Ep. 98: Leading with Purpose

with Marylou Sudders
Episode hosted by: Sandy Fenwick

January 18, 2023


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Marylou Sudders
Former Health & Human Services Secretary, MA

Marylou Sudders is the Secretary of Health and Human Services for the Commonwealth of Massachusetts, where she oversees 12 state agencies and the MassHealth program, with a combined budget of over $27 billion and 22,000 public employees. As a social worker, she is committed to the health and well-being of Massachusetts residents and addressing equity and reforming behavioral health care. In March 2020, she was appointed by Governor Charlie Baker to lead the state’s COVID-19 Response Command Center and under her leadership, Massachusetts stood up robust in-state testing capacity, a nation-leading contact tracing program, and a nationally acclaimed data reporting system. Currently, Massachusetts is a national leader in vaccine administration.


Seeking help is a sign of strength, and not weakness.



Sandra Fenwick: [00:00:00] Hello and welcome to her story. This is an opportunity for me to have an incredible chat. With an amazing woman leader and for you to hear her leadership journey. I’m Sandy Fenwick. I recently retired as the CEO of Boston Children’s Hospital, and I currently serve on a number of independent boards and nonprofit organizations. I’m here today with Marylou Sudders. Who is the Secretary for Health and Human Services for the Commonwealth of Massachusetts? Marylou, we’re thrilled to have you here today. So first of all, congratulations and absolutely welcome. Marylou, I know everyone wants to hear from you, and so would you just start a little bit about your journey and share where you started and how you got to where you.

Marylou Sudders: Well, thank you for that. It’s our journeys are I think of them as [00:01:00] chapters and I certainly didn’t start my chapter thinking I’d become one day Secretary of Health and Human Services in the Commonwealth of Massachusetts where one in three individuals are directly touched by something I am responsible. And if you think of some of our public health programs, right, it’s the entire Commonwealth. It is an awesome and humbling responsibility, but my journey really comes from, my, my childhood my father having had three girls. I think I was the designated tomboy. And there’s no question I learned how to play hardball at the age of four. Not softball, but hard. Much to my mother chagrin. But my father really instilled in me belief that I could do anything, anything was possible if I really put my mind to it. And I worked hard. I mean, the work ethic. And I think people describe me as someone who will who never quits and who will work and work it until we come up with a path. So that was really the gift my father gave me. And, I was lucky. [00:02:00] I really didn’t, I didn’t hit the glass ceiling until I was an adult, until I was in professional, and all of a sudden it’s like, well, you’re a woman, and some of the subtle things and not so subtle things that happened later on. So I, I had that bubble, like anything was possible for my father. My mother’s was a different story. My mom and I’ve been very public about. My mother suffered from very severe depression probably a postpartum depression from me. That triggered a profound clinical depression that really marked my relationship with her. Because depression is, it just sucks. It can just suck the life force out of a person. And she was pretty she was she was a pianist. She was our church substitute organist. She was the person who everybody was waiting for Lily’s baked goods after church. She was a substitute teacher. I mean, she was just one of those givers and community. And then all of that just started to retreat as her illness [00:03:00] really consumed her. And people didn’t understand it. And I it destroyed our. I mean, we really broke our family apart. And my mom died from depression and she self-medicated with alcohol just after her 40th birthday. And that that experience of loss of not understanding why people were blaming my mom for being lazy for not being able to get off the couch. and the community and even our family just retreated. And I was an adolescent and it had a really profound impact on me. And it really doubled down wanting to understand what this depression thing was and insurance barriers. And that really is what, I didn’t know where I was gonna go with that journey, but I, that was my journey cuz I. My mother was disrespected in many ways, and I, as an angry adolescent, I tried to channel it in a more positive direction.

Sandra Fenwick: I think you, there is such a group of many people [00:04:00] who are just overlooked. And so what, you talked about how you what drew you to the work that you do. Obviously this inspires you. It obviously gives you a sense that you can potentially move mountains to do something about it, and you have done that. What inspires you more and what frustrates you?

Marylou Sudders: I really sandy it, that social worker in me. I which actually for me was the perfect training, understanding people in the context of their environments and not minimizing the complexity of people’s lives and trying to really understand it. I have always been driven by , all those numbers that you cited in the beginning. 22,000 public employees. It’s actually a 27 billion budget. And one in three people’s lives are directly touched. I never forget that. Behind all those numbers are people and families and communities and people who really just, they wanna have good lives. And to me, [00:05:00] government at this where I am now, government should create those opportunities for people to have good. With the understanding that it’s public dollar, right? These are public dollars, and so you have to ensure the public confidence that the dollars are well spent and I can, I try very hard to be able to manage those cuz I don’t see them in conflict. If I manage public resources well, I’m maximizing the public good and hopefully the legislature then responds with more resources or the opportunities to help more people and that I thrive on. I thrive on trying to take the complexity in a way to explain it, which you and I have done, around mental health. When we started the children’s mental health campaign, right? Mental health is still for many people, right? It’s segregated. It’s a mystery for people. It’s scary. And one of the things we tried to do in the campaign was to speak. People with depression, people [00:06:00] with anxiety disorders, right? We put the people first and then describe the illness and the resources people needed, the treatment, the support, not blaming to help people have good lives. And I try to do that. I’m not a marketer by any stretch of the imagination, but I try to bring the humanity of people’s lives to the forefront and respect their.

