From Military to Memorial Hermann (ft. Noel J. Cárdenas)

Welcome to Digital Voices, where healthcare and life science leaders explore the real work behind transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marks. Thank you for joining Digital Voices. I'm so excited to have an amazing guest, Noel Cardenas. Noel, welcome to Digital Voices. Oh, thank you for having me. I'm really excited about the opportunity to speak with you today. Yeah, this is going to be awesome because you have this background of a few different things that I admire so much. One is a military background, which we'll talk about. And also, obviously, as a hospital CEO and leader, it's going to be a pretty amazing discussion. And we first met, we were both at an organization called National Association of Hispanics in Leadership, NEHIL. And this was the Austin chapter and Austin, not Austin, but Houston. And Houston has the most Hispanics, as I understand it, than maybe any other metropolitan city in the country. So it's great that there's this large professional organization of health care leaders and you and I both spoke there. And I was so impressed listening to you. I just had to have you as a guest. So thank you for being our guest. It's an honor to be here today with you. So, Noel, one of the main questions everyone wants to know the answer to are what songs are on your playlist? What kind of music do you like to listen to? Oh, so as I thought about this, like I'm like all over the place when it comes to music. Right. I love to listen to classical music, soft rock, even rock, easy listening and country. And then, of course, I can't forget about my Hispanic heritage. Right. And being Mexican-American, you know, I love to listen to Spanish music as well. So music to me was always important in high school. I was in the band and loved that part of it and enjoyed playing an instrument when I was in high school. Oh, that's great. What kind of instrument did you play? So I started off on the trombone. I always wanted to play the trumpet. Every kid wants to play the trumpet, right? But I was told I had to play the trombone, which my dad had played the trombone as well when he was in high school. And then later on in high school, I transitioned and started playing the baritone and had to learn to go from using a slide on a trombone to using valves. But I had watched my brother do it, so it was pretty easy to transition between those two instruments. My youngest actually played the trombone as well, and I still have his old trombone in my garage. That's awesome. And isn't there like, I don't know what you would call it, a mix of country and Spanish music called Tejona? It's called Tejano. So, yeah, you get the Spanish piece to that, and then you also get the country piece. So some of my favorite singers, I've learned Callum Scott is one that my wife introduced me to, one of his singles, and then One Republic. I go back, you know, a long time ago. You know, Neil Diamond was popular when I was growing up and still is. I actually got to see his Broadway show most recently. Of course, you know, Queen and Elton John. I went to an Elton John concert in the last few years. Dua Lipa is one that I still want to I want to attend her concert at some point. I did go to a Pink concert here in Houston and she what an entertainer. Right. It was incredible. So I've even gotten, you know, the vibe for Taylor Swift. You know, my daughter-in-law is really excited about that because I actually bought the latest Taylor Swift album. And then I've grown to like Post Malone, Luke Holmes, Lainey Wilson. And then probably one of my all-time favorites is Andre Bocelli. Yeah. I've been to two of his concerts, and you walk away from his two concerts just amazed at that voice, right? Because there's nobody else like him. so it's all over and then even most recently i i had to learn who bad bunny was and uh that that's a funny story because my son uh wanted to see if i could get the the suite because i worked for more herman and luckily i was able to get it so i went to a bad bunny concert didn't know who he was and and now i've started to like his music and of course he'll be playing at this at the super bowl yeah no that's pretty cool yeah it's a eclectic mix of different types of music what about life message and mantra, are there words or quotes that you live your life by? Yeah, I live life, you know, of hard work and character. And it's one of those things that I've always told everybody is you take care of others and you will succeed. I'm a big Abraham Lincoln fan. And I tell everybody, if I had the opportunity to spend a day with a leader, I'd love to be able to go back in history and spend a day with Abraham Lincoln. And he has a quote that says, to predict your future, you have to create it. And I think for me, that's something that has lived with me most recently as I've reflected in how I got to where I am today. And I was able to predict my future years ago, but I did it by creating it, right? And, you know, I have a story to share about that. Years ago, back in 1996, I was sitting at Brook Army Medical center with my wife on a Sunday, she was seeing an OBGYN with our second child. And we're sitting there waiting and she's asked me flat out, she goes, what is it that you want to do? You know, where do you see your career going? And so I sat there and thought about it for a while and just started naming off different jobs, different positions in the military that I wanted to do over the course of my career. And as I went back and reflected, she told me a few years ago, she said, everything you said on that list, you