Footsteps3

f 1 1
I' . •
' IN THE FOOTSTEPS OF.
1 · OUR FOUNDE:RS . · .•. 1.
. . . .
I
Nii Meheu O Nii Ali 'i
.....· .. ·. . Reflections. on the Value; of ..· . ' ... II-
King Kamehamfha N and Queen Emma ·· ·_
By KENNETH F. ·BROWN ·
I
Ii ·
THE QUEEN'S ..
~~HEALTH SYSlEMS

IN THE FOOTSTEPS OF
OUR FOUNDERS
Na Meheu O Na Ali'i
Reflections on the Values of
King Kamehameha IV and Queen Emma
BY KENNETH F. BROWN
•
.
,<
THE QUEEN'S
HEALTH SYSTEMS
Edited by George S.H. Kanahele
Copyright ©1996
The Queen's Health Systems

2

Introduction by
Kenneth F. Brown ................................................................ 4
Biography of Queen Emma ................................................. 6
Biography of King Kamehameha IY. ................................. 12
Statements of Founders' Values & Reflections ................... 16
3

Kenneth F. Brown
Chairman of the Board
ver the past few years I have pondered deeply and
discussed at length our values as a hospital and as a growing
health system. Values are the soul of any organization because
they tell us and the world what we stand for. Let no one underestimate
the importance to our success of having a set of clearly
shared values.
In our efforts to identify and clarify our values, I decided to see
what our Founders said about their values and ideals regarding
our mission and vision. I initiated a search among their writings,
such as letters, speeches, journals, and essays, for phrases or sentences
that spoke to our present and future needs and challenges.
With the assistance of Hawaiian scholar George Kanahele, who
is presently writing a biography of Queen Emma, we found
about 40 specific utterances related to values by the King and
Queen. I was impressed, excited and moved.
4

The purpose of this booklet is to share those values and my
own thoughts and interpretations. Although I have taken some
liberties, in most instances I have remained faithful to the text as
well as its context. I have tried to stay consistent with the overall
historical and cultural perspective of the King and Queen.
When talking about values, it is worthwhile noting their
"clustering effect." That is, values are interrelated so that when
you talk about one, it leads you to another and another and so
on. Values, therefore, frequently appear in clusters rather than as
single, independent choices. This explains why, for example, we
can talk about "fairness" and "respect" as well as "trust,"
although the King may have mentioned only "equality."
I hope that the values and thoughts expressed here will inspire
you to make them integral parts of your work. Indeed, many of
you are already doing this as reflected, for example, in our
Lokomaika'i Philosophy stressing the inner health for our
patients and caregivers in a healing environment. I believe our
Founders would be pleased. Again, my desire is to help us better
understand and fulfill our individual and collective goals and
aspirations as caregivers.
Kenneth F. Brown
Chairman of the Board
The Queen's Health Systems
5

6

Queen Emma was born in Honolulu on January 2, 1836, in a
home just below what is now the Catholic Diocese Office on the
Fort Street Mall.
Emma's mother was Fanny Kekelaokalani Young, the daughter of
John Young, haole counselor for Kamehameha I, and
Ka'oana'eha, Kamehameha's niece. Her father was high chief
George Nae'a.
The little chiefess had apparently been promised before her birth
to her mother's sister, Grace Kamaiku'i Rooke and her husband,
Dr. T.C.B. Rooke. An Englishman, Dr. Rooke had arrived in
Honolulu on a whaling ship in 1830, barely 24 years of age. A
skilled surgeon, he was serving as the court physician when
Emma was born.
Unable to have children of their own, the Rookes adopted
Emma. It is said that Grace loved the infant the first time she
saw her on the day she was born.
Rooke doted over Emma, a small but pretty child, with delicate
features and fair complexion. She was, after all, one quarter
haole. Growing up she was bright, sensitive, and fun loving, but
she also had a stubborn streak.
Rooke raised Emma to be very British; her aunt Grace raised her
to be Hawaiian. She grew up speaking Hawaiian and English.
Eventually she came to speak the latter with a "perfect English
accent. ,, 7

Emma's formal education began in 1842, at age 6, when she
entered the Chiefs' Children's School, one of 16 royal students,
including Alexander Liholiho, Lot, Bernice Pauahi, David
Kalakaua, and Lili'uokalani.
In 1849 when Emma was 13, the school was closed. Rooke then
hired an English governess to tutor Emma for about the next
four years.
Dr. Rooke took a major part in her education. He had the
largest private library in Honolulu at the time, and wrote serious
and learned articles on various subjects. Emma's interest in reading
and books was no doubt influenced by her father. She
turned out to be quite an all around woman, with a good knowledge
of the world, conversational skills and an avid interest in
gardening and music.
By the time she was twenty, Emma was "a beautiful and accomplished
girl," "quiet and retiring in manner," but capable of
"thoroughly enjoying the gaieties of youth." She was 5'2", slender,
well-proportioned, with "large, black, beautiful eyes," and a
lovely smile. She was an excellent horse rider, a fine vocalist, a
talented pianist, and a good dancer.
8