Sandra Fenwick: Marylou Could also talk a little bit about the journey that you took to get to this extremely large complicated role that you have today. I know you have led both in the public sector. I think you ran the largest state hospital in Massachusetts. You were also commissioner of Medicaid sorry, mental health. And you were also involved in the private sector, and so maybe talk a little bit about how each step along the way taught you something. Obviously there were lessons learned but it was a, [00:07:00] an amazing step-by-step role that got you to this place. Could you describe that a little?

Marylou Sudders: Well, it’s definitely in, I think one of the, my lessons and one of the things I try to impart to other, and particularly women. It’s not a linear journey. And and to be open to possibilities. So I started as a clinical social worker many years ago and never thought, I never aspired to be a leader. I knew I would I was always challenged by the barriers people experienced. And so I always wanted to understand like, well, what’s the policy? What is this? What does prior approval mean? Prior authorization doesn’t mean clinical care. And so I really was very interested in the barriers that would impact the people that I worked with. And so I moved quickly from being a clinical social worker into helping to design programs and, design the interventions to meet people’s needs. And I was good at. And I always was willing to step up. There’s a project that needs a leader. There’s a there’s a challenge to be [00:08:00] solved. I was always, I was one of those people who always put up my hand and said let’s figure it out. And so, and I was, I also. Developed strong relationships with some women, particularly early in my career, who are to this day, almost 50 years later, are still the women who are part of my safety net. So, people you and I know, and these were women who I saw as leaders as managers, leaders, and I aspired to be to not be them, but to gain from them. How they achieve success. And they took me under their wing. I, this is true, Sandy. I have never applied for a job. Cold. It is women and other people who were my mentors who opened doors of opportunity that, I had to walk through and I had to convince somebody I was right. , but that is the power of my really developing strong relationships and seeking help seeking, I’ve never [00:09:00] shied away from asking for help even to this day in this role where people come to me often that, reaching out for help is a sin sinus strength. And I’ve never seen that as a weakness. So I moved rather quickly in the public sector into positions. More and more responsibility, not necessarily with the skills I would be gone. Right? You’re learning how to supervise people, how to manage budgets, how to the complexity of, politics and policy. And then really the, probably the defining moment was having always worked in the c. Both in the private and nonprofit, public and nonprofit space. The commissioner of Mental Health asked me to be superintendent of what was then the largest state hospital in the Commonwealth under extraordinary difficulties of patient abuse and complicity of silence by. So, 500 beds, a [00:10:00] thousand staff, nine unions, and terrible tragedies for people. And I took the leap and accepted the position and leaned heavily on the people. who I trusted for support and information and help. And the reason the commissioner, I’ll never forget when I said to him, why me? Cause I said to him, I don’t know how to be a superintendent. And his response was, that’s true, but you know how to manage and motivate people. You have a true inner core and you know the questions. and you will work harder than anyone to open up the institution and to heal it. And it was I also, I was willing to take that risk because I felt that there was a safety net to support me. And that’s really then what sort of, I think that was that, we have those moments that then creates [00:11:00] that trajectory. And then I was seen from that point on as someone with leadership quality.

Sandra Fenwick: Marylou, you talk about taking risk. I think one of the, I mean, you’ve taken many along your journey, but Governor Baker appointed you. To lead the state’s covid response command center. Talk about being thrown into the, I don’t even know if there was water in the pool. . And having run, a hospital during that truly unprecedented first year of the pandemic. I know the challenges and I know how hard it was, but you know, you really Were in the spotlight. I mean, everybody saw you on tv. You were there 24 7. You lived in the command center. You were taking the slings and arrows of of things that, we were still trying to figure out what is this and what do we do? And the data is changing, but you. Made some unbelievable decisions and many of them are now national [00:12:00] leading examples for many of the other states and for the country. Testing data sharing and data reporting. Contact tracing. I mean, you did so many things that were first and. it also took its toll. So could you describe speaking of leadership and speaking of, being, taking risk what that was like?

