In reading Dave Snowden's article on a sense of direction, I was reminded of my experience several years ago working as a Patient Care Tech at UAB. I had started volunteering there and then took a part time job to gain some clinical exposure and decide if I wanted to make a career change into nursing - turned out I did not.
Anyway, I worked in the Emergency dept. which was a level one trauma unit. A trauma call is a complex thing. Injuries are often hidden and severity can vary wildly even with patients that present with similar injuries and histories.
There are some basics of course. Airway, Breathing, Circulation - if you don't get those right it does not matter how well you set the bones or if you stitched up the cuts in a way the won't leave a scar.
There are some corollaries in the world of Agile. They could be Build, Test, Deploy - if you can't build, without breaking stuff, and deploy it for use - the color selection and button placement don't matter. Like, at all.
After a patient is breathing reasonably and holding their blood in, a team can worry about things like blood chemistry, organ and brain injuries, broken bones and abrasions.
Similarly, when a team can routinely and safely deliver software for production use, they can start worrying about what features to deliver, in what order and how to manage that work.
Scaling the management framework might be kinda like taking up a new hobby after a full recovery.
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