Changemaker Playbook: The New Physics of Leadership

Henry De Sio

256 pages, Nicholas Brealey, 2021

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The world is undergoing a dramatic shift socially, politically, and culturally. For millennia, society fiercely pursued the perfection of efficiency through organized repetition. Work was largely clustered by skills and specialties governed by hierarchies that were powered with a centuries-old, one-leader-at-a-time mindset. It was a way of working that reached its zenith with the advent of the assembly line in the early 1900s, and the rise of the white-collar professional in the mid-20th century, who enforced the bureaucratic systems meant to maintain order and production through repetitive processes.

That system is now breaking apart. Our one-leader-at-a-time past has given way to a present reality in which everyone has the potential to lead in every aspect of our lives. This has enabled more of us to contribute and play more fully in virtually every aspect of society, and it is changing everything we know about change. When change was a game for a few leaders, keeping up with the speed of change was a challenge for the rest of us. Now, change is a game of the many, and that is causing disruption on a constant basis. Change is no longer linear and faster. It’s explosive and omni-directional.

The promise that comes with this transformed environment also brings complex societal and institutional challenges. The continuous generalized disruption we are experiencing increasingly affects us all. This set me on a path to find the exemplars for playing in this new and very different game, and I was introduced to an elite community of these new-game players through Bill Drayton, whom I’d met in fall 2011. Widely credited with creating and defining the field of social entrepreneurship over the past four decades, Bill Drayton introduced the world to the notion that there is nothing more powerful than a bold new idea in the hands of an exceptional entrepreneur innovating for the good of all.

The organization he founded, Ashoka Innovators for the Public, boasts a fellowship of the world’s leading social entrepreneurs, with some 4,000 high-impact innovators having a presence in more than 100 countries. These are individuals who tirelessly devote their entrepreneurial capacities to creating broad systemic social change through their own initiatives and citizen-sector startup organizations.

Based on my discoveries about leading in change from these world-leading changemakers, Changemaker Playbook: The New Physics of Leadership shows you how to thrive in every aspect of today's transformed societal landscape. Readers can apply the principles in this book to the new everyone-a-changemaker world we now live in, making it as much a new leadership handbook as it is the definitive individual and organizational achievement playbook.

The following adapted excerpt introducing Wellington Nogueira offers readers an unforgettable tutorial on the principles of empathy-based ethics, co-creative teamwork, and the other capacities needed to thrive in this new game in which change is the only constant. Wellington’s work and his view of the clown is a kind of source code for understanding the social entrepreneur—the prototype example of a changemaker—and frames critical lessons that are revealed in the stories of the parade of changemakers throughout the rest of the book. —Henry De Sio

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Shortly after signing on with Ashoka, in 2012, I was sent to São Paulo, Brazil, to see the work of my new organization there and to become acquainted with the social entrepreneurs in the region. After my initial sessions with Bill, I was quite eager to meet these highly effective changemakers I’d been hearing about. I anticipated my visits would be rich with exposure to their leadership ideas.

I wasn’t given a lot of information in advance of this trip, and after I arrived, I found myself shuttled from meeting to meeting over several days. I was scheduled to next meet with Wellington Nogueira, and for this particular visit, I was feeling a bit unsure. I didn’t know much about him except that he was passionate about healthcare and that he cared a lot about young people. He also was a leadership enthusiast like me. Upon arriving at his office, Wellington wasn’t immediately available to see me, so I waited in the lobby. The space looked and felt like a regular business office, except it was painted with bright colors, giving it the air of a hospital pediatric unit. This seemed unusual. There weren’t any children around. The art on the walls depicted clowns and seemed to celebrate the idea of the circus. This also seemed odd. Maybe it’s a Brazilian thing, I thought.

Continuing to look for clues as to the nature of the work carried out in this curious space, I strolled over to a window. We were on the third floor, and this window overlooked a large garage—or maybe it was a studio—where more than a dozen people in their mid-to-late teens were moving in synchronized patterns. It looked like some sort of yoga class, except there were no mats.

“They are in training,” a confident voice boomed from behind me, acknowledging my curiosity about the happenings below. When I turned around, I was surprised to see an unimposing figure whose casual dress and warm smile exuded playfulness. With his goatee and long salt-and-pepper hair swept back, Wellington looked like a magician you might find entertaining young children at a party.

“Training for what?” I asked after we shook hands and exchanged greetings.

“To be clowns,” he answered. I honestly didn’t know what to say. “It is a career in Brazil,” he explained, perceiving my confusion. So, it was a cultural thing after all. Clowning, he explained, was a trade in which students could find gainful employment. “Some will be clowns,” he said, “and others will learn the skills of the clown that they can use in other careers.”

Wellington then proudly announced that he, himself, was a clown. Bill Drayton had promised to introduce me to new leadership thinking. What lessons in leadership could I possibly learn from a clown?

