The Perfect Vision of Dr. V.

It is the only mystery worth solving: the mystery of leadership. And here's the question that's wrapped around that mystery: Why is it that even leaders who have the most-beautiful intentions create projects and organizations that don't come close to resembling their original vision?

Between the idea and the reality falls a shadow. This obscuring cast has given us a graceless DOS, crappy cell-phones, brain-dead customer service, hollow-hearted TV programming, and idiotic airlines. Worse, it robs us of pleasure in our own work and lives. Settling for "good enough" makes us all feel small and mercenary.

What if it doesn't have to be that way?

There is a place you can go to find the answer: India. But don't go to the megacities of Bombay and New Delhi or to the newly minted software center of Hyderabad. Go to the wild, wild south, mystic cowboy country, where gurus roam the plains, and where a John Wayne western turns into a Mahatma Gandhi eastern soon enough. Climb into a beat-up 1980 Chevy Impala. Ride for seven hours with an eye doctor who is 82. Ask him to tell you the secret, to answer the question, to solve the mystery. Listen carefully to what he says. Watch everything he does. And learn.

You know he knows. He's an eye surgeon -- a man of vision. He has learned how to deliver perfection, and to do it despite crippling obstacles. As a young man, a brand-new obstetrician, he contracted rheumatoid arthritis and watched helplessly as his fingers slowly twisted, fused, and grew useless for delivering babies. So he started over, this time studying ophthalmology. He managed to design his own instruments to suit his hands, and these tools enabled him to do as many as 100 surgeries a day. He became the most admired cataract surgeon in India.

Twenty-five years later, he confronted another potentially crippling obstacle: retirement. In 1976, facing the prospect of social shelving at age 57, he opened a 12-bed eye hospital in his brother's home in Madurai, India. Today, he runs five hospitals that perform more than 180,000 operations each year. Seventy percent of his patients are charity cases; the remaining 30% seek him out and pay for his services because the quality of his work is world-class. He is a doctor to the eyes and a leader to the soul.

If corporate leaders who have the best educations, the best consultants, and the best financial and technical resources consistently deliver projects that are dead on arrival, how does perfection emerge for the Chief, Dr. Govindappa Venkataswamy, Dr. V.? How does his execution so closely match his vision? How did his original hospital, Aravind Eye Hospital in Madurai, invent a service so perfect that it created its own market -- and how did it do so without any significant resources, and with a paying clientele that represented far less than half of its customer base?

What is the secret of leadership that would let us actually do what we see so clearly in our heads? Perhaps a visit to Dr. V.'s hospital, halfway around the world from the comfort, wealth, and complacency of Western leadership, will improve both our vision and our capacity to deliver on that vision.

The Journey to Sight Begins with a Cyclone

On the surface, India is a mess: It has a population of 1 billion, raw sewage on the streets, and traffic that moves at 20 MPH. But if you can look past India's visual obscenity, you will see a country that is turned inside out. India is the new frontier of the new economy, and American business will have to become more innovative -- not just technically, but humanly too -- to reach this market space.

The map can't tell you what meridian this new frontier is on, but 911 sounds about right. In India, every minute is an emergency: Birth, death, life, and infinity rumble past the windows of your car. To see the future, you have to travel to the rough edge of experience. This ride is going to be a bumpy one. Dr. V. is ready; he loves a good emergency. And in India, your wish is the universe's command.

We are driving from Pondicherry to Madurai, which is a seven-hour journey. The Indian gods who govern every learning experience have provided us with a challenge: In hour five of the journey, the skies blacken. Rain lashes the windshield. "Cyclone!" yells Dr. V., picking up his mobile phone to call his sister Dr. Natchiar, 60, Aravind's joint director of business development, to report exultantly on the amazing weather.

Later, in one of Aravind's classrooms, I will see a sign: "If You Are Looking for a Big Opportunity, Find a Big Problem." But it seems that this problem has found us. Billboards, uprooted by the winds, fly through the air. What better time for Dr. V. to remember his last heavenly vision! He was 55 when he first saw the golden arches of McDonald's, and it changed his life.