September 2, 2026: Salus Forum

Then there is something called hard emergence. Hard emergence is where essentially there’s something that comes in and impacts on the system, and the system ends up operating in a way it’s not used to operating. There is a notion of the stampede that represents hard emergence. The stampede occurs when the system essentially has radically changed the way in which its operating. Unlike a swarm or a flock, the cattle are not moving in a beautiful, graceful way. They’re standing there doing whatever, and then suddenly there’s the attack, gunshot or whatever occurs. And then the cattle for a period of time actually do not operate in a coordinated manner. There’s no neighborhood effect. They’re bumping into each other, moving all the place, and there’s often damage. It’s much like occurs as we all know when there’s fire in a theater. Initially, before the group begins to move out the doors, there’s often trampling, all sorts of damage done.

There are a couple other ways I’ve introduced that I think are part of hard emergence. One comes from a colleague of mine. She says this is what’s occurring in many systems today. There is a shake-up. She uses the metaphor of the snow globe. So as a child, we had a globe. Within the globe is a Santa Claus or snowmen or something inside. And you shake the globe up.

There is this flittering of the snow in the globe. My colleague Suzi Pomerantz says that there are systems which are like the snow globe. There’s just stuff flittering all over the place. The flittering is evidence of the impact which hard emergence (the shake up) has had on the system. The shakeup has led to a major disruption.

The other one I was going to bring up, concerns swallowing. It’s hard emergence where a system gets swallowed up by another system. Abraham Maslow, many years ago, wrote a whole piece about Jonah and the whale, and what it means to be swallowed up. Obviously, especially in healthcare, that’s occurring when we look at mergers and acquisitions. So swallowing is a kind of hard emergence that occurs in those settings.

The other distinction I wanted to draw is that is between the condition when we can predict that emergence will occur and the condition when you can’t make this prediction. In many contemporary healthcare organizations, there’s a very good chance that emergence will soon occur. The whole system is essentially going to be shaken up. There are times when we can predict emergence. For instance, emergence is likely to occur the more complex a system is, and healthcare systems are complex. The more complex the system, the more vulnerable it is to essentially being shaken up, flittering all over the place with the intrusion of any kind of external event.

There are other forms of emergence that are unpredictable. Those are what I’m calling radical emergence. And that is emergence that you can never expect. Some of you know might know of Nasim Taleb’s work on black swans. His work on black swans is quite extraordinary. Essentially, what happens when we don’t witness white swans? What happens when a black swan shows up? What happens when something is coming in that you could never expect, you cannot understand. It goes back to even some of the stuff with Carl Jung about the numinous, the experience that is so awful and awesome that you essentially sit there frozen in place, in most instances. So, what are the implications of this for leadership in terms of soft emergence and hard emergence? What about radical emergence versus emergence you know is coming? What about the unpredictable and the predictable? These are some of the issues that I think are worth looking at today as we look at leadership.