did. And, you know, she said, when you think of that quote, you know, you predicted it, but you created those, you know, those opportunities for you to be able to get to where you are today. And that one of those last things on that list was to be a CEO of a civilian hospital when I left the military. Yeah. But, you know, there's some there's some other things that that have come to mind. Right. I was thinking and reflecting about this. And I still remember during my first deployment to Iraq, my dad sent me a book and the book was entitled by Julian Mantle. It's the book is entitled The Monk Who Sold His Ferrari. And I don't know if you've ever read that book or heard of it, but it's about a personal transformation. It says, you know, you sow a thought, you reap an action. You sow an action, you reap a habit. You show a habit, you reap a character. So sow a character and you reap your destiny. And so as I thought about that, you know, everything that when I read that book, it is all kind of just come together. So it's really, as I go back to it, it's that quote from Abraham Lincoln that I've lived it. Yeah, there's a power to having a vision and a sense of purpose. You know, many people live their life without it and come towards the end and look back and have a lot of regrets. But if you live the way that you're suggesting and the way that you have, when you come to the end, you probably won't have any regrets. Yeah, you don't. One of the things that I took away from the military was if you take care of people in return, they're going to take care of you. And that's something that's just lived with me. The other thing that my wife always talks about, a quote, and this kind of stuck with me too, is from Maya Angelou. She says, you know, people forget what you said. People forget what you did. But people will never forget how you made them feel. So there's been times when I had to reflect on how I made people feel and have to go back and kind of patch that relationship. Yeah, you're a good person for doing that. I've had a similar experience in my life, too. When, yeah, you just grow and you realize, whoa, I didn't treat someone the way that is in my character today and I need to go and make amends. And, you know, people might be struck, you know, that this is coming from a colonel in the Army. So tell us a little bit about first about you growing up and then I want to go straight into your Army career and talk about some of the leadership training you received So yeah you grew up in Texas So tell us about that Yeah So I grew up in the deepest part of South Texas you can go to. I grew up about four miles from the border down in the Rio Grande Valley. So, and people always say, well, you know, they go San Antonio. I go, no, you still have to drive another four hours South of there. And so it's right along the border between Westlaco is where my hometown, it was a community. And just when I was growing up, it was about 17,000 now. So it's close to about 27,000. And growing up, you know, my parents, obviously, growing up as Mexican-Americans, they were the first to get a degree and, you know, a college degree. And obviously for us, they felt that that was important too for us to do that. And, you know, growing up along a border town, you know, you kind of see everything from citrus fields to vegetable fields. And my dad grew up picking cotton. My mom did, you know, a lot of work like that similar to what she was growing up. Luckily, they had done so much that we didn't have to do that. But I still remember a lot of the kids when I was in elementary school, they would leave all of a sudden and you wouldn't see them. And they would leave South Texas and go up north to work the fields and to pick apples and so forth. But, you know, deep rooted and, you know, Hispanic traditions, Mexican-American traditions. But for me, you know, growing up, there was about family, Right. Family was so important. You know, I my career aspirations were always in, you know, growing up was health care. Right. My first experience in health care was as a first grader. I had pneumonia and spent six weeks in the hospital. It was my first interaction with a nurse. And I tell this story and people go, oh, please don't share that story ever again. But I still remember being in the hospital and I was had been moved to a higher level of care because of the pneumonia. and they put another baby in the room with me and the nurses came in and they said, I could tell probably because they were short-staffed or something, but they said, if you hear that the little girl's not doing well, you need to alert us, so hit the call button for us. And I'm like, boy, putting that responsibility on a seven-year-old is a lot, but I kind of felt like that was kind of the path right to where I was going to go. So I always had a dream of going into medicine, becoming a doctor, And I had an uncle who actually delivered me. And I was not born in a hospital. I was actually born in a clinic there in the community. And I've shown pictures of it. And so that drive to go into medicine went into high school where I was a health occupation students of America. I was part of that program. And my senior year in high school, I had spent part of my day in school. And the other part, I spent working for an orthopedic surgeon as a nurse assistant and had a lot of interactions with patients, but I'll tell you, you know, you always remember one patient that had a difference in your life. And there was this little, this little old lady, you know, she's probably in her seventies. She had a diabetic foot and it was, you know, she had had