On June 19, 1856, she married twenty-two-year-old Alexander
'Iolani Liholiho, or Kamehameha IV, who had ascended the
throne the year before. He had been an admirer of Emma's ever
since their days at the Chiefs' Children's School. Tall, dark and
handsome, he was also intelligent, well-read and fluent in both
English and Hawaiian.
The new Queen quickly became involved in the King's
business-especially that of saving the Hawaiian people from
extinction. In his maiden speech to the legislature, the King
made an impassioned plea to establish a hospital "to stay the
wasting hand that is destroying our population." The native
population in 1778 when Captain Cook arrived was 350,000.
By this time, it had fallen to approximately 71,000.
On June 19, 1856, she married
twenty-two-year-old Alexander 'Jolani
Liholiho, or Kamehameha N, who had
ascended the throne the year before.
The legislature agreed and passed the necessary legislation to
establish three public hospitals, but the treasury was empty. The
King and Queen decided to go to the public and raise the
money themselves. The government newspaper reported:
"His Majesty, notebook in hand, has been seen in the most frequented
parts of town, soliciting subscriptions to the hospital
for his poor subjects. He accosted people, slipped into their
homes and offices as he happened to pass. Upon foot and in the
rain he has worked many hours a day to accomplish his selfimposed
mission."
9

The Queen also went from house to house, and within a little
over a month, the King and Queen had raised $13,530, exceeding
their goal by $8,000.
On May 24, 1859, the King and his cabinet met and decided to
give the new hospital a name. It was named after the Queen
without whose efforts the hospital could not have been established
at the time.
On May 20, 1858, the Queen gave birth to a son, Albert
Edward Kauikeaouli Leiopapa a Kamehameha. With an heir to
perpetuate the Kamehameha dynasty, both King and subjects
rejoiced. But four years later, the boy died suddenly. Fifteen
months after that, on November 30, 1863, weakened by chronic
asthma and a broken heart, King Kamehameha IV died. He was
only twenty-nine.
The saddened Queen took on a new name after the deaths of
her son and husband. She was henceforth known as
Kaleleonalani which means "The flight of the heavenly chiefs."
10
The Queen also went from house to
house, and within a little over a month,
the King and Queen had raised
$13,530, exceeding their goal by
$8,000.

Her remorse, however, seemed
to only strengthen Emma's
humanitarian efforts. She
helped to organize the District
Visiting Society, composed of
ladies who volunteered to aid
the sick and the poor.
Though she was dedicated to
health care, she was also keenly interested in the welfare and
education of young people. She adopted numerous children. She
helped to found and support two schools, St. Cross in Lahaina
and St. Andrew's Priory. She was also devoted to the Anglican
Church and went to England to raise the funds ($30,000) for
the construction of St. Andrew's Cathedral.
When King Lunalilo died in 1874, she became a candidate for
the throne. Lunalilo had wanted her to succeed him, but he
failed to make the legal pronouncement before he died. Had he
done so, she would have reigned as Queen. Instead, an election
for a new sovereign was held. She campaigned actively and colorfully
with campaign songs and chants. Although she believed she
had a chance to win, she was defeated at the hands of the legislature
which selected David Kalakaua. Her followers rioted and
stormed the assembly hall wounding several legislators.
Emma died on April 24, 1885 at age forty-nine. She was given a
royal funeral and was laid to rest in Mauna 'Ala beside her husband
and little son.
She left the bulk of her estate in trust for the hospital. Today the
estate consists of 13,000 acres, 10,000 of which are on the island
ofHawai'i and the rest on O'ahu including some valuable land
in the heart ofWaikilci.
11

12

Alexander Liholiho 'lolani was born on February 9, 1834, the
fourth child of Kina'u and Mataio Kekuana'o'a. At the time, his
mother Kina'u was Queen Regent or kuhina nui and his high
chief father was Governor of the Island of O' ahu. An imposing
figure at six feet and weighing several hundred pounds, his
mother was the daughter of Kamehameha the Great.
He attended the Chiefs' Children's School and was described as
"one of the best scholars and promises to be an active and capable
man. His natural perceptions are quick, and he has a vigorous
inquiring mind that seeks to know the why and wherefore,
seeking to understand the reason of things." He was a voracious
reader and an excellent writer and speaker in Hawaiian and
English. In 1849 he and his brother Prince Lot accompanied
Dr. Gerritt P. Judd to Europe and Washington D.C. on a diplomatic
mission representing the Kingdom of Hawai'i. In Paris
they met Napoleon and in England Lord Palmerston and Prince
Albert (husband of Queen Victoria). The two brothers made an
excellent impression on European society, but a somewhat different
impression on Dr. Judd who constantly lectured them on
~eir late night card playing, dancing and drinking.
13

