elements, which seem like common sense, when you describe them so eloquently, are, they’re actually, you know, it can be quite hard to achieve a, say, in a Department of Surgery where you have so many members over so many sites, you know, some some certainly cities do that better than others, but it is interesting to the things you sort of touched on them, maybe to take them a bit further, was accountability. So as a leader, and as a coach, how do you create a an environment or or structure that that can achieve that in sort of a non threatening, 2020 way? And then I’m curious beyond that, how do you address or how do you approach the individual for, you know, for whatever the reason might be, who’s, who’s not responding to either their personal accountability within the team, or is just struggling in general?

Dan Van Hooren  16:30

Well, I think there’s a couple things there, you know, so if we start with accountability, I think we really need to know what that is, and, and it that people walking their talk, so you really have to have some people with integrity. And, and for me, with the team, I, there’s some benefits there. I get to select the people based on not just their competence in basketball, but really what their character level is like. And so that’s foundational to being able to build relationships and understand what trust is. So if, if we go through that sort of five dysfunctions of a team and you’re saying, okay, we’ve got trust, then we’ve got relationships, then we have the ability to have the poignant conversations that you’re talking about, like, what’s your approach going to be, but sometimes, the truthful approach is difficult for another person to swallow. And without that relationship there that anchors that conversation in some fashion, it can, it can go really the wrong direction quickly. So it’s, the relationships are the most important thing, in order to create the accountability that you you want to have for the expectations that the group has. The other thing I would say is that, from my perspective, I never been this kind of coach where I would dictate what the expectations for the team are outside of a few things like being on time. You know, I think that our players contribute to those conversations. And so the buy in is, is much, much stronger, and we end up with more trust in, in the end, because of that. So if we can generate accountability because of those relationships, then then when you approach these conversations, like you say, that are more difficult, I think you end up with, with not only a more grounded conversation with more emotional intelligence in it, but also more capability for better results in the end and, and, and more creative thinking in what those results or solutions to the problems could be.

Ameer Farooq  18:56

Dan, how, how much time do you think you spend with your athletes, let’s say in a given week, have you put together practices and games? And is that the only time that that you spend with with athletes?

Dan Van Hooren  19:11

No. Yeah, so let’s lots lots and lots of time, whether it’s individual workouts, whether we’re together at practice, whether we’re watching game film, all the basketball related things, for sure. But then there’s the conversational ones where they’re coming into my office and we’re talking about academics. We’re talking about things like their budgets or future planning. Really, their girlfriends it you know, there’s so many things that the guys will stop by the doors open, they’re coming in for sure and sitting down and I think a lot of people think of those things sometimes as time wasters, but if they are approached the right way, they can really be time savers down the road. So we spend a great deal of time with our guys. conversationally. If you include just traveling with them even, you spend so much time on airplanes and buses and in different scenarios, eating meals together, it becomes very difficult probably not to know each other really well.

Ameer Farooq  20:26

And what’s so fascinating about that is that, you know, this is this is for sports and for basketball. And yet, you know, Dr. Ball has talked about this in the past on the podcast with with one of our anesthetist colleagues, that we rarely have the same team, doing an operation, even even really complex ones, like the ones that Dr. Ball does, you know, you’ll rarely have the same set of people in his operating room, doing the operation with him, you know, you’ll have a resident come on the service for two or three months for their rotation. And you know, sometimes with call and, and things like that, it’s not the same person every day, even for those three months. And so what strikes me about what you’re talking about is that fundamentally, what you’re doing as a coach is building a relationship with your players in your team. And that sounds like it starts even from when you select them. Is that the big principle that you have in your mind as a leader and as a coach? Or are there are there any other really important principles that you sort of abide to when trying to govern a team full of perhaps different personalities and people of different abilities?

