Editorial
What does the chaos of an emergency room have in common with a monastery in Dharamshala? Surprisingly, quite a lot, especially when it comes to leadership.
Dr. Al'ai Alvarez, an emergency medicine doctor, traveled to India to learn from Tibetan Buddhist leaders, including the Dalai Lama. What he returned with wasn’t a new medical technique or clinical framework — it was a deeper, more grounded understanding of what it means to lead well.
With burnout rising, trust fragile and performance pressure constant, the reflections Dr. Alvarez shared with me felt timely for every leader.
Below are five principles that came from our conversation — valuable lessons drawn from his experiences and the deep human need to be seen, supported and sustained — that can serve as a guide for all leaders looking to create vital and thriving organizations.
1. Trust Begins With Compassion
Compassion is leadership’s starting point, not its bonus feature. Dr. Alvarez said that compassion in this context was not the soft, vague type, but the kind that shows up every day and wants to relieve suffering.
He sees it as his responsibility to improve the well-being of the people he works with. “When I show people that I’m sincerely and consistently trying to improve their well-being — not because I have all the answers, but because I get it and I get them — they begin to trust me. They see I care about what they’re going through.”
This insight echoes a teaching of the Dalai Lama: just like me, others want to be happy and avoid suffering. The recognition of the shared humanity between a leader and their team is foundational. It builds psychological safety, lowers defensiveness and opens the door to honest and genuine connection.
As a leader, you can build trust not just by proving competence, but by demonstrating care. Ask yourself, do my actions show that I genuinely want things to be better for the people I lead?
2. Agency Is the Antidote to Stagnation
Another core idea was the power of agency and “the understanding that we are not stuck.”
“One of the things that struck me was how the Tibetans I met — many of whom had suffered immense loss and upheaval, including risking their lives to escape Tibet — still radiated hope and purpose,” Dr. Alvarez said. “They rarely showed signs of helplessness.”
The belief that our actions, words and thoughts shape the future, allows us to continue forward, even in challenging times. It allows us to direct our mental, emotional and physical energy to actions that move us forward rather than keep us stuck.
“When we act with compassion, we reduce harm and suffering and create the conditions for a better future, for others to experience happiness, and also for ourselves,” Dr. Alvarez said. He connected this to the Buddhist law of karma, not in a mystical sense, but in a practical one. The seeds we plant now, through our choices, will shape what’s next. As leaders, our own belief in possibility is contagious. Our thoughts, words and actions create ripple effects.
As a leader, you can model agency. When things go wrong, don’t default to blame, passivity or playing the victim. Help your team see where they do have control, even in tough moments. Remind them that their effort matters, and so do yours.
3. Leadership Is Advocacy
Dr. Alvarez reminded us of a core part of leadership, saying: “The Dalai Lama reminds us that happiness isn’t in what we get from the world, but in what we give. As a leader, that means using our influence to reduce suffering — even if that means speaking uncomfortable truths.”
Reading "Voice for the Voiceless" brought home the power of using one’s position to speak up for others for him. “I realized that as someone with certain privileges — education, position, authority — I have a responsibility to speak up. To advocate for those who don’t always have the same access or visibility.”
Advocacy isn’t always loud. Sometimes it’s as simple as redirecting credit, spotlighting unseen contributions or challenging norms that silence others.
As a leader, use your voice. Where are there gaps, injustices or invisible burdens in your team or organization? How can your position help shift the system — not just for your own benefit, but for others’?
4. Self-Compassion Is a Leadership Skill
“One of the most meaningful ways I can lead is by showing what it looks like to treat myself with kindness. That includes accepting my limitations and taking care of my own well-being,” said Dr. Alvarez. Self-valuation, a practice promoted at the Stanford Medicine WellMD/WellPhD Center, which means holding ourselves accountable and being gentle with our imperfections is one way he does so. “It’s not about avoiding responsibility,” he clarified. “It’s about showing others what it looks like to own mistakes and grow from them.”
He shared a powerful metaphor from Dr. Tsetan Dorji Sadutshang, the chief medical officer at Delek Hospital and one of the Dalai Lama's personal physicians. “He told us the world is full of thorns. You can’t clear them all–but you can wear rubber shoes.” Dr Alvarez took this as a reminder of self-compassion. “It doesn’t remove the hardship, but it helps you move through it with less pain for yourself and those around you.”