It is said that he behaved like ''an
English gentleman of aristocratic
birth" and adopted ''a similar sryle of
grooming and dress. "
Of course Alexander did some constructive things in Paris, such
as studying French. He wrote in his journal: "I hope we shall be
able, before we go away, to speak French ... It is a sweet language."
In December of 1854 Kamehameha III died, clearing the way
for his adopted son and only heir, to assume the throne as
Kamehameha IV
Only twenty, the new King was tall, slender and athletic. He had
a high forehead (greatly favored by Hawaiians), a "delightful"
smile, and "lively, intelligent eyes."
It is said that he behaved like "an English gentleman of aristocratic
birth" and adopted "a similar style of grooming and dress."
He was easy and informal with ordinary people, but, as with all
ali'i, kept them at a "definite distance."
By 1856 he had decided to "reform his conduct," "take care of
his already threatened and uncertain health," settle down and get
·married.
His marriage to Emma Rooke was welcomed by some, but criticized
by others partly because of his and his wife's pro-British
feelings. They were not anti-American, but they were fearful of
American power and especially annexation.
14

The King and Queen were great favorites in Honolulu society.
They entertained grandly and frequently. They gave musicals and
operas in which they participated as singers or actors.
He enjoyed horseback riding and excelled at cricket. He preferred
popular English writers such as Tennyson and Thackery
and was "forever quoting Shakespeare." He also knew the Bible
well and translated the Anglican Prayer Book into Hawaiian.
Yet, for all his brilliance and gifts, his character was somewhat
contradictory. He could be "intellectual and logical and he also
could be highly emotional and thrown into deep fits of melancholy."
The death of his four-year-old son shattered him completely. He
never recovered from the blow. After years of suffering from
nerve disorders and asthma, he died unexpectedly on November
30, 1863, in the arms of his wife and his father.
15

16

1. CARING FOR THE SICK
"Let me remind you that so
long as sickness shall exist there
will be a duty imposed upon us. "
(1860)
Kamehameha IV spoke these words at the laying of the hospital
cornerstone on July 17, 1860. Our "duty'' is and always will be
caring for the sick. We are all caregivers.
2. OUR BROTHER'S KEEPER
"The destitute and the sick
are our brothers and sisters. "
(1860)
Just as we care deeply for our brothers and sisters so must we
c·are for the sick and the poor. We are their keepers.
17

3. OPEN HEARTS
'Wever close your doors on
the hungry through sickness, misfortune
or wrongs received by
others." (1860)
We must open our hearts to all who come to us. The King
reminds us again of our role as caregivers-all of us whether or
not we come in contact with a thousand patients or none at all.
Think of it this way: if we're not caring for a patient directly,
we're caring for someone who is.
4. VISITING THE SICK
"Be always ready to note any
sickness in the family you are visiting
and offer help for any and
all of their needs. "
The Queen spoke these words to the female volunteer members
of the District Visiting Society which she had established, but
they could 'well apply to all of us.
18

5. OUR OBLIGATION AS DESCENDANTS TO
THE PAST AND FUTURE
"They have always kept their
stations high as well as renown
and it becomes us their descendants
to do likewise." {1874)
The Queen was reminding her first cousin Albert Kunuiakea of
his obligation to honor the legacy of accomplishment left by
their ancestors. (Note the Hawaiian term for obligation is 'ai'e
meaning to owe a debt to, especially to benefactors. It connotes
not only a sense of being responsible but a sense of appreciation.)
Queen Emma could just as well be talking to us, for as employees
we are all heirs to her legacy and hence, have an obligation to
honor and protect it. But it is not only to the Queen that we
have an obligation. We also have an obligation to honor the
good work of those who have come before us.
After all, we bring nothing into this world; everything is all here
for us when we arrive. As a Maori elder put it, we all stand on
the shoulders of someone else-we are the mere beneficiaries of
our predecessors.
In this chain of obligations, we also have an opportunity to pass
on our work to those who come after us better than when we
received it. Or as the Queen so eloquently put it, each of us
must "add another laurel to our ancestral tree."
19

6. UPWARD AND ONWARD
':Albert, you and I are
descended from a line of ancestors,
the men and women of which
have acted their parts well and
shown that upward and onward
was evidently the motto they acted
on, as their illustrious deeds tell. "
(1874)
"Upward and onward!" Imua! is the common Hawaiian expression
meaning moving forward not only quantitatively but qualitatively
as well-always striving to be better. The same idea is
expressed by the Japanese term kaizen or continuously improving.
What the Queen was trying to persuade Cousin Albert to
act upon was the long tradition of excellence which enabled their
ancestors to succeed. This theme of excelling occurs again and
again in her writings. So, our modern day concern for things like
quality assurance is totally consistent with the Queen's views on
the matter.
20