Dan Van Hooren  21:38

Well, I think that the that is the governing decision making principle is around how we manage the relationships. If you think about leadership, not only being your ability to influence, but also your, it’s really grounded in your ability to serve. And so a service oriented mentality can generate a much better environment. So for me, like we do have some moving parts, obviously, with players who come and go from graduation and those kinds of things, but certainly not on a daily or weekly basis that you may have in a surgical suite. And so I think, one of the key elements for me, when I think of what Dr. Ball’s challenges might be, really would be around the the concept of how I can manage those relationships when they’re coming and going. And, and then, when you think of the different roles that people have, and the different influences that you already have, based on, on the hierarchy that exists within the surgical suite, and some of that’s definitely necessary. So the roles and, and responsibilities of each person, it really would be an interesting concept to have. If I was a surgeon, somebody walked in, and I’d said, no, no, I got that I, I’ve got the garbage or I’ve got whatever, at the end of the surgery, I help somebody else out with something if I have the time to do it, which is probably another challenge. But I think when you give people your time, or you give them something, from a service perspective, you’re going to get something back. And, and if you only have them for a day, and you start off your day, that way, with just a little bit of a nudge that says, hey, we’re really glad you’re here, I got that for you, I think you’ll probably get in, in the end, find that your day is going to go a lot better with those people.

Chad Ball  23:41

It’s so interesting how you frame that I think you’re right, you know what, getting to know people in your immediate environment, even if it does change every day is is so critical. I mean, it’s interesting to look at just locally, how many of our surgical colleagues would know the names of the porters and the cleaners and, you know, the support staff that quite frankly, without we can’t do an operation at all. If we shift gears here a little bit down, I was hoping that I could ask you about sort of the the ever changing generations of athletes over time. And obviously the way that that you coach athletes, and the way that we train surgical trainees and trainees has changed significantly over time. And 2020 looks very different from you know, I don’t know around 2001 when I when I trained couldn’t be more different and there’s certain things that historically might have happened or a style for example, that you really can’t apply. Now. I’m curious in that in the world of elite coaching, how that’s how that’s sort of evolved over the years and I you know, I think of certainly extreme characters like a Bobby Knight, for example, who was beloved by many and also disliked by many. We have the same sort of characters in in surgery as well, historically, who, you know, were very well known national figures, even potentially changed the landscape of surgery sort of forever in a really, really innovative way. But maybe are remembered more for some of the more intense interactions, then a legacy that might be more more appropriate. So I’m just curious how your styles changed, and what that means to you over time?

Dan Van Hooren  25:28

Yeah, I think that that’s a really important concept. I think we do tend to search for what would be an appropriate balance in how we hold people accountable, and what we say to each other, and what our passions are for the outcomes that we’d like to see. I think I certainly am challenged on a daily basis that way at times with with different things. And with elite coaches, or you mentioned a guy like Bobby Knight, I met coach Knight probably in 2000 2001, something like that. And in truth, I think that he is a very genuine person. And when, when that is there, as an athlete, or as a person who’s maybe trying to follow along and learn from or, or act as a mentor, or with the think that, that when you’re genuine, you do have a little bit more capability to be an influential leader. Certainly, generationally, I think you see different kids, I’ve seen changes for sure. If you think about the coaches I played for, kids these days, I don’t know if they’d they would maybe manage them better, or if they would struggle even more. But it takes a certain kind of personality to take some of the abuse that was doled out back in the 1980s when I was playing, or I’m sure when you go back even further. So overall, I I think that’s that’s a really, really tough concept. I think that there’s a lot of great changes right now with inclusion and cultural diversities that bring in new creativity. The way we form our language, I think is massively important. So if you think about it this way, that I can’t remember who wrote it, but how you perceive the world tends to show up in your language. And if if you’re a harsh leader, and you’re demonstrating something, then you’re definitely showing yourself and your team and your group of people are going to speak that way and and how they’re perceived and how they perceive you and how they perceive the team is all going to show up in their language. So I do think that it’s important that we have made changes in in how we verbalize things, what things we joke about what things that we utilize for disciplining people. But it is challenging, and it it does definitely create some interesting environments to work in.