After a quick tour of Wellington’s office, we took a cab to a local restaurant, where the clown motif continued. The restaurant was festive and colorful, with images of jesters mixed with folkloric Brazilian décor. We sat in a booth adorned with miniature clown ornaments dangling from the light fixtures by elastic bands, making them seem like they were dancing all around us. My mood immediately lightened.

As Wellington spoke, I found myself drawn into his story. He described his middle-class upbringing in the 1960s and 1970s in Brazil during a time of oppressive authoritarianism and censorship. Despite the stifling effect this had on the arts, Wellington discovered a passion for theater that ultimately brought him to New York City as a young man. He was following his dream and finding joy. His career seemed set. However, it took a sharp turn when Wellington was invited to spend a day with the Big Apple Circus Clown Care Unit, which had been founded by a clown named Michael Christensen. There, Wellington got to experience first-hand how clowning impacted the lives of terminally ill children, and it changed his life forever.

Soon after, he was called back to Brazil to tend to his dying father. Wellington was deeply affected by what he saw in his country’s health-care system. Brazilian hospitals were in disrepair; they were austere, gloomy places. Many were housed in deteriorating old buildings with dull, dingy walls. Wellington connected these two recent discoveries— that clowning could give joy to sick children, and that Brazil’s hospitals were joyless places. That was the genesis of his organization, Doctors of Joy. He returned to Brazil permanently to launch a venture to bring clowns into the nation’s hospitals.

“For children with extended illness, their life feels out of their own control,” Wellington said. “We train people to be clowns to help them regain control of their lives and their bodies.”

As he described his ideas about the power of humor and happiness in the healthcare equation, I imagined clowns armed with tambourines and balloons bursting into hospital lobbies and patient rooms.

“We go into the operating room,” he said wryly when I shared my mental image.

I laughed in astonishment. “I can’t imagine that,” I replied. “What doctor would let a clown in the operating room?”

“We are part of the medical team,” Wellington said with a look that combined his enjoyment of the idea with that of deadly seriousness.

“So, you are actually a doctor?” I asked.

“No, we are not technically doctors,” Wellington answered, “but we are members of the medical team.”

Clowns as part of the medical team? How is that possible? The operating room hardly seems like a place for clowns. But I wasn’t being snarky in my questioning. I was over my earlier skepticism and was now genuinely curious. Clowns infiltrating medical teams seemed as improbable as clowns squeezing into a space capsule with astronauts before liftoff. It couldn’t possibly have been welcomed, right? Did they just barge in?

A clown would never just storm in, Wellington assured me. A clown has to be invited in.

When Wellington started Doctors of Joy, he wasn’t envisioning leading a parade of clowns into hospital reception spaces or recovery rooms for visits. His goal was for clowns to work as integrated members of the hospital staff alongside surgeons, nurses, and psychologists. He saw “clown doctors” as being integral to the healthcare team. He credits the idea’s success to a few very special doctors with the power to open doors, allowing Wellington’s clowns into the operating room. “It was a conquest based on trust,” he said.

The clowns play a role as part of the child’s familial system, and they meet with the family regularly so they can engage with the child and the child’s family away from the medical staff. But to be effective, clowns also need to understand the medical treatment the child is undergoing so that they can coordinate and integrate their work into the young patient’s care. They actually attend meetings as members of the medical team. Outside of these structures, clowns also have their own teams connected to Doctors of Joy, which continuously looks for new ways to bring humor and joy into children’s lives. Thus, the clown is actually a member of three teams: the familial team, the medical team, and the clown team, all of which work together for the child’s well-being.

I instantly recognized that Wellington was describing a team of teams system, a fluid, collaborative organizational model not unlike the one that we transitioned into during the Obama campaign. It was the same system Bill Drayton and I had discussed. But how did this work in the operating room?

“The first thing to know is that, for the clown, the child is always in charge,” he said. “If the child says jump, the clown jumps.”

The clown is likely the only one in the operating room with that mindset. Certainly, a traditional surgeon wouldn’t think that way. I was starting to see that the clown could be an empowering advocate for a child in a way that doctors and nurses couldn’t. Before anesthesia takes effect, the child knows that at least one person in the operating room is there to do whatever they want. Others in the room may be in charge, but the child hasn’t lost control completely. Knowing that the clown is there to do their bidding may ease their fear.

At the same time, the clown has to be mindful of the others on the team, Wellington explained. The doctors, nurses, and others in the room are providing life-saving, life-enriching care, and the clown has to contribute collaboratively, in a way that respects their work.

Both mindsets require one important quality: empathy. The clown in the hospital is the quintessential outsider, yet they must connect with the people they are working with. As a core member of the child’s team, they need to have one eye on the child and their wants and needs, and as a collaborative member of the medical team, they need to have the other eye on what doctors and nurses need to avoid disrupting their medical care. The clown must be able to put themselves in the place of the medical professionals, while still accommodating the needs of the child. It’s a high-wire act requiring remarkable emotional dexterity and a highly developed capacity for empathy to work with totally different types of people and personalities.

