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Leadership is never easy—not for nothing did Shakespeare write, “Uneasy lies the head that wears the crown.” The job of leader may seem even more imposing these days given a range of social, economic, and geopolitical forces—both micro and macro. But amid the challenges, there is always the opportunity for growth, says Daniel Vasella, the former chairman and CEO of Novartis AG.

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Vasella has counseled hundreds of global CEOs through his involvement with McKinsey’s Bower Forum and sits on a number of corporate boards. As a physician who has been recognized for his research on neglected diseases of the developing world, and as a global executive, Vasella has touted the importance of authenticity, vulnerability, and a range of other “softer” attributes required to innovate and grow as a leader.

He discusses the challenges and opportunities for today’s leaders and why being a CEO is still “the best job you can have” in this new interview with Ramesh Srinivasan, a senior partner in McKinsey’s New York office. Srinivasan is a codean of the Bower Forum and a coauthor of The Journey of Leadership: How CEOs Learn to Lead from the Inside Out (Portfolio, September 2024). What follows is an edited version of their conversation.

Ramesh Srinivasan: CEOs are facing a raft of challenges these days—some unprecedented, some perennial, but all of them emerging and compounding faster than ever before. How well do you think leaders are navigating these challenges?

Daniel Vasella: As you noted, the challenges are multiple, and not all are of the same nature. You have geopolitical issues, including power blocks between the East and West that have changed in recent years. That affects business and can make things difficult to navigate.

The effects of the COVID-19 pandemic have also created a very challenging situation. In the first moment, there was disbelief: What is happening? One doesn’t realize entirely the gravity of the situation. And then it sinks in, and we discover how people lead an organization through a crisis.

For instance, Stephen Squeri, chairman and CEO of American Express, implemented a policy that no one would get laid off during the crisis. That was very important for colleagues to feel more secure in a period of fear because, as you remember, there was fear all over the place.

The humanity of that approach—and the collegiality that it developed—was very important for employee morale. At the same time, the company continued to invest in the enterprise and offer benefits to customers who were having difficulties.

Ramesh Srinivasan: You mention the pervasive fear at that time. Leaders also experience emotions such as fear and disbelief. How can they balance the need to share their emotions and some of their own vulnerabilities with setting a clear direction and making tough decisions? How have you done that as a leader yourself?

Daniel Vasella: I certainly evolved over time. As a leader becomes more self-assured and authentically at ease with oneself, it becomes easier not to be so self-protective.

I would separate the question of vulnerability into two aspects. One aspect is positive vulnerability, which means you are not building a big wall around yourself. Instead, you’re approachable. Negative vulnerability would be someone with thin skin who, when criticized, immediately gets hurt and reacts negatively.

These are different forms of being vulnerable. I would encourage leaders to be as normal a person as possible. The CEO position creates distance between yourself and others. Because you are a person of authority, the role can draw overly positive or negative reactions. Some people may find the relationship reminiscent of the past, maybe recalling a parent, a teacher, or another authority figure. So I think it’s very important to be aware that you need to be especially approachable.

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Ramesh Srinivasan: Thinking about this notion of approachability and human-centric leadership—how does it change for a leader who is just starting the job compared with someone who has gotten more comfortable in the role?

Daniel Vasella: In my own case, in the beginning I wanted to do the job perfectly, to exceed expectations. And being self-critical, I was constantly in action mode. But over time, I learned what really mattered, and that I didn’t have to be perfect. That gets us back to the question of vulnerability, as well as the idea of approachability. Not being perfect and allowing yourself not to be perfect provides a lot of freedom.

When you are trying to be perfect, you can find yourself in a prison of perfection. Whenever I was criticized in the media or in a more public way, I always checked in with myself to see if the criticism had merit. If I truly believed in something I was doing, I decided not to care if it was popular or not. I would just try to follow through. But I always wanted to take in feedback, especially if it was negative, then admit a mistake if there was one and continue on my path.

Not being perfect also empowers others to speak up. People like to see that bosses admit when they’re wrong, that they are comfortable asking questions so they can learn, and that they are grateful for good answers from the people around them, who may in fact know more than they do about a particular issue. This complementarity of capabilities and knowledge is very important to be aware of so that it can be used to the benefit of the enterprise.