Fear's Connection to the Three 'Poisons'
Practicing self-compassion also means understanding how natural it is to feel afraid. Our minds are constantly scanning for potential threats, whether physical, emotional or social.
In Tibetan culture, fear isn’t seen as a standalone emotion. It’s deeply interconnected with what are known as the three root afflictions or “poisons”: ignorance, attachment and aversion. These mental states generate fear and are often shaped by it, too.
- Ignorance, in this context, isn’t simply a lack of information. It’s a fundamental misunderstanding of reality and ourselves. It often fuels fear of change, uncertainty or failure.
- Attachment, the second poison, arises when we cling to roles, identities or outcomes we believe will keep us secure. We fear losing control or stability and end up holding on too tightly, even when it’s counterproductive.
- Aversion often takes the form of anger or blame — a reflexive pushback against anything we perceive as threatening. When leaders feel exposed, rejected or uncertain, this can easily turn into defensiveness.
When these three poisons tighten their grip, they cloud our thinking and pull us away from compassionate, values-based leadership. Self-compassion is the counterforce.
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Self-Compassion Is the Antidote to the Three Poisons
Self-compassion allows us to notice fear without immediately reacting, which builds the self-awareness leaders need in high-stakes situations. It helps us stay grounded in the discomfort of uncertainty, recognizing it as a universal human experience rather than a personal failing. From that grounded space, we’re more able to return to our core values and choose how we want to respond, rather than letting fear take the lead.
This is self-kindness. In leadership, this isn’t just a mindset shift. It’s a skill we can cultivate to shape how we show up for others and ourselves.
“Practicing self-compassion isn’t just about making big gestures or engaging in formal reflection. Sometimes, it’s as simple and as difficult as letting ourselves rest, asking for help, or allowing others to care for us. It takes intention to pause, soften, and respond to ourselves with the same kindness we often reserve for others,” said Dr. Alvarez.
If you want your team to prioritize their well-being, then start by modeling your own. Rest. Ask for help. Acknowledge when you’re struggling. That vulnerability is not weakness, it’s wisdom in action.
5. Contentment Over Control
Lastly, the doctor shared a metaphor from Thubten Wangdu, a Tibetan monk: “Building sandcastles on the beach.”
“The message was clear,” he said. “It’s not about avoiding building or getting overly absorbed in building the sandcastle. It's about allowing our inner child to enjoy the act of creation, knowing that the tide will eventually come. We don’t need to fight the inevitable. By focusing on the joy of the work, the process, and the effort, we can let go of the many shoulda-coulda-wouldas and trust that our work speaks for itself.”
When you have so much on your plate and everything is so fast-moving, this can seem like a foreign concept. But it’s incredibly freeing. Leaders who focus on purpose over perfection, and progress over control, often foster the healthiest, most creative teams.
Ask yourself, are you leading from a fear of loss? Or leading from the presence and enjoyment of the process? Are you celebrating the work itself and letting go when needed?
Leadership Is a Daily Practice in Humanity
The whole conversation was inspiring, from the wisdom of the Dalai Lama and the spiritual teachings of Tibetan monks, to the humility of Dr. Alvarez, who, despite the life-or-death nature of his job, clearly sees leadership as a deeply human practice.
It starts with compassion. It’s shaped by agency. It asks us to speak up, care deeply and show ourselves the same grace we offer others.
As the Dalai Lama teaches, and as Dr. Alvarez reminds us all, the work of leadership isn’t about status or certainty. It’s about relieving suffering — our own, and that of those around us. And while our world and days often feel thorn-covered, that kind of leadership might just be the protection we all need.
Editor's Note: Read more thoughts on leadership in 2025 below:
- How to Build a Thriving Workforce in 2025 — A motivated, productive and engaged workforce can be yours if you focus on these six areas.
- Leadership at a Crossroads: Flourishing Through Change in 2025 — The pressure to invest in technological innovations might lead you to believe it should come at the expense of workforce investments. That's a false dichotomy.
- People-Centric Leadership and AI: Can We Have Both? — AI can support people-first leadership, if we use it with care.
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