Ameer Farooq  28:38

Okay, I’ll just say it because I’m the millennial in this conversation. I think, I think what you’re trying to say is that millennials can’t take criticism is that is that what is that really what the differences are? Or is it something fundamentally different and I guess what I’m what I think part of this conversation is sort of dancing around is that we look back on these teams that were so successful, you know, you think of the Bulls, Michael Jordan and you know that the documentary “The Last Dance” where Michael Jordan is essentially just taunting his teammates and just really just pushing them to the limits of their ability to get the best out of them, you know, that on the one hand is so you know, amazing and we look at that and say think wow, but yet we do also recognize that you know, that being harsh on players or on the people who are under us doesn’t probably bring out the best results. Like how do you reconcile those two kind of opposing results like you have people who really went hard on their teammates and on the the people that they played with like Michael Jordan, and got great results and yet, you know, we subjectively think that and and studies have now shown us that, that you know, bullying and things like that don’t have the the intended outcomes that we think that they do. So how do you kind of reconcile those two kind of problems? Are those two situations or that those two ways of looking at the world?

Dan Van Hooren  30:11

Well, I think that there are there, they’re distinct, but they’re very connected. To say that a millennial can’t take criticism, I think is a mistake. Number one, I think that one of the challenges with today’s environment is how fast information moves and how quickly things happen. So feedback is immediate. How many likes you get on your posts on Instagram, or on Facebook or wherever are all immediate. So there’s this instantaneous kind of world out there. And I think that, that the generations prior to the ones that have to exist in this world, never really had to experience that as much. So their their world move much slower. Feedback wasn’t quite as quick. The rewards further efforts took more time. And so they appreciated I think maybe the process of things a bit more than today’s generation has been allowed to appreciate it. I don’t blame them for it. I think they’re in it. And I think the hard part is for the people who didn’t grow up in that to truly understand that environment better. Yeah, I don’t know if, if I’m answering that very well. But I do think that, that those challenges exist, I think that there, there needs to be a balance and there needs to be a space for accountability to be allowed, or you can’t be successful, not at least to the level that you could achieve. So there’s got to be moments where your relationships have to be strong enough to be able to have, like I said, those poignant, direct, truthful conversations, like you’re not playing well, that’s not bullying. Maybe a little bit harsh at times, but necessary, in many respects that, and I think it changes depending also on how valued the outcome of what you’re doing is. So if we were to say, what’s a great team, and you said, well, maybe it’s the Canadian Armed Forces, and we’re looking at what they have to deal with, well, the outcomes of what they do, are life threatening. And I think that the outcomes of what Chad does is life threatening. So there are moments where some poignant, direct, very, very truthful, moments are going to be needed in order to avoid having a really, really negative outcome. And, and I think that’s a challenge. That’s a difficult balance on a surgical level. Whereas for us, it’s winning or losing or losing a possession, it’s, in the end, we can say, at least from a healthy perspective, it’s a sport. It, it has meaning and it helps generate and create character, but the outcome in the end isn’t going to be life or death. So I think we have to find the right spaces to be healthy about what it is we’re doing.

Chad Ball  33:28

I think that’s a great description. Dan, and but I think you also, you know, undersell a little bit, and maybe intentionally so the importance of of athletics and achievement, really, at every point along the way, and, you know, I don’t have quite the athletic background to you, but I did play at University of Alberta hockey in major junior and a few other things. And, you know, to your point, as you as you mentioned, before we started when you’re in that world, I mean life or death, military and nonmilitary that really is everything to you. So you know that the stakes always seem I think quite high in a in a driven individual, regardless of of the life or death or lack thereof nature of it. I’m glad you brought up the stresses in current student athletes and just just sort of students in the world in general, because I think it’s it’s an interesting time to reflect on that over the past week or so I’ve noticed a number of very prominent from Wayne Gretzky all the way down experienced hockey players talk about their belief that the World Juniors, for example, in team Canada, the stress that those that those young men are, are under is much, much greater than what they experienced, you know, in their case almost 40 years ago, because of a lot of the immediacy of social media and of immediate feedback and of an environment that can be overwhelming in nature. And part of that discussion that evolved over the past week has also been maybe some of the benefits of being essentially in a bubble and Edmonson playing that tournament and being able to sequester yourself away a little bit, I’m curious what some of those other stresses are for, for students that you deal with, for young folks that you deal with, you know, year in and year out, and also, how COVID has impacted you guys as a program?

