“Staying in the race”: The story and lessons learned from the first African-American woman Army Surgeon General

Shannon H. Polson
Aug 27, 2018 · 11 min read

This weekend we lost a great American hero in John McCain, a man if integrity, honor, and courage. In a time where these traits seem in short supply, it is encouraging to look for others still in the prime of their careers both demonstrating and developing those traits in the next generation. One of these people is Lieutenant General Nadja West.

In December 2015, LTG West became the 44th Army Surgeon General, the Army’s first black woman lieutenant general and the highest ranking woman to graduate from West Point. After earning her bachelors degree in engineering at the United States Military Academy, she went on to earn her doctorate at the George Washington University School of Medicine, specializing in family medicine and dermatology.

Her experience with grit came early on. The youngest of twelve children adopted by an Army warrant officer and his journalist wife, she grew up understanding Army life and service. In an interview with the Army Times, LTG West says:

“I joined the Army because I come from a military family. I kind of grew up eating, drinking, breathing, living Army. My dad was in — he joined the Army in 1939, when the Army was segregated, and stayed in for 33 years.

Nine of my siblings were serving. I’m the youngest, so to me it was just something I could not wait to do. I knew I would be serving in some capacity in the military.”[1]

She credits her foray into science to Star Trek. Watching Spock on the Starship Enterprise, “I wanted to be a Vulcan. And I wanted to be a scientist.” West has also commented that another Star Trek character, Uhuru, inspired her early on.

Advice to new leaders

When West went into the military, her father had a few words of advice:

Do your best, conduct yourself in a dignified manner. And really work hard, because you’ve got people watching you. People are going to look at you, and your mistake is going to reflect on a lot of people. Your success is going to reflect on more people.”

LTG West as a cadet at the United States Military Academy at West Point

Looking back at her beginnings in uniform from the benefit of her decades of experience, West adds a couple of recommendations.

“I would tell myself not to take myself so seriously, not to be so afraid to venture out, not to be so risk averse. I was so focused on work- work- work that I missed a lot of fun — I really lacked confidence in myself. I would tell myself to take advantage of every opportunity, and look beyond my self-imposed boundaries.”

I mention that it seems hard to imagine that she would ever lack confidence, and she laughs.

“We have all read about imposter syndrome — even Sheryl Sandberg mentioned in her book that she has it, and I just can’t believe that!”

How did she overcome that lack of confidence?

“West Point was a confidence builder,” she says. “I did things I never imagined I could do.”

West Point

In an interview with CNN, West talks about her experience at West Point in one of the first classes to admit women. During her plebe year at West Point, the senior class was the last all-male class. Some of them wanted to “run all the women out before they graduated.”

One interaction she recalls in particular, an upper-class cadet stood nose to nose with her and, in an obvious attempt to intimidate, said “You will not be here when I graduate!”

His attempt to belittle her had the opposite effect. “That was a motivator for me because I said, ‘I can’t not make it now because I don’t want to prove him right.’”

Cadet LTG West

Still, she was far from confident, especially when she considered medical school. A chance encounter with a West Point alumnus in an elevator got her past the hurdle. When he asked what West was interested in, she said: “I’m interested in going to medical school, but I don’t think I will be able to get in.”

The alum wouldn’t accept that. “What’s wrong with you?” he asked. “Why do you think that?”

She went on to medical school, and later graduated top in her class as the distinguished military graduate from her flight surgeon class.

“One of the things that I tell people is just believe that you can, and then don’t sell yourself short or don’t take yourself out of the race before you even start running. I almost did.”[2]

What matters

West’s outstanding performance was not of interest to her battalion commander when she deployed as a captain to Desert Storm. Nor was the fact that she was a black female officer. In the field, how she did her job was all that mattered.

“He asked, ‘Doc, can you fix broke soldiers?’ And I said, ‘Yes, sir, I can.’ And he said, ‘Glad to have you aboard. Glad to have you with us.’ And so he didn’t ask me where I went to medical school or ask what my grades were. He looked me in the eye and asked me if I could take care of soldiers. And in my heart of hearts, I knew I would do my darndest to live up to that.”[3]

West in the field as a young officer

Building confidence

Does she see that there is a way for people to build their own confidence?