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Ramesh Srinivasan: McKinsey’s Organizational Health Index data show that high-performing organizations have cultures in which leaders are willing to listen to the people around them and to empower their teams with a clear direction and vision so that they can produce results. You’ve coached CEOs and other leaders about culture. What have you seen when it comes to leaders switching from a command-and-control approach to one that emphasizes empowering people and inspiring teams?

Daniel Vasella: At Novartis, it was crucial to develop a shared purpose and to talk about convictions. We asked ourselves, what do we deeply believe in, and how will we act accordingly? What boundaries should we set? When it comes to values, what will we not tolerate? What will we promote and support and celebrate? We also created clarity around aspirations.

One mustn’t forget that being part of a leadership team is also about competition and winning. That can be very enjoyable. One should take pleasure in competing. And then, of course, purpose also relates to business strategy. You have to have clear goals and align people with them. Then you have to take action and implement those goals. And then you have to measure what is being achieved. That takes transparency.

I see many more companies thinking about purpose now. But you can’t just hang up a slogan somewhere in the office. You must really think about purpose—debate it, discuss it, and commit to it. It’s not a one-time thing. One has to repeat, “Is it still true?”

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Ramesh Srinivasan: You have said that “you can teach concepts, but you can’t teach experiences.” How does that play out in the CEO role?

Daniel Vasella: We all act according to certain concepts, even if we don’t know it. Basically, we have a framework—we have a pattern that is influenced by personal experiences, by what we have learned, by what we have observed.

I learned a lot from my predecessors, in both positive and negative examples. I looked at the negative consequences of certain patterns but also at what [my predecessors] did extremely well. And I have to say that all my supervisors and bosses had at least one towering strength. That’s what I tried to focus on and learn from. In my experience, many people have a particular gift, and I’ve seen many CEOs who are really gifted.

Ramesh Srinivasan: It’s true that many CEOs are gifted. At the same time, they have to be mentally, physically, and emotionally fit to do such a complex and demanding job. How can they stay strong through the journey?

Daniel Vasella: Overall, I would say you don’t get to that position if you don’t have a certain level of resilience even before you become a CEO. So the first question is, how do you gain resilience? I think some is given by Mother Nature—your biology. But having gone through very tough periods and deep challenges, I also found that after the bad days come good days. Knowing that after the rain, the sun will appear again is a very important perspective that helps one become more resilient. A certain realistic optimism is helpful.

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This reminds me of Jack Stafford, who was the CEO of American Home Products many years ago. When I became CEO, I went to see him. He had the reputation of being very experienced and tough. We talked about a lot of things, but one thing he said stuck in my mind. He said, “Dan, you can’t trust anybody but your wife.”

That was a very stark viewpoint, but it wasn’t entirely wrong. Family or other trusted confidantes become an important pillar of your stability because you can really be open with them in a way you can’t quite be with others in an organization, even if you have close allies. It’s important to remember that when you’re in the CEO position, the day will come when you leave that role, but your family and friends will remain.

Second, you need to give yourself quiet time so that you can reflect. For me, that meant thinking about a challenge and running through possible approaches for how to solve it. A rumination process can be productive. I went for long walks with my dogs, for example. This gave me time to think.

Ramesh Srinivasan: You’ve noted that having a diverse set of experiences can help leaders build resilience. Can you share examples of how this works and what it looks like—whether in your own life or in the lives of other leaders you’ve worked with?

Daniel Vasella: Yes, one simple example is working at a multinational company and being able to move around a bit. Living in different cultures with different beliefs and languages tends to open the mind. And even when you come back home, you can discover your own country in new ways.

That’s a company example, but there is also the example of a person being grounded in some topic or industry, knowledge-wise and capability-wise, that gives them a strong foundation for a career. Then they can add onto that various roles, various geographies. You may also become more innovative or creative because you look for alternatives you didn’t think of before.

At the same time, there can be disadvantages. If you move roles or companies a lot, maybe you’re not as expert in one field or at one organization as you might like to be. It’s useful to realize that in any career, it’s not possible to have everything. So you make choices—some planned and some unplanned.

Ramesh Srinivasan: We discuss empathy in our leadership book. Why is it so important for leaders to develop, and how can they use it to drive culture and performance?

Daniel Vasella: Empathy is critical for learning. You also need it in very specific moments. One may be confronted with a colleague who just lost a child or a spouse or who had an accident. These are moments when having the emotional understanding of what is going on in another person’s life will help you address the situation in a much deeper and more supportive way. It’s important to just be human.