Dan Van Hooren  35:22

Well, from a stressors perspective, they’re they’re individual, and collective. So I think that there’s two versions of that. If you’re looking at your example of Team Canada, or even your experiences in hockey, the more you win, the more expectation, the more expectation, the more attention to every little detail. Yeah, I watch how they’re analyzed, and how each individual player has to perform to a certain level, and they’re scrutinized all the time. I think as athletes we grow up around that a little bit, you know, when you become a bit successful you, you slowly grow into that. But I think that one of the things that’s difficult nowadays is the speed of which that can be out there. And how, how accessible it is to each individual person or to your team. Because they can quickly go online, and there’s 50 tweets about how your team played or what you did that night, or maybe what decision you made as a coach or as a surgeon, I think that those things get out there quickly. And I think there’s a skill in ignoring some of it, or turning down that volume when you know, it’s necessary to do and that takes maturity and experience. And I certainly didn’t do it well. I don’t think as a young coach, where your alumni is upset or or, you know, there’s something healthy about being grounded in celebrating your successes, but not getting too high and not getting too low. And I think if you watch some of these young players, for Team Canada and the World Juniors, even the team that I coached World Junior Championships for basketball, they’re the they have pressures to play at a certain level. If they don’t, it affects their future contract, it affects their future as a professional athlete. It affects team Canada’s brand on a global level. Like if they spent their time focusing on all those external factors, then they wouldn’t be leading from the inside out. And, and there’s a maturity and getting to a point where that character that’s necessary to, to block out all those external things and focus on the things that are internal with your team and with yourself. So that you can stay in the process and not get outcome focused, is the only way that success can even be achieved to begin with. So I’m shocked at how well some of these kids do really truthfully.

Ameer Farooq  38:16

I think that’s one area that really overlaps with us in surgery is sort of the mental side of things. And it’s very hard when you’ve had a bad outcome and a patient to get back on the horse, so to speak, you know, the next case, you just have these visions of making the same mistake again. And there really is an element of fear and major anxiety. Very similar to when you’re you’re playing sports, when you remember the last time you messed up or when you’re at a particularly crucial moment. How do you coach athletes? And how do you prepare them for the mental side of the game, when they’re going into these high stakes, high pressure kind of situations?