“Definitely,” she says. “The more experiences you have the more successes you have, the more confidence you develop. Success builds on success. Those times I don’t feel it, I put on a strong face and move out. You have to start somewhere. Instead of looking at the enormity of a task, make a checklist, and get advice from others. Start with the first task at hand. I’m lucky I have a great team around me to assist.”

She has two additional thoughts for leaders starting out. Both are critical.

West at a field briefing

The big picture

“Understand how you fit into the big picture early on,” she suggests. “We are all so focused on what is in front of us. There was a young Lieutenant Colonel who provided remarks at her promotion to Colonel. She said that the reason she had stayed in the service so long is because she understood how her job related directly to national security. It gave her a sense of purpose and she knew why what she did every day mattered.

Obviously, early in your career you are focused on learning your craft, but also stay connected to why what you are doing matters.

Her recommendation fits with the research done by Aaron Hurst, CEO of Imperative and author of The Purpose Economy.

“Every CEO I talk to is someone who has always thought strategically from the beginning,” Hurst says.

When I ask Hurst if that perspective might not change over the course of a career, he stands fast, and explains it’s a characteristic of people who make it to the top. For West, it is no exception.


“Seek out mentors,” LTG West says. “Be obnoxious about it. I was a little bit timid. I didn’t want to bother anyone.”

But her advice is more specific:

“Find someone you want to emulate. We are all drawn to people who look like us, but pick a diverse group of mentors. Make it known that you really want to learn, and mentors will go out of their way to help you.”

Her advice on diversity recalls similar advice from General Ann Dunwoody, and both are supported by management and leadership expert Tom Peters in his newest book The Excellence Dividend (“Motto: Same-Same kills in 2018”).[4]

When it gets hard

At her senior rank, LTG West considers the most difficult circumstances managing the complexities of politics. “The higher you go, you are maneuvering in an environment that isn’t as simple as black and white,” she says. “There is more to it than just the facts. It’s about the narrative, about perception.

When considering the value of military medicine, you are looking for ways of balancing effectiveness and efficiency. How do you determine what gets priority? How do you make the hard decisions? And as a leader, how do you communicate your decision to the members of your team in an area that is not the top priority so they still feel valued?”

West recalls her time as a commander at Ft. Eustis from 2003–2005.

“We were transforming from being an in-patient facility to out-patient same day surgery center. It made business sense, but because we were on a training base we could provide services that would not be considered cost effective in a civilian hospital.

The hardest decision was closing down the in-patient facility and losing some of our civilian employees.

As a leader, I had to lead the change knowing that this was the best decision for the Army.

Communication was key. We used to have frequent town hall meetings to keep our staff informed.”


When I ask LTG West about what she is proud of, she talks immediately of her two children. Her daughter, 25, is in her second year of law school after graduating from Villanova. Her son followed in the family footsteps, and is at West Point.

“I’m really proud of them, and their resilience, living all over the world,” she says. “It is grit these kids develop when they have to make new friends, learn to navigate a new environment. They develop grit making decisions in a new environment every day. Problem solving seems easier for them.”

How would she define grit?

“That ability to not be defeated — agility and adaptability. Grit is deciding to move past uncertainty, it is when you keep getting up…having that resolve.”

West remembers times she had to tell herself to keep going.

You “get your rear end up there and keep going.” When she doubted herself, she would tell herself, “stop it — just go, don’t think about it, just go.”

She remembers back to her time at West Point.

“On the indoor obstacle course, I thought there was no way I would be able to do it?could do it. How can I do it?”

Then she told herself — don’t think about it, just go.

West believes that grit absolutely can be developed.

“If you have any issues of confidence, start with discipline. It is like working on push-ups. The only way you can learn how to do them is to do them. You start small — set goals, and when you achieve them, set the next goal. Success breeds success.”