a partial amputation. And here I was a 17 year old caring for her. And the one connection that we made was she didn't speak any English. So I was able to communicate with her with what I'd call my, my broken Spanish, as my parents would say, cause it wasn't, you know, as good as theirs. but I tried my best, but I was able to communicate with her, but we built that connection and I took care of her and would, you know, debride her foot and put her in a whirlpool. And we made such a connection that she would only allow me to take care of her. And so that patient to this day, she's, Ms. Maria always, Ms. Maria always sticks with me because I'll never forget her. And so I knew that healthcare was going to be part of what I wanted to do. Going into college, you know, My intent was to become a physician. And then late in my sophomore year in college, I ran into a gentleman who's a little bit older than me, and he was in a military uniform. And I asked him about the uniform, and he shared with me about the ROTC program. And I had had kind of a little bit of an interest in the military going back into high school where I had heard a Medal of Honor winner speak at a program called Texas Boy State. And that kind of triggered some interest in the military because he talked about the brotherhood and giving back to your country. And so that spark was there, but it didn't ignite. You know, I still remember my parents saying, don't even think about it. Right. When, when I started to get all this army, uh, army things coming into the mail and they go, what is all this stuff coming? I said, Oh, I've registered for this. And they go, don't even think about it. Right. But so left that behind. And then of course, then I go fast forward back to those two years later in college and, and I actually went home and talked to my parents and they said, absolutely not, right? You're not doing this. You know, you're going to go off, you know, your goal is to, you know, become a physician and, you know, and go to medical school. And I said, well, the army will allow me to do that. And again, they said, don't even think about it. Well, you know, I was known as the hardheaded, right? I was the stubborn one. And so I went back, spoke to that gentleman again, and he took me down to the ROTC buildings. Two days later, I went in actually and talked to them and decided to do it and went off to what they called ROTC basic camp at Fort Knox, Kentucky, where I was awarded a scholarship to finish my college education and was able to finish that at the University of Texas. And at that time, I was part of the Texas National Guard for three years while I was going to college. And then, you know, there was that point in my career right when I was graduating from college where I had to decide, OK, medicine was still part of what I was thinking about applying to medical school, but I was going to probably have a year off. And so my professor of military science brought me in and talked me into, he said, I really think you should consider going on active duty. And I said, well, you know, but what about medical school? And they said, well, if you go on active duty and then you get into medical school, you know, you'll be allowed to go to medical school. So I went ahead and went on active duty right after college. So I graduated in May of 1988. In July of 1988, I find myself at Fort Sam Houston on active duty as a Medical Service Corps officer. So that was kind of where my military career started back in 1988. Yeah, no, that's fabulous. And thank you for your service. Yes, you did a couple of tours in Iraq. And go ahead and take us through in just two or three minutes, if you can, your military career all the way to the time that you retired, because I want to talk about then Memorial Herman and a little bit about the ACHE. Yeah. So like I said, as I went into the Army, my intent was always to go into medical school as part of the Army and become an Army physician. And so I went in my first assignment. I went into logistics to start my career in the Army. Somebody had talked me into that, saying it was a great field, great opportunities. And so first assignment was Fort Hood, Texas, where I was the division medical supply officer and actually deployed for the first time. So I actually had three combat tours during my time in the military. The first one was Desert Shield, Desert Storm. So I was doing medical supply, did a follow on assignment, then did my officer advanced course and then became a company commander. So the leadership piece in me was starting to really grow and develop. And I was really enjoying that part of it. And again, still thinking about medical school at that point. But it was one of my mentors one day that pulled me aside and said, he said, have you thought of hospital administration? And I said, I don't know much. I said, tell me a little bit about it. And he goes, well, you're basically the guy running the hospital, right? And so you'll have to go off and get your master's and the military will pay for that. So very fortunate. I got selected for the Army Baylor program. So it's the Army, the Department of Defense's master's in health care administration program, But Baylor University, you know, provides the degree. So I have a master's from an MHA from Baylor. And so at that point, I'm starting to navigate my career and still thinking about logistics. But then one another my preceptor at the time who is when I was doing my fellowship pulled me aside and said hey we really need more hospital administrators than logistics officers And so at that point I made the decision and then transitioned