On Vision: Defining The “What” Before The “How”

A photo of Jeremy Courtney and Cody Fisher working at a cafe.

Note: This is the second of a three-part series on defining and achieving Vision. Click here to read the first part of this series.

I was sitting in an Iraqi hotel lobby in 2007 when one of the hotel staff who was serving me tea approached me and asked: “Can you help my cousin? His daughter was born with a hole in her heart, and no one in all of Iraq can help her. Please, can you help?” I had just moved to Iraq with my family to work with a different NGO. I didn’t know anything about heart surgery for children or anything about taking children to other countries for treatment. From the beginning, helping this little girl seemed impossible. And she wasn’t the first child I’d met in Iraq with a life-threatening heart defect. In fact, it seemed like almost everyone knew someone with a child who was born with a messed up heart. My work with the organization I was with was not capturing my heart. It seemed to lack both vision and impact. And, in any case, it was not set up with an exit strategy—there was no developmental finish line.

Around the same time, Cody Fisher began telling me of his NGO work with many of these children in need whose files were piling up on his friend’s desk as she sought to find them heart surgeries outside the country. The more I inquired, the more intrigued I became. I learned that there were seven hundred children within a two hour drive of our city who were waiting in line for lifesaving heart surgery. You would never find a backlog that large anywhere in America!

Over the course of this journey, my wife, Cody Fisher, Michelle (then Bailey) Fisher and I chaffed under the tyranny of life as we knew it in Iraq. After all, it seemed that many of these heart defects were not simply occurring naturally but were probably directly attributable to acts of war—both martial and economic. This was an issue of justice. As Americans, we felt directly responsible for some of this. But it was primarily as Christians that we decided to jump into the unknown and commit ourselves indefinitely to the cause. Defining the cause itself could have taken us a number of different directions. I am grateful to God that we got this one right amidst all the unknowns: we defined the what before the how. Would we create an organization primarily because Jeremy had met a little girl in a hotel lobby? No. Would we create an organization primarily because Cody had a few connections to get us off the ground quickly? No. From the very beginning we established a vision that was far more grand than anything else in cardiac care nationwide. “… to eradicate the backlog of Iraqi children waiting in line for lifesaving heart surgeries.”

Looking back, it was ludicrous. It was naive. But it was never a mere “dream.” It was a vision. (See my last post on my differentiation between a dream and a vision). There was a moral conviction behind it. It would never be enough for us to simply help the children who crossed our path. It would never be enough to clear the files or the “backlog” on our desk. We had to exist for all the children of Iraq who were waiting in line for lifesaving heart surgery. 

Months after articulating our vision for a Backlog-free Iraq, I learned that the leading expert in the region had actually dumbed down the number of children waiting for surgery because he did not want to scare us off. The number was actually 5X greater—closer to four thousand children. We were still waiting on estimates from the rest of the country. We started to suspect ten thousand children or more were waiting for surgery. And we were not smart enough at that time to really question how many new children were born into the country each year in need of heart surgery. We were almost immediately faced with a crisis. Our 20-child per year pace was never going to “eradicate the backlog.” Our methodology—the how—could never see our vision realized. 

Do we change our vision to meet our methods, or must we change our methods to meet our vision? 

Nothing had changed in our desire to see Iraq free of a burdensome backlog. We had established our vision—our what—before we had a clear idea how we were going to bring it about. So we stuck with our vision and forced our methods to catch up. We redoubled our commitment to eradicate the backlog. We personified The Backlog—for he was a devilish foe who needed to be vanquished by all the heroes like you who would partner with us in the coming years. The Backlog only existed because of injustice—both local and internationally imposed. To defeat The Backlog would be more than a triumph of our organization; it would be a victory for every family across Iraq, because every family across Iraq is susceptible to congenital heart disease, the number one birth defect in Iraq and in the world. 

Our vision was still maturing, to be sure, but we got this one thing right: we established the what before the how. There are other organizations that work into Iraq in an effort to help children with heart disease. But sometimes I wonder if the how has taken precedence over the what. Candid conversations often reveal a complete absence of vision; a settling for the methodology of today for lack of a compelling picture of the future. 

Since our inception in 2007, we have made four major programatic (methodological) changes in an effort to stay the course and eradicate The Backlog. Every one of them was scary. Every one of them could have been a colossal failure. But vision demands innovation and risk. 

Do you have a hard time accepting the world as it is? Do you feel morally compelled to work for a different future? Do you have a vision that you are currently nurturing or pursuing?

If so, do yourself a favor: define the what before the how. Methods change with technology, culture and economics. Don’t focus on the how. Get your sweeping vision right by defining the destination point at which you want to arrive. Let the how work itself out one step at a time and don’t sacrifice your “what” for a method that leads you astray. 

Can I be a helpful ear as as you try to work out your vision? Don’t hesitate to send me an email by clicking this link!