All of this was a lot for me to take in—clowns in the operating room, outsiders on the inside, children in charge, teams of teams, radical empathy. But I was blown away by Wellington’s personal story and his work, and I wanted to understand it better.

Back at his studio, where the clowns-in-training had been practicing, I had a million questions, and it was hard to know where to begin. There are so many different dimensions to Wellington’s work. He has trained many everyday citizens to be clown-doctors through Doctors of Joy, and they now work in hospitals throughout São Paulo, Rio de Janeiro, and Recife, reaching hundreds of thousands of patients. This has made him a credible voice within the larger medical community, bringing his perspective on Brazil’s healthcare system to symposia and policymaking forums. His work influenced the development of policy that led to the creation of the Department of Humanization of Hospital Services, inaugurated by the Brazilian government in 1999.

He also spearheaded outreach programs for disadvantaged and marginalized young people, giving them skills training so they can get clowning jobs and offering what he calls “advanced clown courses in innovation and entrepreneurship.” A passionate advocate for the odd-sounding idea that clowning skills build careers, he maintains that the abilities he’s honed for his multifaceted career—other-awareness, empathy, and collaborative teamwork—translate into all kinds of professional settings, including leadership positions. In that regard, Wellington is also a fixture in Brazilian board rooms, offering leadership lessons for executives that are drawn from clowning.

If clowns in a hospital operating room seemed pretty dazzling to me at first, clowns penetrating the C-suite sounded even more improbable. And yet, Wellington offered me leadership lessons from the example of the clown’s ancestor, the court jester. “The fool always knew where to position himself to be noticed by the king or the emperor’s men,” he explained. “He found a place just outside the gate and devised a clever way for being invited in, perhaps with tricks or shows of illusion.” Wellington was in full storytelling mode now, and he paused for dramatic effect to drive home his point. “The fool, you see, is always invited in,” he added.

“Once inside the palace, the fool uses the host for his objective,” Wellington continued, likening him to a kind of parasite or “leech.” Since the fool doesn’t have a staff, money, or other resources of his own, he leverages the host’s resources for his personal agenda. Once he had latched onto the host, the jester could become a voice for the common people in the ruler’s ear and get the ruler to act for their benefit. The fool held up a mirror to the ruler (literally—mirrors were often part of their equipment), showing them the truth. But like the clown in the operating room, this was a high-wire act requiring great dexterity to pull off. Speaking truth to power in this way often meant the fool was putting his life on the line. He had to be highly inventive to bring together these two spheres— the court insiders and the outsiders—without going too far.

Then, Wellington pivoted to the modern-day clown and how he migrated from the court to the theater to the circus tent. The Big Top, he explained, was originally for the elephants and other animals. Next, it became the venue for daredevils attempting death-defying feats. “This wasn’t the natural home for the clown,” he said. “The rise of the repetitive industrial world, fortified by the arrival of the assembly line, couldn’t tolerate the inspirational creativity of the clown, and he was pushed into confinement.”

This was an interesting point that I wanted to understand better, but Wellington was on a roll, and I didn’t want to interrupt his flow. He suggested that the world of repetition had forced the freewheeling clown into a new home where he was again an outsider. This time, it was among an assorted collection of animals and acrobats. But like his ancestor at court, once inside, the clown hijacked the Big Top and quickly became synonymous with it. Today, one couldn’t imagine the circus without the clown.

“The image of the elephant was branded on one side of the tent, and the clown was on the other,” Wellington said. “But, notice that inside, the clown put the child in charge.” I was beginning to see the analogy he was drawing to the clowns in the operating room. Circus clowns were on the child’s team; they were also part of the team that contained animal trainers and other entertainers. The clowns were especially focused on children, but they also had to be mindful of the other parts of the show. They had to be nimble and resourceful. “If there was only a pocket handkerchief on hand,” Wellington said, “the clown used that to entertain the child.”

Wellington was blowing my mind, and I complimented him on his brilliance as a storyteller. He gently chided me, putting his hand on my arm. “I am a clown,” he said with pride. Then, after a pause, he added, “I am also a social entrepreneur.”

It was through Wellington’s story that I came to understand what a social entrepreneur actually was. Like the jester or the clown, social entrepreneurs bring different spheres of society together. To do so, they must be dexterous, skilled, resourceful, and above all, empathetic. They advocate for children and common people and serve the common good. In some ways, they are the quintessential outsiders, gadflies, or observers with a unique perspective or insight, yet they also understand how to get “inside.” They are skilled at getting themselves invited into circles of power, and from this unusual vantage point, they are able to speak truth and bring about insights that had been missing. Lacking resources of their own, once inside, they leverage the resources they find there.

These ideas were all new to me, yet I felt them clicking into place. I came to São Paolo looking for perspective on new leadership for the new game. Wellington supplied that, plus a whole lot more. For me, Wellington’s work and his view of the clown was a kind of source code for understanding the social entrepreneur—the prototype example of a changemaker.