my career into hospital administration And then went off and did a school for a year where the Army trained me to be a staff officer. Then at that point, they brought me back into the operational side of Army medicine with a field unit out of Fort Hood Medical Brigade. And so there I went back and did a logistics job for a year because of my background. But that's when my career really pivoted when my brigade commander pulled me in one day and said, hey, I'm going to make a decision on your next assignment, and I'm going to send you down to be the executive officer of the 21st Combat Support Hospital at Fort Hood. And exciting, great assignment, great opportunity. But prior to that, we had had 9-11 happen. So everything had changed as far as where we were in the Army at that point. So going down to the 21st Combat Swaroff, I knew there was a chance that I could potentially deploy. So about six months into that assignment, that's when we got the deployment order and I deployed with that unit to Iraq or initially to Kuwait. And then at that point, the decision was made to split that hospital into two locations. My commander took part of that hospital, which is the 84-bed slice of the hospital, and he assigned me to take the 164-bed slice to just north of Baghdad. So he took the smaller piece up to Mosul and I took the bigger piece up to Balad. And so that deployment entails setting up that hospital north of Baghdad. So we started on, you know, once we got all our equipment up there, got the team up there, we started on a Friday morning building the hospital, all 10-age, you know, and it has pretty much everything you can think of in a hospital, right? It's got, you know, surgery suites, intensive care units. It's got all the support functions that go with it to include, you know, lab, pharmacy, all the imaging, x-rays you can think of. And so by Sunday, we set that complex phase of that hospital up and we started taking casualties that night. And so that was in April of 2003. And then I was there through March of 2004. At that, you know, throughout that year, we kept building the hospital bigger and bigger. Right. Then, Got back after that deployment, that was when I was told, hey, it's time for you to come back into hospital administration. So that's where my career started going. And so I was the chief operating officer at an Army surgery center at Fort Wachuk, Arizona, then followed that assignment as the chief operating officer of the hospital at Fort Carson, Colorado. Then at that point in my career, I was kind of contemplating retiring because I was hitting, I'd hit the 20-year mark and not quite sure what the Army was going to do for me. And that's when, you know, opportunities come to you, right? And so I get this call that says, we had this tremendous opportunity, which was something I had been wanting to do, and that was to be a battalion commander. And so I got selected to take the battalion command in Germany, then deployed that unit again back to Iraq for another year where I was a task force commander. Then after that assignment, then I was assigned to be the chief operating officer at Brooke Army Medical Center, which is at that time the largest Department of Defense facility or healthcare facility, because at that point, we merged two level one trauma centers, which was the Air Force and the Army, into one location. So I had the responsibility of bringing that together as a chief operating officer, as well as the $3.2 billion in construction to put all that together. Finished that assignment three years there. And then my last assignment, the one thing I wanted to do was to run an Army hospital. So I had the opportunity to do that at Fort Sill, Oklahoma. And at that point, I attained the rank of colonel and did that for two years. And then at that point, that was when I decided it was time to hang it up, right? I still could have done one more assignment. I still had about two and a half years left that I could have to hit 30. But for family reasons, it was the best time. And that was when I transitioned and then started to seek opportunities in the civilian health care. Yeah. Yeah. And to be a full bird colonel, that's that's a pretty amazing career in and of itself. And people could retire with that and have looked back and said, hey, job well done for sure. But you kept going and here you are today. Memorial Hermann. Tell us a little bit about your role today and what attracted you to Memorial Hermann. So when I was transitioning, you know, one of the things, it's not easy transitioning from military health care to civilian health care, right? It's viewed as a different health care system. As I've told everybody, the only thing that's difference between the military health system and the civilian health care system is the finances, you know, process of it. It's how it's paid for, right? because we did everything in the military. We did joint commission. We did compliance. We did OSHA. Everything that you had to do as part of a hospital, we did it just like a civilian hospital. But the finances was completely different. In the Army, I was given a set amount of money. Here's your budget. Don't overspend or you'll get fired. And then to the civilian side, it's about building business, right? You've got to build that business. So as I was looking to transition, I started, you know, sending my resume out, talking with hen hunters. But it was really the connections that I made through the American College of Healthcare Executives where that allowed me to link up with some really key people. And I really attribute my transition to three individuals that