Dan Van Hooren  39:00

Well, what we’re talking about is confidence. And, and I think that, let’s start with a few things that generate that like one is repetition. So if you’ve done the work, you can be confident that you have the abilities to do what’s necessary when the time comes. That’s a big part of it. And convincing young athletes for us that they’ve done the work or they’ve gone through the process to be where they are and they deserve to be there, I think is a big part of generating the eventual outcomes you’d like to see. There you could take things like injury as well and put that in there with the ability to get back on a horse where that confidence has been eroded in some way whether it’s in a part of my body that I’m not really sure is going to function the right way. Or whether it’s in my ability to manage my emotions and the anxiety around outcomes. As a coach, it’s important for me to be encouraging and not discouraging. When I sell people out, it’s got to be about a more well thought out plan, so that I don’t erode their confidence by doing that. So, like, give you an example, if a player on offense in basketball is open, and they should shoot a shot, but they don’t, that’s different than when they turn the basketball over, they give it to the other team, for whatever reason, they’ve passed it to the wrong jersey. If I subbed them out, after each one of those instances, I’m going to have a different emotional response. When I bring the player off, because they didn’t shoot it, when they’re open, and I tell them, you’re coming off, because you should shoot that shot that has a more positive, build up to confidence, then one where I take them off and say you’re giving the ball to the other team you’re off. Then their ability to go back out there and do it again, in a different way to be more impactful for us is, is better. So I think you do need a plan, you need repetition, you need the relationship, to help build the confidence of an individual so that they get back on the horse. And then individually, they need their own plan. And from a sports psych perspective, that can come down to things like breathing, how they manage their emotional control systems, the visualization of positive results, sometimes that’s about you really, their positive self talk or, and, and some practice events like that. One of the things that we tend not to do is we treat all the skills of the game of basketball, like we have to do repetitions of them. But a lot of people forget that we need to do the repetitions of the mental side of things as well. Those are skills, and they need to be practiced in order to be able to be performed in situations that create some kind of tension. So it’s important to be able to visualize, it’s important to be able to do positive self talk and, and generate your own levels of confidence. So everybody gets nervous. And that’s what some people don’t seem to understand. They think, oh, he’s got ice in his veins. Well, no, he’s just not showing it. But he’s nervous. Every single player gets nervous, every single surgeon I’m sure gets nervous. But how do you manage that needs to be practiced, like you say.

Ameer Farooq  42:56

And the parallels are just striking. I wanted to just pick apart one thing that you said, which is actually the the whole idea of subbing people on and off. And you have to make that decision as a coach as to whether to bring someone off because you’re thinking they’re they’re having a bad day or and to bring someone on who potentially can help the team out better. But what goes into that decision, particularly if you think someone’s going, having a sort of a bad night, you know, and I’m thinking of right now about myself, sewing the bile duct with with Dr. Ball and a whipple where, you know, for example, I’m not having a good day, and Dr. Ball has to sort of take over. And he has to make that judgment call at some point in a way that hopefully, you know, he and I know he Dr. Ball did this for me in a way that allowed me to not hurt the patient, but also maintain my my confidence and my dignity. So how do you sort of go about thinking about that process of subbing people on and, and subbing people off?

Dan Van Hooren  43:57

While there’s something to be said about giving them chances. And that’s what I meant by the consequences of when you have to make those decisions. I get that I’m passionate and I love what I do. And I want to win, probably more than most people. But the consequence of me subbing somebody out because they miss a shot is very different to the consequence of sewing that bile duct in the wrong manner or connecting it inadvertently to something you shouldn’t connect it to. So I think that, that there, like I said, there’s moments where something needs to be said, and maybe you do need to get pulled off, and that your approach can still be in a human way. Sometimes it can be with just a slight physical contact. It’s like hey, just a tap on the shoulder. I got this for you. I think that there’s something to be said about laying out the groundwork beforehand, as well. So we spend a lot of time talking about what your 10 game is, versus, you know what your six game is. And, you know, I think that some players struggle to get towards their 10 game and, and maybe spend more days at six. But there’s going to be days where your a 10 in days where you’re an eight in days where you’re a six. And sometimes you’re really acting as the 10, if you can get to a six on some days, and I’m sure from a fatigue perspective, if I was a surgeon, and I was in there for 8 9 10 12 hours, and I’m working a shift that takes me into the next day, that my 10 might become a six. And it might mean that I have somebody come over and say, Dan, you got to step out, we’ve got a, we’ve got to do this a little differently today. And, and it’s a human thing, where somebody says, Yeah, you know, what your, your a 10 today. But your 10 today is a six, and you need to get some sleep. I think those human conversations are necessary. And that’s what I mean about accountability really, is you have a relationship with these people. So how do you how do you give them that human respect at the same time is telling them really, you’re not good enough for what we need to get done today? And can those people self evaluate enough to say, yeah, you know what, you’re right. That’s where for us, I think video is really helped us. I’m sure that you guys use video in surgical suites all the time. And, or if and when you can, depending on all the issues and different things that go on. But you have the ability to study and self reflect and look back at performances to say, hey, we really did this really well that day, how did we do that? What did I feel like that day, and so on. So there’s many, many, many ways, I think to to achieve that the right way. And they’re individual. They’re based on each individual’s personality and how you manage them.