Some people have more empathy. I tend to believe these people have suffered more in life or have had experiences of suffering. They can imagine what goes on inside an organization or, more specifically, inside an individual.

You may have empathy and decide not to act upon it and not to show it because you think it’s not appropriate for various reasons. Or, as has happened to me frequently, you have to give negative news to someone. You can have empathy, and you can imagine how difficult it is for the person, yet you still have to do it. In my previous profession as a doctor, I sometimes had to reveal bad diagnoses to patients. It’s always tough.

In an organizational context, you may have to tell someone their job is being eliminated in a restructuring. You must transmit this information while being attentive to the feelings of that person. At the same time, you can’t lose the capacity to act despite your feelings of empathy. I think for CEOs generally, they should understand that acting with empathy, whether in routine circumstances or in crises, builds connections that can strengthen the organization.

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Ramesh Srinivasan: Let’s talk a little bit about work–life balance. Do you think the workhorse mentality is changing, especially as younger generations move into the workforce?

Daniel Vasella: I believe things have changed to some degree. While younger people all work hard, they often don’t view that as the right way to live their lives. They are much more oriented toward balancing work, life, and life at work.

My experience was very different. Being a physician, there was no question that you worked whenever you were needed. We had a day shift, a night shift, and a workday without pausing. That was a given. And that has changed. At least in Switzerland, the rules of the hospital have changed.

When it comes to my children, they tell me that their lives don’t just consist of work. They want their hobbies. In the beginning, it was a bit difficult for me to understand, to be honest.

My oldest son is going to do a fellowship in reconstructive surgery. And he decided to stop working a few months before taking the new job. When he said he would take a sabbatical, I thought: “A sabbatical? Why?” He replied that it was a unique opportunity between two intense jobs to take some time off. I probably would never have done it, but then I realized it’s totally fine.

I can see that these are positive changes that can help people learn from a different set of circumstances and experiences. It will help them build a sustainable career as people live longer, healthier lives. I think the trend of younger people taking breaks, trying to have work–life balance, looking for different paths are all welcome changes.

Ramesh Srinivasan: What advice do you have for CEOs trying to manage a modern organization with so many demands and stakeholders?

Daniel Vasella: First of all, my advice would be to enjoy it. Being a CEO is the best job you can have. It’s a wonderful job, even with all the challenges and negatives.

My other advice relates to coaching. In the past, coaching was viewed as something that a leader might do if something went wrong. Not anymore. Having productive conversations with someone from outside the company is valuable. I see that at many organizations where the top executives all have coaches.

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This is part of the broader idea of getting help. Leaders may have a yoga instructor or a therapist. These changes reflect how views of leadership are evolving, away from the classic authoritative type of leader to a more collaborative approach. Most recognize that we can use help and support. This shift also supports how Gen Z views leadership, and how it may evolve in the future.

Ramesh Srinivasan: When you talk about taking pleasure in the competition and in the CEO role, is that something that you felt you did from the start of your career? Or did it take a long time to feel that way?

Daniel Vasella: I had that feeling right from the beginning, even in previous positions where I was not CEO.

As head of development, for example, it was fun and challenging to be faster at bringing new products to market. I retained that feeling as I moved up the ranks.

In my CEO coaching now, we develop trusted one-on-one relationships that last months and often years. I see how very talented people take pleasure in most aspects of the job but still have things that bother them. In fact, the biggest challenges are often not about strategy or financial issues. Often it boils down to personal relationships—someone who is difficult on a team, or how and whether to confront someone or not.

Taking pleasure in the job is such an important concept. During the Olympic Games this summer, we saw how the American gymnast Simone Biles worked through challenges. Facing and overcoming obstacles must make the medals so much more satisfying.

For CEOs, what drives satisfaction? What makes them want to stay in the role and improve their organizations? These are essential questions. I would say the answer is a mix of elements we’ve discussed: articulating a common purpose around which the organization can rally, understanding yourself and what motivates you so that you can understand how to lead others, relying on family, friends, colleagues, and coaches for their views and support, being empathetic toward others, and asking for help when you need it. And finally, knowing that sometimes you will lose. But if you never lose, the game wouldn’t be as interesting, right?