I stood in front of a room full of people - ranging from students to professionals, academics to consultants, public and private sectors and everything in between. Behind me was the screen of slides illustrating my ideas, to my left was a panel of experts who were primed to chime in and guide. This was the culmination of a two day summit for the Lindy Institute Urban Innovation Fellowship. Three of us were selected as Fellows based on our ideas to tackle unique urban issues in Philadelphia. My proposal focused on capitalizing on the role and reach of the urban Emergency Department as a tool of health equity and urban resilience. With the example of the opioid crisis in our midst, I made the argument for EDs to be seen as critical partners in addressing the needs of a community and city as a whole. 

I finished my presentation to applause and some blank stares, including from the panel of experts. The questions and comments that followed further clarified the fundamental error I made in assuming that anyone could imagine what we see and do in Emergency Departments every day. It was clear few if any in the room had any idea of the basic context of my idea and yet felt compelled and secure in the judgments they passed and the questions they posed. Except for one. Sitting front and center, Jeremy Nowak vigorously shook his head in affirmation, clapped, and gave me an emphatic thumbs up sign as final punctuation. Unlike the others, Jeremy joined my discussion group earlier that day with the simple “I don’t know anything about your area of expertise, so thought I’d come and try and learn a little bit.” This is how our time together began. 

I am embarrassed to admit that I didn’t know who Jeremy Nowak was before the Fellowship began. I had heard his name, but did not realize that despite not sitting on the panel to my left, he was THE expert in the room. He had dedicated his career and life to civic engagement, urban development, reinvestment and advocating for issues that would ultimately benefit our city as a whole. He had advised mayors and gone head to head with powerful men and women for what he believed was right. He was revered, but always found time to share with and educate the many who reached out. He may not have been perfectly diplomatic at times, but he was always authentic.

Being a physician and spending the bulk of my career in the world of academic medicine, I have been surrounded by titles preceding names and letters following them. It is a world of hierarchy, where one’s titles, rank and letters allow others to quickly determine one’s level of importance. They allow for posturing. They permit the disregard and dismissal of those who may think and act differently. Academic medicine is the epitome of what Jeremy called “slow changing incumbent institutions.” But Jeremy was different. I never knew his titles or letters; he did not care about mine. He had the ability to listen and immediately highlight the most important voice  and words in the room no matter who uttered them. Jeremy would intently observe and effortlessly identify where great potential lie. He would mark it with a thumbs up.

It was fitting that The New Localism was published just weeks after I first met Jeremy. I was feeling the constraints of academic medicine closing in on the missions that drove me, where resource allocation was not directed to those with greatest need, but instead to greatest profit or visibility. I questioned how I could best contribute and where I could actually move the needle on the health of vulnerable populations in my city. Together with Bruce Katz, Jeremy and The New Localism helped me see my space, my efforts, my work in a different paradigm. It described me to me.

• The ability to get things done has shifted from command-and-control systems to collective efforts… that are characterized by multidisciplinary and multisectoral networks rather than by narrow, specialized silos. They can craft and deliver better solutions to hard challenges since they match problem solving to the way the world works - integrated, holistic, entrepreneurial rather than compartmentalized and bureaucratic.
• New sets of leaders are upending conventional wisdom about what solves problems… (they) embrace diversity rather than ethnocentrism and are curious rather than closed.. are guided by pragmatism rather than ideological fervor.
• In sum, power increasingly belongs to the problem solvers. And these problem solvers now congregate disproportionately at the local level.

Over the next several months, Jeremy became my mentor and friend. He led the way by being curious to learn more about my sector. He was quick to share his experiences and insights, but also selfless in sharing his resources and the connections of his network. Jeremy pushed me forward in every way - he forced me out of my comfort zone and allowed me to grow and develop in different planes. Jeremy was also quick to come to my side after traumatic events shook my very foundation and dropped me to my knees. His usual pit bull demeanor and furrowed brow gave way to warmth, kindness and empathy. “Priya, you have to give yourself some time to heal. But then move on. I know you’re going to do great things ahead. I believe in you.” His confidence in me allowed me to stand up again. He helped me develop a framework for how I wanted my work and life to be - where functionality and intentionality meet and lead to meaning and impact. He helped me regain hope in a future that had lost its crisp outlines “in the era of Trump.” 

To me on that first day, Jeremy was the guy who walked into my group, admitted his lack of knowledge, sat quietly to listen and understand, and immediately grasped the context, message and missions I was trying to describe. He immediately set about to help me achieve my goals. He went on to show me a new world and a new way of thinking. He gave me not only the permission but the command to use my voice to bring change and advocate for those I represented. He reminded me that I was strong and showed me where my power was. To me, since that day, Jeremy Nowak is the illustration of what a mentor and sponsor is, what a true disrupter can be, and what the best leaders should be. I carry these lessons with me in his absence. 

Priya Mammen MD, MPH was selected as a Lindy Institute Urban Innovation Fellow in 2017.