helped me. The first was actually an Army General, Major General David Rubenstein, who I'd shared with him that I was retiring. And he said, OK, we've got to get you connected with some people. And so the first person he connected me with was Rich Cordova, who was at that time, he was the CEO of the L.A. Children's Hospital. And one of the connections that we made where we were both, you know, Hispanic, we're both Mexican-American. And Rich took an interest in bringing me under his wing and wanted to and was mentoring me, especially mentoring me on my transition. One of the things he had talked about was bringing me out to L.A. to work for him. But being a Texas, you know, boy, I was like, I want to come back to Texas. I want to be close to my family. I had been away from my parents for, you know, they were getting older. My kids were ready to start settling. And so I had to be honest with Rich and say, I really would like to move back to Texas. I need to be close to family. And he was really respectful of that. He goes, I understand family is important, right? It should be your number one priority. He goes, give me a couple of minutes and I'll be right back, right? And so I'm standing there waiting. I'm not sure what's going on. And so Rich walks over. He comes back to me and he said, hey, come with me. And I said, where are we going? And he said, well, I'm taking you to your future. So we walk over. And at that point, he introduces me to a gentleman by the name of Chuck Stokes. And Chuck Stokes was the chief operating officer of the Memorial Hermann Health System. And this was about two years prior to my retirement. So I actually had started working some of this as far as my transition. And Chuck took me under his wing and mentored me for a little over a year. And then when it came time where I made that decision to retire, he started walking me through as well as Rich did. Right. Because one of the things I'd never had to do was interview for a job. And so they helped, you know, Rich helped me with the interview processes. And so but I had the opportunity to interview with the Memorial Hermann Health System in May of 2015. And then a couple of weeks later was called that I, you know, had been selected for the role as a chief operating officer up at the Northeast Hospital. So, again, it was just a tremendous opportunity. And, you know, I was very honored and humbled by that opportunity and was really thankful to Chuck for giving me that opportunity with Memorial Hermann. I had actually learned about the system when I was still in the military on active duty, because one of the things that Memorial Hermann was known for was their focus on patient safety and quality and also being a high reliable organization right there. There was a clear focus on this system about providing that high quality care, which is something I was used to in the military. And I wanted to be part of a system that that was their overall priority and their goal And so to land here I mean it just been a tremendous and humbling opportunity for me So I did that for five years as the chief operating officer up at the Northeast Hospital. And then in September 2020, that's when I was selected to be the CEO of the Morehormand Southeast and Perlin hospitals. Yeah, they're lucky to have you and great timing for everything. As we talked about earlier, that you were available and Memorial Hermann is one of the great healthcare organizations in our country. And so what a great opportunity. I don't want to lose any time on this. So I want to make sure we talk about ACHE a little bit. So tell us about your role in ACHE and why you would encourage other healthcare leaders perhaps to participate. Yeah, so I've been a member of ACHE since 1997 when I was going through my master's program. Some of my colleagues that were going through the Army Baylor program, they were talking about this organization, ACHE, ACHE. And I finally, I said, somebody's got to tell me what's ACHE all about? You know, I hear the word ache, right? Right. And they go, no, no, it's not ache, it's ACHE. It's the American College of Healthcare Executives. And they said, well, it's a professional organization. It's geared towards healthcare executives. It provides, you know, it's not about advocacy. They don't get into politics or anything like that. It's about professional development, education, and networking, right? So I read up about the organization, and then a day later, I joined as a student member and then continued my development through that. One of the things that's key about what ACHE provides is it provides board certification. I tell everybody, right, we expect physicians, nurses, and others to be board certified. Well, ACHE provides that opportunity to be board certified in our field. And so I attended my first Congress, which is their annual meeting in Chicago in March of 1998. And I knew at that moment that I was part of just a phenomenal organization that really did focus on supporting their members through education, through networking, through, you know, just developing strong relationships. relationships. And really, you get opportunities to mentor with leaders. And so I continued my membership throughout, right, throughout my Army career, and even became part of the structure within the Army because they have an Army regent who represents the Army membership on the Council of Regents. And that was one of my goals was eventually to potentially fill that role. But part of that was also had to get back, right? So I was on the Army Regents Regional Advisory Council. I had done a number of things on that council supporting