Marylou Sudders: As I look back now on that period the governor and I actually laughed the other day when we thought that the command center was gonna be three months. And that was very initial, right? The very right. The. March, June would be such a better time. And we think now we say, what were we thinking? Because every day was a, it was like, it was an onslaught Sandy. And there’s so many lessons and there are so many lessons that we don’t even know yet from Covid. But I think what makes, there’s no other state I would’ve rather been in than Massachusetts, honestly. . Well, yes, there’s a lot of opinions. There is such talent in our state. [00:13:00] So, we quickly put together a medical advisory board the best thinkers private for the governor and for me, right? So these were not the people you saw out in the paper every day. It included people like Rochelle Wilensky, who’s now our CDC director. Rochelle went public that she was part of the Governor’s medical advisory board, but we said to. You can tell people, but we don’t want you to experience what we’re experiencing. In terms of that, just the, the fear, people’s anxieties were just honestly dumped on us. And I understand that. So we had the medical advisory board and they were giving us information based on what they were able to source. It was clear early on. in a very dramatic way that states were on their own. That was a very I’ll say this now, that was a very lonely moment when I, when you just realized, oh my, like it’s 50 states on their own. And I had that like 30 seconds of just [00:14:00] now. And, I immediately go into overdrive. I told the governor he was gonna have a bunch of phone calls with other governors, and I was gonna reach out to my counterparts and we were just gonna patch together. PPE my favorite four letter award, by the way. Like what were other states doing? And just if we couldn’t rely on the federal government, we had a, I had a network of 14 other secretaries. Covid people, covid command people in other states, and we just worked it. I shared everything we were doing and took ideas from other states and it was messy. I will tell you that because we were, there was no playbook. I stepped on a lot of toes. I’ve apologized to people, but I said, We were making decisions with incomplete data and the governor and I were very, we became comfortable with making decisions based on incomplete data, and I said to my friends in some of the public [00:15:00] health communities, I can’t wait for perfect.

Sandra Fenwick: And I was. Say, this was not only an incredibly, I think all of us reflecting back would say how incredibly successful and again, I impactfully you led this effort, but it did take its toll on you personally. And I can only imagine having felt some of those same things How hard that was for you. And I remember you saying at one point people were questioning not only your role as the secretary, but your role in leading this as a social worker. Right.

Marylou Sudders: Yes. Why was it not an infectious disease physician leading the command center or the National Guard? And I I think the fact that I mean the governor. As the governor has said publicly I don’t know if I really like the analogy, but Marylou is the one you want in the foxhole with her during a time like this cuz she will never give up and she will continue to ask questions and bring in information in order to make the very best decisions [00:16:00] possible. And I knew that the governor and we’ve worked together for so long that he had my. And so, it made those difficult moments at least tolerable because, he would question, I mean, trust me, I mean, you know him he demands excellence and he demands answers as does the public and as did the public. And we did our best. And and I hope it’s one that we never have to replicate in the. Or in our country, or in the world. I think one of our, my takeaways is a reminder to all of us is that our world is a very small place and we need to engage locally, nationally, and globally together on these public health crises.

Sandra Fenwick: you bet. Marylou, were almost out of time. And I, there are so many pearls, I think in this very short chat. But any parting words of wisdom to particularly women leaders? Because I think your journey is just so inspiring [00:17:00] for so many people, no matter where they are in their journey. Young, middle, and, at the other end. And I know every time I have. Next to you or across the table from you. I have been incredibly inspired by you, Marylou. So any parting words?

Marylou Sudders: Sandy, that’s so touching cuz I, I feel the same about you. I’ve always, whenever I’m in your presence, I always feel enriched. Please know that. So what I would say to women is to not fear being a leader. And that women w want to help other women succeed. And so when some of us are in positions of leadership, and it, well, I haven’t done it for a while, but when I have guests lectured and the like, and I say to people, if you want, I’m happy to engage with you. Here is my email in, we’re we are offering to be helpful and take us up on it. Like, having a safety. is so important because [00:18:00] we are judged differently than men. Still today. It’s changing and you feel the change, but have a safety net. People who support you believe in you and are brutally honest with you and not tell you just what you want to hear. And finally, honestly, it’s our own inhibit. That keep us from accepting a, maybe that leap in opportunity and seeking, I can’t say this enough. Seeking help is a sign of strength and not weakness. We are all works in progress and we have so much to offer. Women have so much to offer as leaders. And so that’s really what I would offer. I still am enriched by, as I. Women who I’ve known since the late seventies in graduate school. And, some are more personal friends than, professional mentors, but I am, I’m enriched and I’m grateful to them of their generosity of time and spirit. So that’s what I would offer

Sandra Fenwick: Oh, Marylou, thank you. [00:19:00] This has been as I hoped and suspected just an incredible conversation. Thank you for taking the time and appreciate everything that you have shared with us. Thank you.

Marylou Sudders: Thank you for the invitation. Be well.

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