2. A disaster relief organization, brilliant in messy rescues and stymied by mundane day-to-day management
3. A pharmaceutical company made great by cultivating autonomy among scientists, needing more integration and still more autonomy to safely take more risks in drug development
4. A young biotech company trying to stay-the-course in exacting clinical trials while adapting in-the-moment to shifting business realities
5. Health providers expected to “know” and provide certainty while trying to open their own hearts and vulnerability to be better healers
6. Patient safety leaders striving to create a blameless, collectively mindful culture while removing certain providers from the organization
7. A health organization so innovative and successful in integrating disparate functions that it is unable to grow through differentiating itself in market segments
8. A planning group that confidently brings the best data and crisp answers while trying to let go of assumptions and a pre-determined outcomes
9. A public utility under intense pressure to be “transparent” while encouraging front line employees to take risks and “bend” the rules
10. A newly "merged" company (operating in two countries) wanting to maintain the unique strengths of each while integrating core operations
There was a moment with each of these groups in which the impossible paradoxical truth of their situation became perfectly apparent. It is my favorite moment in a consulting engagement. 
Responses in this moment include “Oh my god!,” incredulous surprise, and intellectual-if-not-emotional catharsis. Often all at once! WHOA! KAZAM! BOO!
In some situations, the sound of pin dropping can be heard. A few folks giggle at the mysterious cosmic joke they are experiencing. Others drop into denial… and then find some part of the paradox to be true.
When we get it “right,” the paradox lives well beyond the immediate consulting engagement. It cannot be fixed, it simply is… a situation that is seemingly self-contradictory or impossible, yet expressing truth. Reality is reframed in a way that restores both complexity and variability in how people might respond. Acceptance seems to unleash the creative adaptability of nearly everyone.
There is absolutely no inevitability as long as there is a willingness
to contemplate what is happening. Marshall McLuhan