the regent. And then in 2012, I decided to nominate for the regent role of ACHEN, was selected as the Army regent. So I served in that role from 2013 to 2015 until I retired from the Army. I always felt it was very important to continue to give back to the organization. So I had served on a multitude of different committees, had supported some of the, you know, some of the Army. But when I got out, I started to look at bigger roles, right? So I talked to Rich and a couple other folks about potentially running as part of the board. And Rich was very honest with me. He said, look, you've got to build your credibility in the civilian sector first. And he said, get onto some committees in your community, join the local chapter, lead some things in the local chapter. And so I did that. I took his advice, immediately contacted the chapter, got involved in some local committees there in my role at the Northeast Hospital, both in the chamber as well as some other organizations, the YMCA, the American Heart Association. And so it's really about building your resume, right, your credibility on the outside. I got on the nominating committee, and at that point, they were looking for the next vice president of the chapter, and there were no nominations. So I went to the chair of the nominating committee and I said, well, what are your thoughts on me nominating for the vice president role? And he goes, I was hoping you would do that. But he said, now I need you to resign from the nominating committee and you got to nominate. So I nominated and then was selected as the vice president of the chapter here in Houston at Southeast Texas chapter and did that for a year and then rolled into the president of the chapter for, it was supposed to be a year. And then we got caught up into the pandemic. So one of the things that I did as the chapter president was I extended everybody's terms an extra year to kind of keep things stable as we worked our way through the pandemic. And so did that for two years. And then at that point, reached out to some people and they said, now's the time to get on the board. And so that's when I self-nominated and then was on the board from 22 to 25. And then this last year in March is then the next nomination process was then to become potentially the chair of the board. And so I self-nominated, went through that process and was selected as a chair elect. So I'm currently serving as the chair elect of the board for the American College of Health Care Executives. And in March here in Houston at our annual Congress, I'll take over as the chair of ACHE. Wow. That's fantastic. I'm sure all the people in your town where you grew up are so proud of who you've become, this great leader in the military, now in the civilian world, all in Texas, too, which is, you know, it makes it even better. And, you know, heading up as chair of ACHE, it's pretty amazing. Well, we covered so much ground. I don't even want to try to summarize. It was so good. I can tell we've only scratched the surface. Is there anything we missed or anything you want to double down on? I'll give you the last word. No, I'm sure there's a couple of things. Some of the things that I tell everybody is always use those values that are part of you. You want to make sure that you maintain your character. Lead from the front. Don't be afraid to roll up your sleeves when you have to and be part of the team. I go back and I think through my career, one of the things, my military career and even to this date because we went through the pandemic, one of the things that I was most proud of when I was serving on active duty. And one of the things that I always wanted to make sure of is that I never lost a soldier. And so I was, you know, very proud of the fact that throughout my military career through three deployments, I never lost a soldier. And then even I remember transitioning into more Herman and then going through the pandemic. I still remember sitting in a room with a lot of leaders and I could see the fear in their eyes, right, being, you know, scared. And I said, we're going to get through this. And our ultimate goal is we're not going to lose anybody. Right. And so we didn't, you know, at both hospitals. And so that was important, right? Always taking care of one another. So I think it's, you know, as a leader, you got to be prepared to lead in different styles. You know, everybody talks about the servant leadership. You know, I always say to everybody, you know, you got to be that authentic leader. You got to be that servant leader. but you also have to be, you know, a transformational leader because at any time in your career, you're going to have to pivot and use different leadership styles to get through different events or through, you know, something you've got to do and accomplish. And so, but lead from the front and always set the example for those that you lead. So one of those things is, like I said, is always, you know, lead with your values and lead with a character, you know, with that highest level of character. But the other part of it, too, is as I as I want to see more of is lead with a strong moral compass. Right. I tell everybody that that's my true north. Right. You got to live towards that true north and as a leader. No, that's a great way to end our time today. Thank you so much for being a guest on Digital Voices. You're welcome. And thank you for the opportunity to share my story. Thank you for listening to Digital Voices. We hope today's conversation sparked ideas, reflection, and connection. Subscribe on YouTube, Apple, and Spotify Podcasts so you don't miss an episode.