7. OUTRUN THEM ALWAYS
"Surpass them in all things,
regard their movements and outrun
them always.-" (1873)
The Queen does not mince words when it comes to how we
should treat our adversaries. We must "surpass them in all
things." How do we do that? For one thing, we need to "regard
their movements," that is, observe and study their habits, techniques,
activities, strengths and weaknesses. The more we know
about our adversaries, the better we can deal with them.
8. BE AMBITIOUS AND BOLD
"Be ambitious and bold to
hold our ancestral renown ever in
its place high." (1874)
The Queen gives us more frank advice on how to deal with
our adversaries. We must be "ambitious and bold" in holding
on to our "ancestral renown"-our reputations, our positions
of accomplishment and leadership. This means being deeply
committed, working hard and smart, taking on new initiatives
and risks, being creative, having the courage to make mistakes
and accepting the consequences of our actions. It is worth noting
that while the Queen never apologizes for being ambitious,
she warns against flaunting ambition, bragging or being arrogant.
21

9. HUMILITY
"Be cautious how you brag or
it may end the contrary-as you
[bragged} once to them, [when
they were in poverty and
degradation}. [It} looks at present
as if these words have returned
upon us instead of them. The
reason of it is that you did not
determine that what you predicted
then should be carried out by
yourself .. " (I 873)
It is interesting that the Queen did not tell Peter Ka'eo, her
favorite cousin who was a leper at Kalaupapa, to stop bragging,
but merely warned him about how much he was bragging. And
if he had to brag, he should have made sure he was able to deliver.
In this instance, he bragged too much, as his words came
back to hurt him as well as the Queen.
22

She knew how difficult it was for chiefs to suppress their egos,
and may have made a little allowance for Peter. But importantly,
she made no allowance for herself. She never indulged in boasting,
showboating or self-glorifying ego trips.
What Peter, if not all chiefs, needed to learn was how to "remain
among the dumps of grasses without elevating themselves" ("E
noho iho i ke o'pii weuweu, mai ho'oki'eki'e"), that is, humility.
A similar injunction that all modern leaders should learn is that
"Ku'ia ka hele a ka na'au ha'aha'a," "A humble person walks carefully
so he will not hurt those about him." Leaders who walk
carefully inspire the respect and allegiance of their people.
10. ON BEING MAGNANIMOUS
'1 want our side to be above
smallness of character, such as vulgar
joviality over an enemy's foll. "
(1876)
This is one of the few passages of counsel in which the Queen
speaks in the first person "I". To paraphrase the Queen, "When
we win a fight, I don't want any of us to gloat, taunt, ridicule or
otherwise make fun of a competitor's defeat. It's small and vulgar
... " She could have added "dangerous" because a humiliated
loser may remain an implacable enemy. All things being equal, at
this point the best course of action would be to reach out and
turn him or her into a friend. Sometimes erstwhile foes make
fine allies.
23

11. NO ROOM FOR INCOMPETENTS
''Let not inferiors step into
our places." (1874)
If we are committed to outstanding performance, to surpassing
our adversaries in all things, we cannot accept incompetence or
incompetents. We have zero tolerance for inferior work or inferior
performers. At first glance, this may seem a harsh judgement,
but modern healthcare demands the highest levels of competence
and performance from each of us.
12. PRACTICE MAKES PERFECT
''Now practice makes perfect.
He has done the practicing and it
is to be inferred [that he} will be
perfect consequent on it. " ( 18 73)
There was no love lost between Queen
Emma and King David Kalakaua who were
rivals for the throne following the death of
King Lunalilo. Nonetheless, the Queen
admired his persistent efforts to improve
himself in ·speaking and writing which
occasioned her comment about practice
making one perfect.
24