Chad Ball  47:14

So that’s so well said, I know, I think the important thing is to figure out exactly what you’re insinuating, which is how you work as an individual on how you’re going to provide, hopefully, again, you have the insight that you mentioned, how you’re going to provide yourself the feedback to help you move forward. I’m also really glad you talked about, you know, the Michael Jordan’s of the world being nervous, because I think we all know, but it’s easy to forget that some level of anxiety is actually can be an improver. with regard to performance. It’s not all not all negative, of course, becomes overwhelming. I think all of us are in trouble. Putting all those things together and done it. I’m wondering, you know, you’ve seen so many great players over such a long period of time. What differentiates the really, really good players from the, you know, the savant, so to speak, they’re really great players that are two standard deviations outside of that mean?

Dan Van Hooren  48:10

Well, I think there are several items. Some are God given where the physical talents that an individual like a Michael Jordan was blessed with, or the body control that you can see in in some of the better players, those those things are, I think they start off at least by bare minimum with the seed of they were given to you at birth. You know, if I was six foot 10, and I could jump as high as Shawn Elliott, then I might have the ability to play at a higher level, but the savant so the world see things differently than everybody else. So if you look at Wayne Gretzky, you look at Steve Nash, you can look at a guy like Michael Jordan. They bring a high compete level, where it matters to them so much more than somebody else. They also bring space and time capability and ability to read a game quicker than others. Where they just see things two and three steps ahead of everybody else. And then you add on the exceptional qualities of competence. They’ve taken the time and put the work in. If you if you look at just the three examples, I gave Gretzky, Nash and Jordan, I don’t think that anybody would argue one way or the that any one of those players worked harder than each other, but they certainly worked harder on their game than all of their opponents. And when you’re given not only the God-given talents, whether its size, speed, and athleticism, and you have that work ethic, and you have that mental focus, then I think you’ve got all the pieces of the puzzle to put together, we sometimes call it the “it” factor, you can see it in some kids. If you look at kids who are who want to play basketball, or hockey, or what have you, they’re out on the driveway, they’re working on their game in a different way than other kids do. They’re not just out there playing. They’re out there working. And they’re working on a skill set, or they’re, they’re touching something up, but they also find a joy in doing that. And, and then in displaying it when the time comes. So I think you have a mental component, you have a God’s gift, physical component, and you have a work ethic, that’s extraordinary. The last item, I would say is creativity. Because they can think the game faster than other people, then their skill sets are so high they become really from a skill and acquisition perspective, experts in their field. And when you’re an expert, a true expert, then you are changing the game. You are creative in your approach. And it’s forcing other people to change how they defend you or how they go about their business to be able to manage what it is you’re doing. They have all those things.

Chad Ball  51:52

That’s amazing. I mean, it makes me think of Ray Lewis and many before him, he would say embrace the grind. That’s where the word starts. What about if we go to the other side of the spectrum, and you know, listening to you talk about the the super hyper achievers makes me makes me think of a couple of stories that the first is that surrounds Wayne Gretzky, and this is a public account. So I don’t think I’ll get into trouble. But in Georges Laraque’s book who you know, is is a close friend of Gretzky, he talks about Gretz being obviously great at everything he did in his life, except coaching. And Laraque tells the story of Gretz when he was coaching the the Arizona Coyotes of getting really, really upset at players who couldn’t do what he wanted them to do. And he would say here, look, just do what I’m doing. And they’re like, we can’t, we can’t physically get that done. It also makes me think of an interview I recently saw with Al Pacino, in the acting world, he was being interviewed by another very famous actor who we all know. And that actor said to him, essentially, you know, what is it like to be on some of these movies or on some of these plays, where, you know, your, your, your fellow actor can’t hit the ball back to you in the way that you’re hitting it to them that they’re a challenge, you know, from from sort of synergy point of view, and Al Pacino’s response to that I thought was really eloquent and humbling in that he sort of said, well, I don’t think like that. I mean, the reality is, everyone in Hollywood has a special skill, this person might be a great writer, or this person can do you know, is a great articulator or this person has a great voice. Just that at the reality, some are more talented than others, but he tries to keep his his mental framework away from, you know, thinking of it in that way. So I’m curious, you know, after running on there, when you’re dealing with folks that are maybe struggling at the at the other side of that curve, how do you encourage them? How do you help them develop? How do you move forward with them? Assuming that you’re not going to cut them or or, or expel them or whatever the scenario would, would be?