West mentions the work of Brigadier General (Retired) Rhonda Cornum, the flight surgeon who survived a week as a prisoner of war during Operation Desert Storm.

“She talked about post-traumatic stress and post traumatic growth. An event occurs that impacts your level of functioning. There may be an initial decline, but depending upon how a person responds, the decline can be reversed and resilience can be improved. Some of it is psychological, and some is attitudinal.”

There is an opportunity to look “at adverse events as potential for growth.” She makes sure to add to “get help if you need it.”

Finding strength

What has been the source of West’s strength and the grit that got her through?

LTG West, 2018

She credits her parents, and talks about her mother in particular.

“My mom was a pistol. The things she did growing up in the segregated south! Her dad was a bellhop at a hotel in Hot Springs, Arkansas, supporting a family of seven with what he made on tips. (My mom) and her sister went to Pittsburg to attend school to become a hairdresser to make money for college. She got up at 3 AM to wash windows so she could pay for school. Some mornings it was so cold the water froze in her eyes. Anytime I start to feel sorry for myself I remember what she went through.”

West also credits her faith and the people for whom she has responsibility for her strength and drive.

“It is my belief in something greater than myself. My definition of that is God.”

When we talked, West had just returned from visiting Ft. Dix, Ft. Jackson and Ft. Gordon.

“Going out to see our great team of professionals working in their spaces every day” helps remind her why she is doing what she does. But she also learns from them. “You learn from all people, every day, from different generations, different occupational lanes.”


When I ask West about how she thinks about the three kinds of purpose described by Hurst of The Purpose Economy with impact, values and craft, she sees her purpose as having evolved over her career.

“When I was early in my career it was about doing my job well, every day in my limited environment. At this level, the impact that I am having is different. I am responsible for 130,000 people, and at this level I may not see my impact daily, but it helps when someone comes up and says ‘you are really making a difference.’ That warms my heart.”

How does she feel about her impact?

It takes work to get her to talk about herself, as West is inclined to credit the people she works with, mentioning specialties from researchers to the combat medics.

“I am proud of the U.S. Military response to the Ebola crisis,” she says, referencing her time as Joint Staff surgeon in 2014–2015. At the time, Ebola had caused over 9,000 deaths after an estimated 23,000 infections in West Africa, with more than 85% of the Ebola deaths in recorded history occurring over 11 months.

As Brian Castner describes for the Pulitzer Center,

“The army’s battle against Ebola did not look like a war. Helicopters flew no dead bodies or Ebola patients, or even blood samples. Combat medics treated no sick people. Soldiers didn’t rescue victims from streets, or enforce quarantines, or provide armed security against mobs crazed by fear and illness.

Instead, the army put up Ebola Treatment Units (ETUs) and taught Liberians how to work in them. They set up blood labs in remote villages and hired local drivers to move supplies.”[5]

“We really helped the staff understand what was happening.” West says. “We rapidly deployed labs and training teams into Liberia and saved thousands of lives.”

When the Army arrived, there were more than 30 cases diagnosed every day, and four months later confirmed cases had fallen to less than one case a day.

But West is also proud of her work in Army medicine as a whole. “During my tenure in Army medicine, I hope I am making it a better organization, a better place, for those who depend on it for their health and their survival.”

But as aware as she is of the big picture, at the end of the day what matters to her is the people.

West gets her ultimate satisfaction from “Knowing that there are mothers and fathers, husbands and wives that have their family members still alive and healthy because of the work we do.”

CALL TO ACTION: GET YOUR FREE CHECKLIST: secrets from fighter pilots and general officers at shannonpolson.com/thegritproject/



[3]CNN, 6/16/2017

[4]The Excellence Dividend, Random House, 2018, xxix.


Shannon H. Polson

Written by

Speaker, Author, Veteran. The Grit Project:Real #Women. Real #Stories. Real #Grit. North of Hope http://ow.ly/rfHO5 Founder: thegritinstitute.com

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