To succeed, we must prepare ourselves for failure
by Adel Nada
Adel Nada, M.D., is co-founder, president, and CEO of GentiBio. GentiBio combines insights from regulatory T-cell biology and antigen receptor engineering to create cell therapies that restore immune tolerance in the body and overcome the major limitations in existing Tregs cell-based therapeutics.
January 14, 2022
Humans have complicated relationships with failure, especially those of us accustomed to success. We’d like to acknowledge that we are open to failure and must learn from it, but we rarely do. In many professions, we equate our egos and innate self-worth with our success.
To short-circuit those instincts, we must build organizations that allow the kind of “good” failures necessary for striking into the unknown and forming the foundations of success. We must foster cultures that prepare us for, and prepare us to learn from, those setbacks.
At GentiBio, the biotech company where I serve as CEO, we’re creating an organization that is pushing against the frontier of novel and exciting immunology. At any frontier, some failure is inevitable. We are making bold and justified bets all the time. We often remind ourselves of the complexity of our projects and how to leverage this complexity to deliver on the some of the holiest grails in immunology therapeutics.
I have not always had the benefit of such a framework. Failure, and a lack of preparation for failure, marked a significant turning point in my own life and career. The ability to embrace and learn from failure is a lesson I wished I learned earlier and one that not every organization aspires to teach, but it’s one we’ve committed to instill in Genti’s culture from our earliest days.
Emergency surgery
Decades ago, as the resident in charge of incoming OB/GYN emergencies, I was conspicuously confident in my technical skills as a junior surgeon. A few of my colleagues and superiors even thought I might have a gift. I was certain that the best was yet to come.
I remember the summer evening my most memorable patient arrived at the hospital. My patient was late in her pregnancy and facing serious complications. Tragically, her baby had died, and she was bleeding uncontrollably. She needed surgery immediately to extract the fetus via a cesarean section and help her uterus contract to stop the bleeding.
Despite a track record of successful C-sections, I had never led such a complicated operation before. The senior resident with me in the hospital asked me “to start” without her. I recall her saying that knowing me, I would probably finish in no time, that I wouldn’t need her much anyway. I embraced the opportunity to lead a challenging operation, an exciting detour away from a routine procedure I had already mastered. Everyone, including myself, thought I would deliver a great performance in the OR; it is called an operating “theatre” for no small reason.
But, horrifyingly, my patient nearly died. She most certainly would have died if I did not have the wits to call for help. This I recall most clearly, as if it happened yesterday: I’m “leading” the procedure, ankle deep in blood and barely able to see into her open abdomen, sincerely wishing that the floor would open up and take me in.
I was failing, and getting immediate and continuous feedback about my degree of failure. Fortunately for the poor woman, my colleagues managed to save her, and I stayed on to deploy my technical “skills” to sew her up. She would eventually make a full recovery.
What happened that day devastated my self-confidence as a surgeon. It is sometimes said that surgeons must possess a god-like predisposition because they require the steely nerves and unwavering edge that justify all the other nasty things traveling with it. Now I questioned the quality of my judgment, my technical abilities, and importantly, at the most basic level, whether I was made for the profession. I would eventually leave surgery, in large part because I could never get over this vivid and spectacular failure.
When we fail, we lose self-regard. Failure becomes intolerable and must be avoided at all costs. We often imagine the world to be simpler and much more explainable than it actually is (the so-called narrative fallacy, coined by N. N. Taleb). Failing in the face of this supposed simplicity runs counter to our cumulative years of education and experience.
But the real world is nonlinear, complex, and perpetually uncertain. We should be in awe of our marvelous progress against all odds. Worthwhile progress is rarely feasible without daunting failures. Our inability to deal with mistakes, let alone accept them, is a byproduct of our evolutionary struggle for survival and status. There is no escape from this predilection, but we can mitigate its negative impacts on our ability to progress.
I propose a three-pronged approach to escape our predicament.
We must emotionally embrace failure. We must accept that we are continuing to push forward to where, in many instances, no one has been before. We must leverage failure to define the frontier’s contours, ultimately accepting that a “good failure” identifies the edge of what is possible today. If we define failure in this way, then we become increasingly adept at using it as a tool for pushing the limits of possibility. If we are not failing, we are not daring.
We must use failure to amplify our opportunities for success. One must not be afraid of iteration. As Mathew Syed, who also frames the narrative fallacy above, details in his remarkable book Black Box Thinking, pragmatically iterating is likely to accomplish much more (and more quickly) than a theoretically inspired march towards perfection. Unilever, for example, wasn’t able to design a soap nozzle that wouldn’t clog, no matter what the geometry said, until they tested 499 designs that proved unsuccessful. This is the same strategy used by our developing brains to master the diverse environments we encounter. Building on David Eagleman’s tantalizing profiling of our brains, our “live wiring” is continuously updated by the successes and, as importantly, the failures we encounter.
We must fully enable ourselves to benefit from failure. This must be an organizational mandate. It is often understood that we must learn from each other’s mistakes to avoid repeating them. The more challenging part is that we must empower each other, regardless of position in the company, to speak up. Done right, we will learn about failures earlier and less expensively. Solutions will be found by those at the frontier, not those on the safer path.
Culture first
At Genti, we know that our success will mean tangible progress in the lives of many patients currently living with intractable diseases requiring them to constantly take medicines that live on the razor-thin edge of remedy and poison. Success will also mean squelching harmful autoinflammation that seriously limits human health and lifespans. Our successes can potentially mean improving standards of care for many diseases for the far better. And we know that for all of this to be possible and for us to ride our company’s arc to a fruitful end, we must sometimes fail and overcome our failures. If we do, we will end up where no one has been before, leaving our people and patients better off.
In practice, we know that our organization must celebrate and leverage individual voices in order to propel us forward. If we continue to truly celebrate and leverage our individual voices, each of us will be able to speak up freely and find the best and earliest path forward without being emotionally challenged by the risk of failure. When we sometimes fail, we will be able to draw on each other for genuine support and mutual learnings and understanding.
I wish that 25 years ago I’d worked in the kind of organization we are building today at Genti. I wish I had colleagues who helped me cope with and understand my failure. I wish I had a healthier relationship with failure in the first place. I may have been able to persevere. Who knows what might have happened?
When we succeed at Genti, we might not only end some ugly diseases, but we might also show how a thriving organization working on the frontier of exciting biology can help all of us end our painful relationship with failure.
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