Calm saving lives, paralyzed by a pasta recipe: ADHD and executive function (Jim Leitch’s story)

Jim Leitch could intubate a patient in the middle of the night — alone, short-staffed, smiling — and feel completely calm. Ask him to follow a pasta recipe? That’s where things got hard: Everyday tasks and executive function challenges.

Jim is a former critical care respiratory therapist and current VP who was diagnosed with ADHD as an adult. In this episode, he talks about the exhausting gap between knowing where you want to go and not being able to get started, growing up with perfectionism and a fear of mistakes, and how he quietly created pressure-cooker situations just to get things done. Also: a Christmas pageant in second grade that left a mark he’s never forgotten.

• Listen: ADHD and the fear of failure

• Read: ADHD and perfectionism

• Watch: Executive dysfunction explained: Why ADHD makes everything so hard

Jim Leitch: I was literally the only person in the hospital that could intubate this patient, so I had to be able to do it. You'd think with that stress, everything that's going on and the emotions behind it, that that would have been challenging, but if you'd have taken my blood pressure at that point or my heart rate, it would have been the lowest it had been all day.

I was the calmest in those situations, and I really couldn't figure out why, to the point where a friend of mine who was a nurse, who commented at the end of one of these situations, "Jim, why are you smiling?"

Laura Key: Hi everyone and welcome back to "ADHD Aha," the show where people share the moment when it finally clicked that they have ADHD. One of the things that has always fascinated me about ADHD is how for so many of us, because of our executive functioning difficulties, everyday basic tasks can stress us out so much.

But at the same time, when we get into emergency situations, we can feel so calm, cool, collected, as if we're in like this Zen flow state. Well, my guest today is Jim Leitch. He's a former critical care respiratory therapist, and he understands this dichotomy so well. Jim, welcome to the show. Thank you for being here, and thank you for writing in.

Jim: Thanks so much for having me. This is a real pleasure. This is exciting for me. I've been a longtime listener.

Laura: Tell me when were you diagnosed with ADHD and what was going on?

Jim: It was actually a bit of a slow burn. I had viral meningitis, and there were a lot of follow-up symptoms and things I had to work through, some pain involved as well. So I saw a psychologist to sort of better deal with that.

And then through that, I sort of rolled into my ADHD diagnosis. I always knew there was something going on with me and the way I sort of approach things, but I think that was when it really hit home is when the psychologist was asking me lots of questions and it was all litany of things that goes, "This is starting to paint a picture."

Laura: Interesting. Give me an example of some of the questions that were starting to paint that picture for you.

Jim: A lot of it was around the pressure I put on myself, even in that time to try to get back to work quicker than I really had to. So a lot of the questions were around what was driving that — this sort of perfectionist attitude that I seemed to carry all the time — kind of an anxious energy towards everything that I was trying to do.

And then on the other side of that, it was this executive functioning challenges that I was dealing with. I was really good in an emergency situation or if something kind of came at me and I could react to it, I was fantastic. But trying to work through like a pasta recipe was like almost paralysis — it was like moving through molasses, I would say. Everything took...

Laura: Did you say a pasta recipe?

Jim: A pasta recipe or I was going to say making toast or something, but I think I could actually do that. But pasta, just sort of anything with steps, there was a good chance where I couldn't figure out where I'm starting, how am I going to get to the end, which I didn't deal with on the emergency side.

Laura: Yeah. And I think the analogy you used was it felt like walking through molasses.

Jim: That was the best way to explain it because everything just seemed to be heavier, harder. I was kind of dragging my ideas along with me, but I could never quite get to where I wanted to go. And I just didn't have a name for it. Kind of through my whole life, that was sort of the challenge is how am I going to get to where I want to go by kind of dragging myself?

Laura: Do you have another example of how in your life this walking through molasses was affecting you?

Jim: Yeah, I mean, I think it kind of held me back from a lot of the things that I wanted to do because I just couldn't sort of properly plan for it. Anything that I had to kind of look into the future to achieve seemed to sort of be the biggest challenge where I didn't know how to get started. I knew where I wanted to go, I knew that I had sort of maybe the creativity to do it or the ability to do it, but I just could never quite get there.