In fact, it was one of her favorite sayings, as she wrote to Peter
Ka'eo, at Kalaupapa: "Practice is the only way to make perfect
anything."
The word "practice" means to perform' or work at repeatedly so
as to become proficient. This is precisely what the Queen meant.
Only through systematic application can we physicians, nurses,
technicians, transporters, custodians, and so on retain our levels
of competency and care.
13. PERSEVERANCE
The Queen admired David Kalakaua for his persistence
and perseverance as we see in the two excerpts below:
"With Taffy's [Kalakaua's}
faults we must give him credit for
a great ambition ... he has exerted
himself, tried ways and means to
secure his coveted object, the
Throne. All these efforts too are
made against strong dislike from
the whole country, who are unanimous
against him. Still he has
riot faltered, but keeps on trying
for the end. This is a good point
25

in him which we must copy. He is
not idle." (I 873)
And:
"So you see that D. K [David
Kalakaua} has developed a great
many points of character all
through keeping on to speak at
meetings, etc., and in company
till now he actually leads. To be
sure, he is not all we want, still he
has made his name by his own
determined effort." (I 876)
Few of us ever achieve anything worthwhile without having to
persevere in the face of some obstacle or challenge. Regardless of
the odds, we go on. Without this quality of stick-to-it-iveness,
how many of us would be where we are today?
If practice :makes perfect, it is perseverance coupled with discipline
that enables practice. The Queen speaks of it as "determined
effort", the kind displayed by Kalakaua. Talent and brains
can get you far, but perseverance will get you there. As Aesop's
tortoise proved to the hare, perseverance can make up for all
sorts of disadvantages. We must persist in the right direction, no
matter how arduous the way.
26

When you need to be reminded of perseverance, persistence, or
determination, think of these three little words: Try, try again.
'Tis a lesson you should heed,
Try, try again.
If at first you don't succeed,
Try, try again.
Then your courage should appear,
For, if you will persevere,
You will conquer, never fear,
Try, try again.
14. DON'T GIVE UP
"Never despond or slacken
"Excelcior" be our motto." (1873)
In her lifetime the Queen endured many of "the slings and
arrows of outrageous fortune." The key to the Queen's
endurance was not surrendering to despondency. She refused to
give in to discouragement, to let disappointment get the upper
hand. This is not to say she did not have her moments of sadness,
but she never allowed herself to wallow in the mire of selfpity.
She hung tough.
She could have slackened or given up when her four-year-old
son died followed by the death of her husband fifteen months
later; she could have slackened after her loss to David Kalakaua
in the election of 1874; she could have slackened when her ali'i
rivals repudiated her genealogy and heaped shame upon her
name; she could have slackened when Parliament failed to provide
the funds to build the hospital; she could have slackened in
27

the face of missionary opposition to her support of the Anglican
church; she could have slackened in her fight to secure her claim
to the lands in Waikiki. Had she done so, many of us would not
be here.
When you are in a "valley of despair," recall these lines from the
poem:
When things go wrong, as they sometimes will,
When the road you're trudging seems all uphill,
When the fonds are low and the debts are high,
And you want to smile, but you have to sigh,
When care is pressing you down a bit,
Rest! if you must but never quit.
(From the poem "You Mustn't Quit.'')
Yet let us remember to have the wisdom to know when to quit
and cut our losses.
15. ACCEPTANCE
"We must teach ourselves not
to grumble at what is ordained
for us although it be ~ontrary to
one's desires." (1860)
We live in a world of finite resources, of definite limits, what
economists describe as scarcity. Hence, we can't always have
everything we want. The Queen says don't cry about it. It serves
no good purpose to grumble and complain about what we can't
have.
28

There is a classic Hawaiian solution to the dilemma of scarcity:
limit our desires. "E'ai i ka mea i loa'a," "What you have, eat." -
In other words, be satisfied with what you have.
On the other hand, the Queen did not mean that we should
automatically resign ourselves to our fate. We know this because
her entire life was devoted to changing unacceptable conditions.
So, accept the hand that you have been dealt, but play it as best
as you can.
16. LMNG WITHIN OUR MEANS
In 1876 Queen Emma had petitioned the court that some suitable
person be appointed guardian to her cousin Albert
Kiiniiiakea, "as he is a spendthrift." As one of his nearest surviving
relatives, she was appointed his guardian. She tried to curb
his wasteful spending.
'1 had for two months made
him live on the $30 food, clothing,
and squander money in it all
[but} he could not endure it ... "
(1876)
Try as she did, however, she could not control his improvidence
nor his drinking and other excesses.
29

The Queen also strongly criticized the "spendthrift" and extravagant
habits of King Kalakaua, as did many others. She called his
actions "irresponsible".
Given the Queen's views on spendthrifts, she might say to us
• be frugal and economical
• husband your resources
• save for a rainy day
• control your expenditures and costs
None of this implies, of course, that we have to be tightfisted
and stingy. The Queen was known for her generosity, not her
stinginess. But there is a balance that we must maintain between
being penny wise and pound foolish.
30
17. SPEAKAND ACT WITH AUTHORITY
"Speak and act with weight
or authority ... Speak often either
to few or many so that by frequent
practice it grows to a habit. Thus
you perfect yourself to public
speaking besides accomplishing
one end, which is bringing those
people to look to and lean on you
as the {prime} mover in all
things." (1874)