Dan Van Hooren  54:11

Well, you’re, you’re talking about the psychology of the reserve roll guy, you know, or person. For us, I think, the, the need to have a sense of control would be I think, my number one answer. So for instance, if I have a player, that’s a star, they’re easy to manage, they know they’re in control of things. That’s why Gretzky can say, just do it this way. But you know, the player down the end of my bench that’s struggling for playing time that’s battling and battling every day, they’re putting the work in, you know, I think that they need to understand that they have a sense of control over their situation. And that may not may only mean up to a point. And the reason why I kind of qualify that is because they may not be gifted enough to get to a different level that they might want to get to. I think that there are some things that are important from a coaching perspective in helping kids be able to self evaluate. And those conversations are tough, where you need to be truthful with them. And your perspective as a coach, compared to that of the athlete often can be so different. And you need to create some tangible objective things that can be evaluated in order to have the truthful conversation in bringing those athletes in, if they do play well, in practice, or if they are making great plays, or they are doing some things and you need to play them. I know that that sounds maybe obvious. But so many coaches don’t do that. They play their key guys, then they play their key guys, and they play their key guys, and they don’t use their benches enough to give those guys not only the opportunities to feel that sense of control, but also to give them the opportunity to continue to develop and maybe grow their circle of influence on your team. Those are important things. We use, you know, some some goofy concepts, we used to use one that was stoplight related. So we’d have red light, yellow light and green light concepts with our players. And we get them in positions and then they’d have to present and the the lights are based on what things that they bring to the team. You know, you all your green light items, maybe I’m a great rebounder, I’m a great defensive player, maybe I’m a DN3 guy, whatever it is, those might be my green light items, but putting the ball on deck and creating for other people or I don’t know, there, there could be any number of items that could be yellow like, that could be a big that’s trying to extend my shooting range. But I’m a green light at the foul line. But I’m really a red light when it hits a gameplay to shoot a three. If for us games are won and lost based on shooting percentage, and if the wrong guys are shooting the wrong shots we’re going to lose. So you need to be able to have a method to tell guys, you’re you’re good at this. That’s what you need to do when we’re competing. And that’s your green light. Your red light is something you just can’t do. And your yellow light is something we’re working on to try to expand your game. So I think there are ways to create that feeling like they have some control over growth, while maintaining your ability to to be successful within competition.

Ameer Farooq  58:08

I have two sort of related points on that topic, which is the first is how do you figure out if someone is struggling? And we sort of already touched on this a little bit? But how do you figure out if someone is struggling because of all the outside things that are going on in their life guy or girl for that matter? You know, whether it’s the relationships at home, or some other thing that’s going on, outside off the court that’s really driving things, versus someone who just doesn’t have the innate ability. And the second thing really is, how do you decide when someone really just doesn’t have what it takes to make it at that level? And how do you explain that to some to a person like, you know, I’m thinking of the analogy in surgery where it doesn’t happen very often. Because, you know, as Dr. Ball will tell you, he can train any monkey to operate. But it does occasionally happen that someone will come through that really doesn’t have, for whatever reason, the aptitude for the career. And you know, they have to be in some ways let go so that they can they can really find something else that to use with their time. So how do you approach approach those two scenarios?