A perfect example actually is leadership in general and kind of where I find myself today. I finally got there after sort of a lot of the support that I've gotten, but I looked at it like, "Okay, this is a monumental shift from being a sales rep or working for a medical company in the past being a respiratory therapist. Now I'm supposed to lead a team of people. How am I going to do that? How am I going to organize myself around that? How am I going to get back to people on email in time? How are people going to rely on me when I feel like I can't rely on myself?"

So a lot of self-doubt sort of carrying me into this sort of idea of I don't know that I could do the day-to-day. I could think my way through it, the thoughts were there, the ideas were there. I wasn't sure that I actually could deliver. That was one of the things throughout my life is if I can't deliver on something or if I feel like I'm not going to be the best that there ever was at doing that thing, then I wasn't going to attempt it.

Laura: I do the same thing, Jim. I will mix up the kind of the higher-level, bigger grain-size things with the lower-level grain-size things. Like you said in there, you had in the same sentence, "How am I going to be a reliable leader?" and "How am I going to answer emails every day?"

And I think that that's a perfect encapsulation of how these things can get so jumbled and almost feel like they're all of the same order when they're not really, and I think that's where a lot of us folks with ADHD can get tripped up.

Jim: Well, I think you're right and looking back working at a hospital, I was in situations where they're life or death — like some of the most challenging emotionally for people, but also just to kind of think your way through in a very short period of time where you need to be on right now.

And I actually found that less stressful than trying to figure out how I'm going to plan my way through my email, and to your point that you just made, the email thing was a bigger deal in my head than actually the emergency room from a practicality standpoint.

Laura: With the everyday tasks, the kind of executive function daily grind struggle, had this been a problem for a long time?

Jim: I mean, my whole life. I think my earliest memory of something was in Grade 2 — I was in a Christmas pageant. Each kid had to say a poem. So I was super excited about that and I remember getting my list of words and I memorized my poem, but I also memorized every other kid's poem.

The night of the pageant, I step forward, I start saying my words, and I'm saying the kid besides me's poem. He's elbowing me saying, "That's mine! That's mine!" And I remember going, "Oh no," so I flipped into mine and kind of delivered it in a pretty eloquent fashion if I say so, but I remember hearing the families kind of chuckle and laugh. And I get it now as a parent — it's cute when that sort of thing happens — but I think at the time I was just mortified.

And now looking back, it's like sort of this epitome of an ADHD moment where it wasn't enough to learn my part, I had to learn all of the parts. And then when it came to sort of deliver, I said the wrong one. And it's funny because it was Grade 2, who remembers Grade 2, but I remember that specifically.

Laura: That's exactly what I was just going to say, like those things stick with you because clearly, even when you don't know what's going on, even at that young age, I truly believe those things leave a lasting impression when they are things that you particularly struggle with and they make a deeper groove in your brain — that is not a scientific term, nobody quote me on that.

But I can just picture you as a kid getting so excited and really hyperfocusing on the whole thing and then when it came time to execute your step, just going out of order. But it kind of got me thinking about that kid with ADHD — this is such a common thing for so many kids — they will actually get really excited about a particular subject in school and do all of their homework and do extra work and research, but then when it comes time to hand in the homework, they left it at home, so they get a bad grade, but they did all the work.

(07:16) Early childhood experiences and how Jim’s ADHD manifested in school settings.

Jim: You know, it's one of those things where I remember, I think it was Grade 4 or Grade 3 and they were doing phonics and it was an example where I'm reading at a fairly high level, I'm understanding the books, I'm trying to move my way through, but I wasn't quick at it.

I remember sort of taking my time, being contemplative, reading, thinking. And I remember being judged for being a slow reader. And so I remember thinking back going, "No, I do understand," but sort of the judgment was, "No, you don't. You're not keeping up. You're not able to do this to sort of the tempos that we're setting."

And for me, that was a big thing and even at this point now, sort of how I handle leading people or even just parenting my kids, I think about that a lot — like what are the tempos that are being laid out for them and are they fair? Do they support them doing their best work?

Laura: Yeah, I really feel that. If you didn't do it fast, then you didn't do it at all kind of mentality, or it wasn't good enough.

