Another analogy for decision-making within a complex adaptive/ dynamic system is surfing….in which the waves are moving, as dynamic attractors, and the surfer the interested agent, making decisions on when to engage with the wave, how much force to enter the wave, when to stand and how to move…..with the outcome a joyful ride to the shore. A team of surfers would be several surfers engaging the same wave in an orchestrated fashion. Leadership is like surfing chaos—it’s directional, rapid decision-making with limited information, involves vision (need to “see the waves coming”).

As Ralph Stacey (1996) has noted, a system moves from complicated to complex when feedback is distal (distant) (“the wave is forming”) and assessment in more complicated (“will this really form into a ride-able wave”). In tracing out the implication of what Stacey has proposed, we suggest that decisions in health care systems tend to move from those that are proximal and made in an Emergency Ward (“clear”) to those that are distal and made about the assignment of patients to long-term care facilities (“complex”).

One of our favorite Buddhist sages, Pema Chodron, teaches that learning to rise off the ground and move with the waves decreases getting knocked over by them–letting go can be safer than “standing firm” when it comes to waves.    Buddhists also talk about universal conditions via waves. Many state that a human individual life is like one of the bubbles on top of the wave.   We are bubbles on the wave (individual, temporary life) and we are water (universal, connected life), which we also find helpful. We spend a great bit of our life trying to become the most amazing bubble ever—while missing the deeper connected life of just being water.