The Queen had much to say about leadership, but what she
makes very plain here is that if you're a leader, talk and act with
authority, take command, set the course, lead the way. That presumes,
of course that you know the way, that you have a clear
vision of where you are going.
The Queen's emphasis on being a good public speaker is understandable,
for in pre-electronic times (and in a Polynesian culture
which esteemed oratory) public speaking was the most effective
way to communicate. It is still an effective way, but nowadays
there are many more ways to convey our intentions. Today, good
leaders must be good communicators since most leaders spend
nearly 70 percent of their time communicating. Ultimately, what
leaders must be able to do is to articulate their vision clearly,
convincingly, and meaningfully. If you can do that, to quote the
the Queen, t_hen people will "look to you and lean on you as the
[prime] mover in all things." (1874)
18. KNOWLEDGE IS POWER
The King took a deep interest in Oahu College (Punahou) and
once expressed the hope that the school's influence would be
such that
"Everyone in Hawaii will
know that 'knowledge is power: "
If not Oahu College, the King could have said the same of any
school, institution, program or process dedicated to learning.
The phrase may be an overused cliche, but when he said it he
meant it. And the best evidence of that was his own example.
(See his biography.)
31

19. READING, WRITING AND SPEAKING
The Queen, of course, was as interested in the pursuit of knowledge
as the King. She made some pertinent observations on tools
we use in seeking knowledge, namely reading, writing and speaking.
The Queen enjoyed reading, for as a child she learned to read
from her scholarly father, Dr. Rooke, who owned the largest private
library in mid-19th century Honolulu.
"Reading aloud to oneself is
more improving than you think.
Interesting subjects or passages I
read slowly and sometimes almost
act them." (1873)
The Queen also enjoyed writing as evidenced by her voluminous
correspondence and journals. One of the habits she urged Peter
Ka'eo to cultivate was writing. She once asked him:
"Do you keep a notebook or
journal? If so you will find it will
give pleasure in after days to look
back over them and see how time
32

has been spent, whether idled or
some good to others. People, incidents
and facts forgotten will all
be there fresh for you to laugh or
be vexed over. It keeps one in the
habit of writing and you know
practice makes perfect." (1873)
We know how Queen Emma felt about public speaking, but she
also approved of debating. She writes:
"To enter into an argument is
sometimes instructing, as it sharpens
one's thoughts on the subject,
besides getting into .the habit of
debating and discussing." (1873)
It is not so important that we read aloud, keep a journal or
debate. What we need to recognize is that reading, writing and
speaking are vital skills that we all need to maintain and improve
upon. Some have stopped trying to improve these skills.
Inevitably this results in slowing down our individual as well as
collective accumulation of knowledge. We must remember that
we are in the knowledge business and that the best investment
we can make is in our brainpower.
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20. PRAYER
''Do not miss praying, asking
and conversing with our dear
Lord for all things. " (187 4)
Both the King and Queen believed in the power of prayer in
seeking knowledge and understanding, guidance and direction,
forgiveness and resolution, and in healing. The Queen urged
Peter to "Never allow a day to pass without" praying. She didn't
particularly care how he prayed, silently or aloud "even only an
'Our Father who art in Heaven, etc." What was important was
to approach life with a sense of holiness recognizing that we are
not alone and that there is a power beyond us.
Some of us may not believe in God or in prayer; indeed, there is
nothing in the Founding Charter that says we must. Although
she was a devoted Christian, so far as we know the Queen never
tried to force her faith on the hospital or any of its attending
physicians, nurses or patients. Queen Emma once confessed she
could not point to anyone she had converted:
"Unto man [or woman}
much has been given in the way
of p~sition, influence, and opportunity,
and yet no convert have I
made nor benefited him [in] any
,,
way.
34

For those who are interested in the subject of prayer and healing,
however, read Dr. Larry Dossey's scientific study Healing Wordr,
The Power of Prayer and The Practice of Medicine. ( 1993)
21. A POLICY OF LOVE
"Contributions towards the
support of a HOSPITAL, are declarations
of kindness aforethought,
and of a long sighted policy of
love towards those who need other
hands than their own to smooth
their restless pillows." (1860)
Mauna 'Ala (Royal Mausoleum)
35