Dan Van Hooren  59:19

Well, if let’s talk about you asked, how do you tell whether or not somebody’s really struggling because of something in their life outside of the sport. For us, we do a number of consistency things. So we’ll run say drill like 35 shoot on a daily basis or a shooting drill. And your talented players let’s say out of 35 or getting 28 on a daily basis and then they show up and they they show up and get a 19. I think there are different methods of creating some kind have mental framework that you know that they should be at from a consistency perspective, and that’s visual and objectively quantified for you, when they show up, and they just don’t have it that day, those moments exist when, when you look at somebody, if you look at an individual overall that maybe has the skill sets and doesn’t seem to be able to perform, I think you’ll see that in practice. Though for us, when I’m when we’re practicing, a player can really shoot the ball, but when the lights go up, and the jerseys on and the consequences are there, and the girlfriends in the stands and everything else, then you see them show an inability to perform. If they do that, more than one or two times, you know that, that they’re struggling with, with their mental composure, really their their ability to manage their emotions. And then it’s up to us, I think, to provide some level of support. So let’s assume this, we recruited an athlete, we’ve spent money and resources on them, and they’ve been in our program for a little bit of time, then it’s really up to us to provide all the support we can for them to be as successful as they can be. If they’re still not showing that lowest success after that continual level of support, then then I think the conversation becomes a simple one, even though it’s difficult in that you care about them, and you want them to feel good about their experience in your program. So if I have to let a player go, it’s going to be quantified, it’s going to be based on a number of objective things where there’s statistically oriented, academics, character based things that we’ve, we’ve kept files on. And we keep, like what we call player profiles on every player. So our individual meetings will take place, and we’ll talk to them about all kinds of things. And those are all filed away so that we have them if need be. And they give us also a guide on what things we can do to continue to support their growth. I think those are difficult things to manage things that are outside of people’s lives, it’s hard for them to block out and not bring into the surgical suite or not bring in to the playing field when we’re playing, whether it’s a girlfriend or academics or what have you. So the the relationships are still the key thing. You’re going to know more if they trust you, and then they tell you and you give them some openings to let them know. So it’s a tough question. It’s a really tough thing to manage. And I think that’s the art and coaching and the art in in leading.

Chad Ball  1:03:08

Dan we can’t thank you enough for being with us on the program today. I think we’re all gonna grow. And we’ve certainly learned a ton from from listening to you. And so, thank you so much. I was wondering if we could end on a, on a, maybe a straightforward two part question that we asked a lot of our guests towards the end which is from the from the coach or the trainer perspective, what do you know now that you wish you had known 10 or 15 years ago, when you started on that part of your voyage? And then I would ask you the the second part really is the same question but from a trainee or or an athlete point of view. So both sides of that coin.

Dan Van Hooren  1:03:50

Oh! From a coach’s perspective, in truth, I would say my first thought that came to mind is how important it is to understand how my athlete got to be where they got to. What was the most significant one or two events in their life that made them who they are today. Knowing that allows me to make more intellectual, emotionally controlled, capable decisions when I’m dealing with each person. And it also allows me the ability to understand their reactions to things in so much more, detailed, healthy manner to create better outcomes. I think you have to understand your people. That’s the key in coaching. As an athlete I would say, I would say that I think that it’s, it would have helped me a ton if I thought the outcome was less important. I was also one of those players that that wasn’t super selfish in the way I played. And I think, knowing what I know now, if I can go back as an athlete, I would approach it with more joy, more having fun, lessen the outcome. And, and I would take more risks because of it. And I think I maybe would have achieved a little bit more. Although I think I get cut off by my, my inability to jump in and it’s a physical drawback.

Ameer Farooq  1:06:04

You’ve been listening to Cold Steel, the official podcast of the Canadian Journal of Surgery. If you’ve liked what you’ve been listening to, please leave us a review on iTunes. We’d love to hear your comments and feedback. So feel free to email us at podcast.cjs@gmail.com or connect with us on Twitter @CanJSurg. Thanks again.