Jim: I think it sticks with you and I think that's sort of where that perfectionist attitude comes from. I have to be good enough to be in the room.

Laura: Did you find yourself throughout your life with being hypervigilant and almost starting to do things too obsessively to avoid messing up?

Jim: 100%. I actually kind of laughed because even just today, I was telling my wife, "Doing this podcast, I'm thinking, 'Okay, I can't screw this up. I have to make sure I enunciate properly, I do this.'" And then my wife looked at me and goes, "You're hyperfocusing on the ADHD podcast."

I just thought that was kind of irreverent, but I'm like, "Okay, yeah, that's a really good point." But I think yeah, 100%, playing conversations through your head — could I have had that conversation a little bit more effectively? Did I use the right words? Especially when you're leading people, you don't ever want to use the wrong words to take a moment that could have been a learning opportunity or a real positive moment for them and turn it into something else. So that's definitely something that I've lived with.

Laura: Tell folks what it is that you do.

Jim: I'm a Vice President for a medical company. We do human medical devices — anesthetic and difficult airway ventilation devices. But we also focus on the animal world, so I help a lot of animal rescues and aquariums and different things improve their skill set at ventilating their animals. Because surprisingly, humans and animals are actually quite similar in that regard, so it's opened up sort of a whole new world for me. And then I have a team that works underneath me that does the same.

Laura: And I imagine that part of your ability to climb and to be now in this leadership position was because you were so successful in doing the actual work, in executing work like this. I introduced you as a former critical care respiratory therapist. I was trying to make a point about how you are in emergency situations a lot, or you have been. So let's talk about that. Tell me how were you in an emergency?

Jim: That was one of the most formative things I've ever done because I mean, it was my first career, so I went to school for it. But what I really noticed was, and it was something that stuck with me and I didn't have a name for it and I carried it with me for years and then finally was able to figure it out, but I would be in some of the worst situations.

So I would be in a room where unfortunately somebody was dying in front of me or not doing well, and then being put in a position where I have to act. One specifically, I was in an ICU in the middle of the night and I was literally the only person in the hospital that could intubate this patient, just because we were short-staffed. So I had to be able to do it.

And you'd think with that stress and everything that's going on and the emotions behind it, that that would have been challenging, but if you'd have taken my blood pressure at that point or my heart rate, it would have been the lowest it had been all day. Like I was the calmest in those situations, and I really couldn't figure out why, to the point where a friend of mine who was a nurse, who commented at the end of one of these situations, "Jim, why are you smiling?"

And I didn't realize in the middle of this stressful situation with this patient I had a big smile on my face. And I think it was just sort of a place where I was at my calmest. I was able to react, be in the moment, not have to sort of executive function my way through it. I could just do it. And what I found was those are the situations where I almost felt like a bit of a — I hate to use the term — but almost like a bit of a superpower in that place, just because it was so stressful for so many people and it just wasn't for me.

Laura: Do you feel like you were hyperfocusing?

(13:01) The tendency of people with ADHD to create high-pressure environments to find focus.

Jim: I guess hyperfocus in a reactionary state. Like it was coming at me and I was able to deal with it. And I think the great thing about that was I didn't have to plan for anything. I had my skill set, I knew what I needed to do, and I just had to do it. And I didn't have a lot of time to think.

And I think that was sort of a big part of it, where contrasting that, doing my day-to-day normal planning to see patients — like I have to see this many patients in the day — the stress that went with planning and "Can I get to them all? What if I don't get to them all? Well, what if something happens and I can't see them? Will they not get the treatment they need if I can't?" Like so it was sort of the logistics would just get kind of I would get hung up on them.

Laura: It's just so interesting that contrast. Like one of the things that you just said is "I didn't have time to think." ADHD is part of that puzzle, right? And it is fascinating to me the way our brains just trip us up with ADHD and to be able to somehow step out of that brain and to just go and just go and do something that has to be done in that moment. There's no decision-making, right? You don't have to make a decision, "Should I do this now or later?" No, you have to do it now.