The King uttered these moving words at the laying of the cornerstone
of the hospital. Whether he intended to say that love
was to be the policy of the hospital or that love was a necessary
condition for healing is not clear, but we know that love and
healing are inseparable.
Throughout history tender loving care has uniformly been recognized
as a critical element in healing. In fact, a survey of 10,000
men with heart disease published in The American journal of
Medicine found close to a 50 percent reduction in frequency of
angina in those who perceived their wives as supportive and loving.
We are told that virtually all healers who use faith and prayer
agree: love is the power that makes it possible for them to reach
out to heal even at a distance.
Dr. Bernie Siegel (Love, Medicine & Miracles) states: "I feel that
all disease is ultimately related to a lack of love ... I also feel that
all healing is related to the ability to give and accept unconditional
love.
"I am convinced that unconditional love is the most powerful
known stimulant of the immune system. If I told patients to
raise their blood levels of immune globulins or killer T cells, no
one would know how. But if I can teach them to love themselves
and others fully, the same changes happen automatically ..."
From the patients' side, reputable customer satisfaction surveys
tell us that by far the most important thing is a caring, compassionate
hospital staff and physician ( The Healthcare Customer
Service Revolution, 1996).
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22. ACTS OF KINDNESS
""We on our parts must not
forget to show . . . loving kindness
zn all ways." (1873)
The Queen reminds us that in our frenetically paced lives we
often forget to be kind. Is it because we don't want to be? Is it
because we don't have the time? Is it because it interferes in
doing our work? Or is it because we don't know how to be kind?
Whatever the reasons, seeds of kindness are sown in all of us. So
the issue is not about whether we can be kind, but whether we
want to be. As caregivers, we may not have a choice. To be an
unkind caregiver is an oxymoron, a contradiction in terms.
Not surprisingly, we do countless acts of kindness in our work,
but far more for our patients than for each other. It doesn't seem
right, does it? Let us begin by doing more of the little things like
saying hello, inquiring after one another's health, acknowledging
a favor, calling each other by name, holding a door open, or just
greeting someone with a smile and aloha. These are ordinary acts
of kindness that could return extraordinary dividends in morale,
teamwork, productivity and efficiency.
23. ENCOURAGE THE WORTHY
'1ndeed encourage all who
deserve praise." (1873)
37

The Queen touches on an important but complex subject of
leadership: recognition and rewards. She may not have been an
expert on the subject, but in this one proffered counsel she had
it right. The experts say that for a reward to have maximum
effectiveness, it must be contingent upon the behavior of the
employee. As in the Queen's example, leaders should encourage
or praise only when deserved. (Charles C. Manz & Henry P.
Sims, Jr., Super Leadership, 1989).
This is easier said than done. Surveys (even at Queen's) show
that many employees feel they are not adequately rewarded
(whatever form that may take), or when rewarded, the rewards
do not really match their performance.
Part of the trick is to catch people doing the right things. For
leaders, this requires being sensitive and alert, open and generous,
willing to share the credit and the applause, and making a
commitment to helping people maximize their potential.
24. LAZINESS
"Never help those who are too
lazy to help themselves. "
No one would dispute the King on the merits of this statement.
But what should we do with such people? He might have called
them, as Hawaiians of old would, kuki'i persons as inactive as a
wooden image, or, worse yet, 'ae'a hauka'e, figuratively defiled
persons, and dismissed them.
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25. BEING ACTIVELY INVOLVED
The Queen quotes the following from an article in the Honolulu
Advertiser: ''.All successful leaders in the world's history have been
aggressive rather than passive. Passive inactivity is not virtue."
Then she says:
'1t keeps people nobodies, neither
felt nor missed in the community.
Therefore, we should see
that our characters do not become
quiet stagnant ponds by constant
retirement and inactivity, mistaking
such for proper reserve. "
(1873)
If we want to be leaders, according to the Queen, we must be
actively involved not only in our work but in our communities.
If we are not, we are just plain "nobodies, neither felt nor
missed." What a frightening thought! How many nobodies do
we have at Queen's? How many "quiet stagnant ponds" in our
midst?
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26. WE ARE ALL EQUAL
"Society makes distinctions
broad enough, but strip us of our
artificial robes, and we are one
and all equally naked and
equally exposed to the keen winds
of want and the torment of
disease." (1860)
On the surface, the King is saying we are all equal because we all
get sick, but at a deeper level, he is also saying that we are all
equal in terms of our essential humanity. Though society "makes
distinctions broad enough," we must respect the dignity of each
human being. Hence, we must be fair and just in the way we
treat each other, e.g., in applying the rules or sharing rewards in
a department. Since we are not all equal in talent, knowledge or
experience, to be fair also means that we respect each other's differences
and that we recognize that what may be the right
approach for one person may not be right for another. Equality,
dignity, fairness, and respect: these are the building blocks of
trust.
40