Jim: And I think it's actually funny because thinking even to what I'm doing now, it's carried through because anytime there's an emergency or a situation where somebody's having a hard time dealing with it and they come to me and say, "Jim, I don't know what to do here, this is very stressful," it's almost like I snap into that type of Jim and I can work through it with them in a very calm way, which has been helpful in this career as well. And again, in contrast to sort of having 8,000 emails and trying to find my way through them, so it's a bit of a give and take.

Laura: There's something, even when the circumstances are dire or even scary, again take that decision-making away from us, there is a relief in that. I am someone who has difficulty prioritizing what to do during like the everyday average day. What do I do first? Sometimes I wish — even like sometimes scary thoughts — I'm like, "I wish something would just happen that made me not have to make that choice," so I was just forced to have to do one thing or the other thing.

Jim: And what I found is I almost — and I think it's a trait that I've heard even on your show people describe — it's almost like you create your own sort of anxious moment in order to react to it. So if it's something that I feel like I'm going to have a challenge with getting this project done or completing this, I'll create the emergency for myself — if it's doing it last minute which is kind of normal — but even just within it, "Where can I find an emergency? Where can I find a place to react and create some calm for myself?"

Laura: Totally. Give me an example other than just waiting till the last minute, which I think is what so many of us do, but do you have an example of another way you've created — we don't want people to create anxious situations, but I am fascinated by this.

Jim: I learned this early on, especially when I became a manager, is I would often put it out there. So if there was something that I thought was valuable to do — like a project that I wanted investment from — a lot of my co-managers would sort of be shy to sort of put it in front of executives for their input.

I always did and I sometimes maybe even too quickly to get buy-in, but what I liked is that I knew they were watching. And so now I had to deliver, I had no choice. So I almost made it more challenging for myself, but at the same time because of that, I was able to find a way and deliver, and then I kind of became known for doing that. But going back, it was that me trying to create some sort of anxious moment for myself so I deliver.

Laura: Creating a pressure cooker.

Jim: Just create that environment so that now I have to react in it. And that's likely maybe why I found my way into critical care, trying to find a place where I can operate under those circumstances.

Laura: When you wrote in, you shared something about writing your grandfather's eulogy, and I'm wondering if you would share that with our audience and what that led to.

Jim: That was interesting because it kind of was born out of my family weren't big on standing in front of crowds and giving eulogies or speeches or what have you. So it was one of those times where I thought I needed to do it because I wanted to make sure that my grandfather had his proper send-off.

So I wrote a eulogy for him. But what was amazing about that is it came very easily to me — just sort of the ability to kind of see who he was, what he meant to not just me but to other people, and to kind of put that into words in a way that kind of really got him. It just sort of flowed.

And so I did it, and family commented on how well I had done at the time — I was quite young — but also people surprised that I was able to do it because I was a quiet, shy kid. But in that moment, it gave me the ability sort of be the outgoing person that I wasn't able to be sort of 90% of the time.

Laura: Is it surprising in that you could do that public speaking and be in front of people, or the act of writing it, or all of the above?

Jim: Both. I think that was the first time I realized I could stand in front of people and deliver something emotional or just words in general because it was never my thing. And I think looking back, you're talking about, "Jim, give me an example of creating that anxious moment for yourself so you deliver," well, that's a pretty good example of one. Once I got up in front of people, and even now, I speak in front of 200, 300 people when I give an educational session. I'm not nervous, which is insane considering how introverted I've been in different parts of my life.

Laura: Before you wrote that eulogy and delivered it, why did you think that it wasn't something you were capable of doing? I mean, is it related at all to growing up with this fear of making mistakes in front of people or am I reading too much into the other stories you've shared with me?

Jim: No, I think it's exactly that. I think it's going back to Grade 2 and my poem situation. Flashbacks and everything else. But honestly, I think it's that where I avoided sort of coming outside of myself to kind of share things like that or to be artistic or to kind of be outside of what I think the expectation is.

Being able to express myself in something that was going on inside of me and realize I could do that fairly eloquently surprised me. And then I immediately — knowing my brain — "What does this mean? What do I need to do with this? How does this sort of work for me? Can I do it again?" And I actually took the opportunities after that to do it more and more and more and enjoyed it. Found confidence in it, I think.