27 INTOLERANCE
'1 am disappointed at the
Americans. They have no
manners, no politeness, not even
common civilities to a Stranger. "
(1850)
These critical observations by the King are from an entry in
his published journal describing how he was treated by the conductor
of a train which he was riding en route to Washington
D.C. on a diplomatic mission with his brother Lot and Dr.
Judd. He was· asked to leave his seat by the conductor who, in
the King's words,
"probably [had] taken me for
somebody's servant, just because I
had a darker skin than he had.
Confounded fool. "
"The first time that I ever
received such treatment, not in
England or France, or anywhere ,
41

else. But in this country I must be
treated like a dog to go & come at
an American bidding. "
Only 15 years old at the time, the experience affected his entire
life. It shaped not only his social and political views toward
America but his own values and norms.
Needless to say, neither he nor the Queen would ever condone
intolerance of any kind.
28. MURPHY'S LAW
'1t is always the case, unless I
see to every article myself things
always go wrong." (1876)
Let's not rush to fault the Queen for saying something we have
all been guilty of: thinking no one can do it better than we can
(the so called ''I'm indispensable" syndrome). We cope with this
partly by learning how to delegate to others.
Instead, let's consider the Queen's point that "things always go
wrong" or what we might call today "Murphy's Law." We laugh
at the latest versions of Murphy's Law, e.g., if anything can go
wrong, it will at the worst possible time. None of us are blind to
the crazy and absurd things that go on in organizational life. Try
as we may to control things, we know that organizations are
often intractable, unpredictable, turbulent, and filled with paradoxes
which defy simplistic solutions or explanations. Perhaps
42

we should not be too hard on our managers and supervisors who
have to help us make sense out of the natural chaos that we live
and work in.
29. LOVE OF GOD AND NATURE
~ Love of Nature and animals
shows an elevated [mind}
that appreciates beauty in everything
God has made-the dashing
waves,_ rosy pink clouds, black
majestic mountains and
rocks-all inspire us with the
immensity of power that is possessed
by the one God who has
made all of them-even the little
troublesome flea, giving it laws to
live by, the flea that has such [a}
wonderfully sharp sense of smell
and so on through all the minute
43

atoms of life and lifeless things
that make up this world of ours. "
(1873)
According to the Queen, our love and compassion as caregivers
should extend to all nature and living things that manifest the
Creator.
30. DEALING WITH THE MYSTERY OF DEATH
'1n my dreams last night Alex
came to me but looking so ill
and poorly. He was very gentle
and tender and oh it was [as} if
of yore. Alas, I woke to lose his
presence ... Oh God's ways are mysterious
and I must bear his
J ,,
aecree ...
44

'1 am found under the shady
koa of this place where the three
of us dwelled. Then there were
two of us, and now only I
remain behind. But it is not for
us to question God's ways."
Queen Emma must have asked the question many times: why
did her son and then her husband have to die? In these poignant
passages from two separate letters the Queen wrote to her attendant,
Keli'imoewai on Kaua'i, she reveals her coping strategy: it's
a mystery, hence, there is no answer. Accept it and place your
faith in a merciful God. Hopefully, every caregiver who works
with the dying will find his or her own answers.
31. KNOWING AND PRESERVING OUR
HISTORY
"Become acquainted with
ancient songs, their origin, object,
composers, effects-also the history
of different events and ceremonies
why one should be and others not
for that is the way our Island his~
tory has been preserved." (J 873)
45

While the Queen is talking about the importance of knowing
our Island history, the same could be said about knowing our
own history at Queen's. But knowing our history is not enough:
we have to retrieve it, record it, collect it, preserve it. We have
much to preserve-wonderful, moving, dramatic and ~emorable
stories to tell of great and heroic physicians, nurses and other
caregivers. We also have some lessons, both uplifting and
painful, to learn. Let it not be said of us that the only thing we
learn from history is that we do not learn.
32. STAY THE WASTING HAND
"Our first and great duty is
that of self preservation. Our acts
are in vain unless we can stay the
wasting hand that is destroying
our people." (1855)
The King uttered these words in his maiden speech to
Parliament in April, 1855 in which he called for the establishment
of "public Hospitals" in order to stop "the decrease of our
[native Hawaiian] population." From 350,000 in 1778, when
Captain Cook arrived, the number of Hawaiians had dropped to
71,000 by 1855. Manley Hopkins, friend of the King and
Queen, predicted that if the decline were not arrested, Hawaiians
would follow the Dodo bird to extinction "within the term of
46

our generation." It didn't happen that fast; it just took a little
longer. At present there are less than 5,000 full-blooded
Hawaiians left.
Of course, no hospital could have prevented the depopulation of
the Hawaiian people, but as a total healthcare system today we
at Queen's can and must do everything in our power to ensure
that the descendants of our Founders can live longer and healthier
lives. This must certainly be part of our first and last "great
duty."
47

33.ALOHA
Aloha nui loa.
The Queen described the phrase as "our most expressive native
greeting." It is also our way of saying goodbye. In either case, it
literally means "I love you much." Both the King and Queen
used it liberally in their daily contact with family, friends and
strangers.
So, aloha nui loa to you all.
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..
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' ~E ~£EN'S · .
~ HEALTH SYSTEMS
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