Laura: It sounds like getting over some fears or working through some fears as well. You tell me if I'm taking too much of a leap here, Jim, but I just find that so many of us with ADHD — you know, some of us maybe went a different route, we were overly expressive, class clowns, kind of covering up mistakes — others, you know, some of us have gone into our shells because no matter how good we were at something, we would make so many little mistakes that would get us into trouble or make it so hard for us to be recognized for the knowledge and the intelligence that we have.

(20:21) Jim's leadership philosophy and how his ADHD background informs his management style.

Jim: No, I think it's exactly that. And I think when I was younger, I was always a great observer, kind of watching how people react to things and what makes them happy, what makes them upset. And even now as a leader, you know, sort of I think one of the things that's made me good at this is I can see people I think quite clearly. It's not a like X-ray vision, it's just that I care, so I'm kind of watching.

And I think in leadership in the past, I've seen a lot of leaders where I'm going to kind of create these assimilated cookie-cutter robots and they need to deliver on the thing we need them to deliver on, and if they're not doing it following these KPIs, then we need to sort of direct them into a better area.

My whole thing was trying to individually see people, kind of understand where they're strongest at, what their gifts are, and then kind of bring them to the needs of the company, but allowing them to be themselves while they're doing it. And that's been the biggest part of my leadership focus and it's really worked well. Like the culture's always been positive from that. People feel like they're doing something meaningful.

And I think that maybe is — and maybe you talk about reading into things — but it might be sort of my way of kind of righting the pageant, you know, seeing people for sort of what they are and allowing them to be themselves in their roles, and I've seen a real sort of shift in culture because of it.

Laura: You know, throughout so much of what you've been saying today, Jim, there's just this ongoing thread of thoughtfulness and this genuine care for other people, not only through your critical care work but just how you want to interact with people. And I find that really inspiring, so I'm grateful to you for that.

Jim: Thank you. I mean, it's important to me because I think I knew how I felt when I was younger and through my life. And for me, it's like how do I — can I be a part of that solution? Can I help people sort of see themselves in their roles, make them feel like they can do it being themselves as opposed to trying to effectively be something that they're not? If I can do that, then I feel like I've done something good for the world around me.

Laura: Is there anything else that you want to share before we sign off, Jim?

Jim: I just want to thank you for creating this platform because I think when I was younger, there wasn't a lot around me that resembled me, at least I didn't know a lot of other kids that were kind of challenged in the way I was challenged.

So to kind of see the people that you bring on your show week after week and be able to relate and say, "Hey, that's just like me, that's something that I've been challenged with," has been super helpful for me. So thank you for that.

Laura: Thank you for listening and thank you for writing in. You did great. I know that you before said that you were a little bit nervous about coming on — you were a little perfectionistic maybe — but you did great.

I know you've been spending a lot of time writing. I've been writing on Substack for my "Focus on the Verb" thing, and focus on the verb meaning focus on the action. Like what can I do to reduce the frustration of focusing on that point in time, but actually doing something meaningful and active, and I think that's really helped being able to kind of get my thoughts out on digital paper and seeing them. So yeah.

Laura: And people can access that, right? That's on Substack, "Focus on the Verb".

Jim: Yeah, it's "Focus on the Verb" on Substack. I write regularly there sort of my musings kind of like this, just to sort of try to make sense of my world and sort of how I'm interacting with it.

Laura: It was lovely to connect with you today, Jim. Thanks for coming on.

Jim: Yeah, thanks so much for your time. Appreciate it.

Laura: Thanks for listening today. As always, if you want to share your own aha moment, email us at ADHDaha@understood.org or send a message to our voicemail inbox. You'll find a link in the show notes along with resources and links to anything we mentioned in the episode.

This show is brought to you by Understood.org. Understood.org is a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. If you want to help us continue this work, donate at understood.org/give.

"ADHD Aha" is produced and edited by Jessamine Molli. Say hi, Jessamine.

Jessamine: Hi everyone.

Laura: And edited by Alyssa Shea. Video is produced by Calvin Knie. Our theme music was written by Justin D. Wright. Production support provided by Andrew Rector. Briana Berry is our production director. Neil Drumming is our editorial director.

From Understood.org, our executive producers are Scott Cocchiere and Jordan Davidson. And I'm your host, Laura Key. Thanks so much for listening.